Comprehensive postoperative monitoring and specialized wound care protocols designed for a safe and steady recovery after cancer surgery

Cancer involves abnormal cells growing uncontrollably, invading nearby tissues, and spreading to other parts of the body through metastasis. 

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Maintenance and Care

Surgical Oncology

Taking out the tumor is just the start of recovery. After surgery, care focuses on helping the body heal, watching for any signs that the cancer might come back, and managing any long-term changes caused by the surgery. This phase moves from immediate treatment to ongoing checkups and rehabilitation. The main goal is to help patients get back to their best possible health and catch any problems early if the cancer returns.

How the body recovers is very important. Major cancer surgery puts the body under stress, causing it to break down muscle and fat for energy. Enhanced Recovery After Surgery (ERAS) programs help reduce this stress. They include things like avoiding long fasting before surgery, using painkillers that don’t slow down the bowels, and getting patients moving soon after surgery. These steps help lower inflammation, keep muscle strength, and help the immune system recover faster.

Tissue Remodeling and Scarring

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Healing after surgery happens in stages. The wound first becomes inflamed, then new tissue grows, and finally, the area matures into a scar. Special cells called fibroblasts build collagen to close the wound. Sometimes, this process goes wrong and causes internal scars, called adhesions, which can lead to pain or blockages. Surgeons use special barriers and careful techniques to lower this risk. Knowing how the body’s support structures work helps doctors manage problems like fluid buildup or wounds coming apart, which can delay further treatments like chemotherapy.

Surveillance and Molecular Monitoring

Surveillance means actively checking for cancer coming back. The plan depends on the type of tumor. It includes physical exams, blood tests for tumor markers (like CEA for colon cancer or PSA for prostate cancer), and regular scans. Now, doctors are starting to use “molecular monitoring.” Blood tests called liquid biopsies can find tumor DNA months before a tumor would show up on a scan. Catching cancer this early gives a better chance to treat it while it is still small.

Metabolic and Functional Rehabilitation

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Taking out an organ changes how the body works. For example, removing the stomach means lifelong vitamin B12 shots and diet changes. Removing the pancreas means needing insulin and enzymes, and removing the thyroid means taking hormone pills. Ongoing care helps manage these changes. Rehabilitation is also important. Physical therapy can help with swelling, speech therapy helps after throat surgery, and pelvic therapy helps after prostate or rectal surgery. The goal is not just to survive, but to live well after cancer surgery.

Managing Post-Surgical Physiology

  • Lymphedema management involves compression garments and manual drainage to prevent fluid buildup in limbs after lymph node dissection.
  • Nutritional support utilizing specialized diets or tube feeding is critical for patients with altered gastrointestinal tracts to prevent cachexia.
  • Pain management transitions from acute opioids to multimodal non-narcotic strategies to prevent chronic post-surgical pain syndromes.
  • Ostomy care and education empower patients with colostomies or urostomies to manage their appliances and maintain skin health.
  • Endocrine replacement therapy is titrated to physiological levels for patients who have undergone thyroid, adrenal, or pancreatic resections.
  • Psychological support addresses the anxiety of recurrence and body image issues associated with scarring or loss of body parts.

The Immunological Window

The time around surgery is important for the immune system. Surgery and anesthesia can weaken the body’s defenses. New research is looking at using immune-boosting drugs or beta-blockers during this time to stop stress hormones from helping cancer spread. Ongoing care also includes healthy habits like exercise, good nutrition, and stress management, which make it harder for cancer to return. For example, exercise can lower the risk of cancer coming back by affecting insulin and inflammation.

Biological and Regenerative Rehabilitation

Regenerative medicine is important for long-term recovery. Fat grafting can help improve scars and rebuild areas after breast surgery. Scientists are also studying stem cell treatments to repair tissues damaged by radiation, like dry mouth from damaged salivary glands or bone problems. The main goal is to help the body heal itself while staying alert for any signs that cancer might come back.

Quality of Life and Survivorship

  • Survivorship care plans provide a comprehensive summary of treatment and a roadmap for future health monitoring and screenings.
  • Sexual health rehabilitation addresses the functional and psychological impacts of pelvic surgeries on intimacy and fertility.
  • Cognitive rehabilitation helps patients manage “chemo brain” or cognitive changes associated with anesthesia and systemic therapies.
  • Cardiovascular monitoring is essential as some cancer treatments can increase the long-term risk of heart disease.
  • Genetic counseling updates ensure patients and families benefit from discoveries in hereditary cancer syndromes.
  • Return-to-work programs assist survivors in navigating professional reintegration and disability accommodations.

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Tahsin Özatlı
Tahsin Özatlı Medical Oncology
Group 346 LIV Hospital

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FREQUENTLY ASKED QUESTIONS

What is an ERAS protocol?

ERAS stands for Enhanced Recovery After Surgery. It is a set of modern hospital care protocols designed to reduce the body’s stress response to surgery. It includes things like avoiding prolonged fasting before surgery, using non-opioid pain killers, and getting patients out of bed and eating as soon as possible. This leads to faster recovery and fewer complications.

Lymphedema is chronic swelling that happens when lymph nodes are removed or damaged by radiation. The lymph fluid cannot drain properly and builds up in the arm or leg. It is a common side effect of breast and melanoma surgery. It is managed with massage, compression garments, and exercise.

Tumor markers are substances, often proteins, that are produced by cancer cells or by the body in response to cancer. They can be found in the blood, urine, or tissue. Examples include CEA for colon cancer and CA-125 for ovarian cancer. Doctors track these levels after surgery to help detect if the cancer is coming back.

A liquid biopsy is a blood test that looks for DNA shed by cancer cells. It is much more sensitive than standard scans. It allows doctors to detect “molecular recurrence” signs that the cancer is back at a microscopic level long before a tumor would appear on a CT scan, potentially enabling earlier treatment.

Phantom pain is a sensation of pain coming from a body part that has been removed (like a breast or a limb). It happens because the nerves that were cut are still sending signals to the brain. The brain misinterprets these signals as coming from the missing part. It is real pain and can be treated with medication and nerve therapy.



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