What to Expect After Surgery for Primary Bone Cancer
Each operation is different. You should ask the surgeon and your treatment team (residents, nurse practitioners, or physician assistants) about what to expect right after surgery. In general, you may expect these things:
You’ll have a large bandage that may prevent you from moving one of your limbs or joints. This will stay in place for a few days to two weeks.
You may have plastic drainage tubes coming out of the dressing. The nurse empties these tubes. They’ll be removed after a few days, when the drainage subsides.
You’ll have pain and be on pain medication. Medication is usually given in a vein. You may be able to control it by pushing a button. This is called PCA (patient-controlled analgesia).
You’ll get fluids through a vein in your arm, called an intravenous (IV) drip, until you are able to eat and drink on your own. Usually, you will be able to eat the day after surgery.
You’ll get antibiotics the day of surgery and sometimes for a day or two after surgery to prevent infection.
You may have a urinary catheter for a few days. This is a tube through your urethra and into your bladder so you do not have to get out of bed to urinate or struggle to use a bedpan or urinal.
After surgery, you may need to have chemotherapy or radiation to reduce the chance that any cancer cells that remain will spread. Having another type of treatment after surgery is called adjuvant therapy. Your surgical incision must be healed before you can start any adjuvant treatment. Usually, additional treatment can start a few weeks after surgery.
The amount of time it takes to recover from an operation is different for each person, and it depends on the type of operation that was done. Most people stay in the hospital for about a week.
In order to go home, your wound needs to be healthy in appearance. Your wound should heal within about a week after your operation. But it may take months for your bone to fully heal. You also need to be able to get out of bed safely. To do that, you may need physical therapy. It's important to participate in a rehabilitation program after limb-sparing surgery to learn how to use the limb and ensure it remains functional.
If there are problems with the wound, or if you have a difficult time moving around, you may transfer to a rehab facility from the hospital for a short period of time before returning home.
If you had a limb salvage operation and needed an allograft or endoprosthesis, you may need more surgery in the distant future. This is usually necessary after 10 or 20 years, but can be within five years. Some people eventually need to have the limb amputated. Children may need more surgery to lengthen the limb as the other leg or arm grows, or to keep the limb the same length as the other limb.
Potential side effects from surgery
Here's an overview of side effects you may experience after surgery:
Pain. The pain will usually be at the incision site. If you have had part or all of a limb amputated, you may have feelings that seem to come from the amputated limb. This is normal and expected. It is known as phantom sensation. At first, it may be painful. Usually, the painful sensation fades over time. The sensation of the amputated part remains, though.
Infection. Infections are uncommon after surgery but can occur. Usually, they will occur within a week or two after surgery. Tell your surgeon if you have increasing pain at your surgical incision, a persistent fever, or drainage from your incision more than two weeks after surgery. Also, tell your surgeon if you have swelling and redness at the incision.
Problems with wound healing. Sometimes, radiation or chemotherapy, or both, can delay wound healing. The surgical incision may open. This may require special dressing changes, or plastic surgery with a muscle flap or skin graft to help close the wound.
Deep vein thrombosis or pulmonary embolism. A blood clot is a serious complication. If the blood clot is in a vein of your leg or arm, it is called a deep vein thrombosis. If the blood clot goes to your lungs it is called a pulmonary embolism. Deep vein thrombosis often causes swelling and pain in the limb. A pulmonary embolism causes shortness of breath. Your doctor may thin your blood with a blood-thinning drug called an anticoagulant. Tell your doctor right away if you have shortness of breath or swelling of a limb.
Constipation. You may have trouble having a bowel movement from using opioid painkillers, not moving much, or not eating much. If you have difficulty having a bowel movement, you should tell your doctor so you can be treated.
Broken grafts or rods. If you have had a reconstruction of your limb with an allograft (bone transplant) or endoprosthesis (metal bone and joint), it can break or become loose. Breakage is rare during the first year after surgery. It occurs more often after five to 10 years and can sometimes be linked to lack of healing.