What Happens After Colon Cancer Surgery?

Immediately After Colon Cancer Surgery

Immediately after surgery, patients are moved to a post-anesthesia care unit (PACU), also called a recovery room. Here, nurses continually monitor their vital signs until the patient wakes up.

Once awake, patients move to a hospital room where they will stay for a few days. Intravenous (IV) lines are used to administer nutrients, fluids, and medications to manage pain and nausea. Patients may also have access to patient-controlled analgesia (PCA), allowing them to self-administer pain medications as needed. Nurses continue to monitor their vital signs and the surgical site for signs of complications. Patients are released as soon as they meet the following criteria for home recovery:

• Their pain is controlled
• They can tolerate oral foods and fluids
• They can walk around
• There are no immediate complications

How long this takes depends on the patient’s rate of recovery. In general, however, patients can expect to stay at the hospital for three to seven days. Some may stay longer if complications develop.

Beginning Life After Colon Surgery

Once the patient is free to go home, they will receive detailed instructions on recovery. Instructions cover topics such as monitoring for complications, diet progression, and medication management. It is important that patients follow these instructions as provided. If the patient does not understand any part, they should not hesitate to ask questions or express their concerns.

Life after colon cancer treatment is a period of recovery and adjustment. Patients gradually heal while adapting to sometimes significant changes in their dietary needs, activity levels, and emotional state. Taking advantage of available resources is encouraged for an easier transition. Patients can speak with their friends and family members, make connections with other colon cancer survivors, research, or attend therapy sessions to help them navigate the challenges involved with colon cancer recovery.

Monitoring for Complications

Colon cancer surgery is a proven procedure that is considered very safe. Like any other surgery, however, it comes with a small chance of complications. After going home, patients should monitor their health diligently for signs of a problem, such as:

• Infection: Watch for fever or chills, redness, warmth, swelling, increased pain, or a pus-like discharge from the surgical incision.
• Bleeding: Keep an eye out for excessive bleeding from the incision, blood in stool, or other signs of blood loss, such as dizziness, lightheadedness, or persistent and severe abdominal pain.
• Anastomotic leak: Watch for signs of an anastomotic leak. Anastomosis is surgery that connects two body channels together, such as blood vessels or parts of your intestines. Signs of an anastomotic leak include severe abdominal pain, abdominal distension, fever, chills, an elevated heart rate, low blood pressure, or confusion.
• Bowel obstruction: Look for bowel obstruction signs, including nausea, vomiting, severe abdominal cramping, abdominal distension, or an inability to pass gas or stool.
• Blood clots: Watch for blood clot symptoms, such as pain, swelling, redness, and warmth in one leg. Also look for shortness of breath, chest pain, an elevated heart rate, or coughing.
• Hernia: Look for a bulge or lump near the incision and pain or discomfort, especially pain that gets worse when coughing or lifting.

Patients should immediately contact their surgeon or oncologist if they notice any of the above signs. Surgical complications are serious, sometimes even life-threatening, and require immediate medical intervention.

Returning to a Normal Diet

The return to a normal diet is gradual. Patients progress through multiple stages to let their bowels recover and return to full strength. A registered dietitian will guide them through the following steps:

• NPO: While at the hospital, patients are kept on an NPO (nothing by mouth) diet. This allows the bowels to rest during the earliest stages of recovery.
• Clear liquid diet: Only transparent fluids without fat, pulp, or solids are allowed. Options include water, broth, some fruit juices, and plain gelatin.
• Full liquid diet: Only liquid foods are allowed. Options include milk, yogurt, strained or pureed soups, smoothies, ice cream, and flavored gelatin.
• Soft foods: Only soft, easily digested foods are allowed. Fatty or spicy foods should be avoided. Options include soups, yogurt, applesauce, and mashed potatoes.
• Normal diet: Eventually, patients may return to their normal pre-surgery diet. There may be some dietary restrictions depending on what procedure was performed.

At every stage of progression, patients should continue to drink plenty of liquids and stay hydrated. They should also eat smaller, but more frequent meals to avoid overwhelming their bowels with too much waste at once.

Physical Activity Restrictions

Like diet, physical activity should also be increased gradually. People need plenty of rest to heal. However, they should walk about as soon as possible. This is because small amounts of exercise are good to encourage blood flow, which helps the body mend itself faster. Once patients are mobile, a physical therapist will guide them through a gradual return to normal activity levels.

Returning to work depends on the demands of the job. Heavy lifting, for example, should be avoided for several weeks to months to avoid stressing the abdominal muscles. Driving should also be avoided until the patient is no longer on strong pain medications. Patients should speak to their doctors about when they can expect to start working again and make the necessary arrangements in advance.

Stoma Care

An ostomy is an opening in the belly where part of the colon or small intestine has been pulled through. It allows waste to leave the body for collection in an external bag. Not all colon cancer surgeries require creating an ostomy. If the patient does need an ostomy, however, then proper care is essential. An ostomy nurse provides education on ostomy care, including:

• How frequently to change the bag
• Where to purchase ostomy supplies
• How to manage stoma output
• What foods create strong odors
• How to care for the skin around the ostomy

Patients with an ostomy may struggle with their body image. Support groups, connections with other individuals with ostomies, and counseling can help them adjust and stay positive about the changes in their bodies.

Scheduling Follow-Ups After Colon Cancer Surgery

At every stage of recovery, follow-up appointments are crucial. These are opportunities for patients to ask questions or discuss concerns about their condition. They also help physicians gauge their recovery, adjust their instructions as needed, and look for signs of new cancer metastases. Follow-ups may feature further testing to monitor the patient’s progress. Test types include:

• Imaging tests, such as computed tomography (CT) colonography
• Blood tests
• Colonoscopy

Patients typically have an appointment every three to six months for the first few years. Afterward, appointments will decrease to once or twice a year.

Find Comprehensive Colon Cancer Care and Support Near You in NJ, CT, MA, and the Washington, D.C., Area

Colon cancer surgery and recovery can be challenging, but the right resources can help patients navigate this difficult time successfully. Regional Cancer Care Associates provides colon cancer treatment and invaluable guidance, helping patients feel more confident about their care. RCCA specialists provide care to more than 30,000 new patients and 265,000 established patients each year. RCCA physicians offer patients innovative therapies, including immunotherapies and targeted therapy, cutting-edge diagnostics as well as access to approximately 300 clinical trials in community-based centers close to home.