Before your operation, your doctor and the nurses on the ward will discuss your treatment with you in detail to make sure that you fully understand what it involves. It is often helpful to talk to someone who has had the same operation, and the medical staff should be able to arrange this for you. On some wards a clinical nurse specialist may be available to discuss any worries that you or your carers may have.

If you have had chemotherapy, your body will need some time to recover before the surgery can be done. Usually it takes at least a couple of weeks after chemotherapy before you are ready to have your operation.

Your doctor and anaesthetist will come to see you to make sure you understand what is going to happen. They will answer any questions you may have. You will have to sign a form agreeing to the surgery. This is the time to make sure you ask all the questions you need to. Many people find that the more they know about what is going to happen, the less frightening it seems. Don’t worry if you think of more questions later; just speak to your nurses again. If they can’t answer your questions, they can contact the doctor to come and talk to you again.

If you have body hair on the surgery area, you will need to be shaved before your operation. This is done to reduce the risk of infection. You may be shaved in the operating theatre after you have had your anaesthetic.

At first your limb will be firmly bandaged. This is to give the area time to heal. You will probably have a drainage tube in the wound to remove any fluid that collects in the area of the operation. It will be removed once it has stopped draining, usually after a few days.

Swelling around the wound

Sometimes fluid can build-up around the wound, especially following surgery to a buttock or limb. The swelling should gradually reduce over a few weeks. Sometimes a lot of fluid builds up around the wound; this is known as a seroma. It may need to be drained by a doctor or nurse.

Nutrition

You may have a drip (infusion) of fluids going into a vein in your arm. This will give you fluids and nutrients for 2–3 days until you are able to eat and drink properly. The nurses on the ward will then take the drip out.

Pain

You will have some pain and discomfort after your operation. Painkillers will be prescribed for you and these are usually very effective in keeping pain under control. To start with you will probably need a strong painkiller such as morphine. This will be given to you either as injections (given by the nurses), or through a small pump attached to a needle in your arm (which you control yourself). It is important to let the nurses know if your painkillers don’t seem to be working.

If you have had surgery on your leg, a different method of pain relief (called an epidural) may be used. A fine tube is inserted through your back into the fluid between the membranes around your spinal cord; a local anaesthetic can then be continuously given into the fluid to numb the nerves that run to your legs.

Exercises

Your nurses or the physiotherapist will teach you breathing and leg exercises. You can help yourself to get better by doing the exercises as often as you are told you need to. Breathing exercises will help to stop you getting a chest infection. Leg exercises will help to stop clots forming in your legs. Chest infections or blood clots can happen if you are not moving around as much as you would normally be. Your nurses will encourage you to get up and about as soon as possible. However, limb-sparing surgery or amputation is major surgery, and you may have to stay in bed for some time afterwards; this may be from a couple of days up to a week.

Your physiotherapist will show you some exercises to keep the muscles in the limb strong and supple. This is so that as soon as it is strong enough you can use it normally. The physiotherapist will also help you to move the limb once you are able to be up and about again. Sometimes you will need a brace or support for your limb. If the operation was on your leg, you may be given crutches to use at first. This is to protect your leg while you are learning to walk again. You will probably be left with a slight limp.

Sometimes trying to walk normally with a limp puts pressure on the leg and causes pain elsewhere in the body. Although it is important to have any continuing pain checked by your doctor, it does not necessarily mean that the cancer has come back.

Going home

Most people are able to go home once their wound is well healed, usually from 7–10 days after their operation.

After limb-sparing surgery, radiotherapy treatment is usually given to the area of the operation, to destroy any cancer cells that may still be in the area. This is done because it is very difficult to be completely certain that all the cancer cells have been removed during the operation.

If a child has limb-sparing surgery while they are still growing it may be possible for them to have an internal prosthesis (false part of the limb) fitted that can be lengthened at a later date. The lengthening is done during a fairly minor operation, which may mean a short stay in hospital.