Surgery side-effects and solutions

Surgery side-effects and solutions

What are the possible risks of surgery?

Possible risks and side-effects associated with surgical procedures include:

• Risk of metastasis (cancer spreading)
• Fluid or blood build up under the skin
• Mild or severe bleeding – may require a transfusion
• Infection at the incision site
• Numbness and tingling which may be permanent
• Lymphedema  swelling in arms or legs
• Damage to other organs
• Pain
• Urinary Incontinence
• Impotence
• Heart problems
• Breathing problems
• Pneumonia 
• Blood clots
• Serious allergy to drugs (rare)
• Nerve damage (rare)
• Atrial fibrillation after surgery increases risk of heart attacks, strokes
• Death (rare)

Sources: Mayo Clinic, Science Daily / University of Toronto, NHS, American Cancer Society

How to reduce surgery side-effects

Your medical team will prescribe pharmaceutical drugs to deal with some of the side-effects of surgery, but these come with their own risks. However, there are many other evidence-based solutions you can use to reduce side-effects, make your treatment work better and safer, and significantly improve your chances of survival. These solutions (most of them natural) are listed below – along with scientific studies showing their benefits.

What is the scientific evidence supporting all the solutions listed above?

1. PREHABILITATION

“Prehabilitation” is any interventions given between the time of diagnosis and the start of cancer treatment. According to a report in the American Journal of Physical Medicine & Rehabilitation, prehabilitation is aimed at reducing complications from treatments and improving physical and mental health outcomes.

Major surgery is like running a marathon—and both require training.

British Medical Journal

Examples of cancer prehabilitation areas of focus
Stress/distress/coping
Pain
Swallowing
Sleep
Fatigue
Cardiovascular function

Goals and benefits of cancer prehabilitation
Prevent or reduce treatment related impairments
Reduce unnecessary testing
Reduce time to recovery milestones
Reduce hospital lengths of stay
Reduce visits to Rehabilitation clinics
Reduce hospital re-admissions
Reduce risk of second primary cancer
Reduce risk of cancer recurrence
Decrease disability
Decrease death
Improve health-related quality-of-life.
This is not a full list

Examples of Multimodal Prehabilitation Interventions in Cancer Patients

This study includes the following:

Lung Cancer
Breathing exercises
Balance exercises
Total body strengthening and cardiovascular exercises
Psychosocial support with specific stress reduction strategies
Nutrition
Smoking cessation

Head and Neck Cancer
Swallowing exercises
Balance exercises
Cervical range of motion exercises
Total body strengthening and cardiovascular exercises
Psychosocial support with specific stress reduction strategies
Nutrition
Smoking cessation

Prostate Cancer
Pelvic floor exercises
Balance exercises
Total body strengthening and cardiovascular exercises
Psychosocial support with specific stress reduction strategies
Nutrition
Smoking cessation

Breast Cancer
Shoulder and cervical range of motion exercises
Upper body strengthening exercises
Balance exercises
Total body strengthening and cardiovascular exercises
Psychosocial support with specific stress reduction strategies
Nutrition
Smoking cessation  

The study also says:
One of the most intriguing questions yet to be fully considered in the prehabilitation research is whether these types of interventions can influence the options for oncology treatment. That is to say, can prehabilitation make surgery a viable option for a newly diagnosed lung cancer patient who is initially deemed to be too high of a risk for surgical resection?  The significant risks associated with this type of major surgical procedure (i.e., thoracotomy) combined with a population profile that typically reflects pre-existing health conditions that increase surgical morbidity and even mortality, often make surgical treatment a nonviable option.  However, this is a population in which prehabilitation interventions should be strongly considered, because the research to date suggests that preoperative interventions may significantly improve physical outcomes, decrease surgical risk factors, and reduce hospital lengths of stay.  Although this question of whether prehabilitation can sufficiently reduce the surgical risk in some patients such that they are qualified to safely undergo resection of their cancer needs further study, there is early evidence that it may. 

Major surgery is like running a marathon—and both require training

Source: BMJ
The impact of surgery leads to significant homeostatic disturbance. The surgical stress response is characterised by catabolism and increased oxygen demand. The extent and duration of the stress response is proportionate to the magnitude of surgery and the associated risk of developing postoperative complications.

Patients who experience postoperative complications within 30 days of surgery have a reduced long term survival rate. Even in the absence of complications there is a 20-40% reduction in postoperative physical function and a significant deterioration in quality of life after major surgery.

Writing in The Journal of Hematology Oncology Pharmacy, Julie Silva MD says:
One cancer survivor wrote a blog that included this question in the title: Are we doing too much in oncology backwards? In his blog post he said, “I was reviewing my blood work after my recent stem cell transplant and noticed that my hemoglobin and red blood cells had dropped 47% from my normal health to their lowest values two weeks after my transplant. I then checked what altitude a 50% drop in oxygen would correspond to. A 50% drop in oxygen represents an altitude of over 19,000 feet. Mt. Everest south base camp is 16,700 feet.” The survivor continued, “It would be irresponsible to send someone to Mt. Everest base camp without training them first, but it is common practice in oncology to physically challenge patients in a similar manner without training them for the difficulty to come. Instead, we nurse patients through the treatment challenge, cheer them when they are finished, then send them off to physical therapy to address injuries.” Then, in bold and italics for emphasis, he admonished, “This is not a success story, this is poor survivorship planning.”

Here are some scientifically validated actions: 

Quit smoking
A review of data from over 20,000 patients who underwent cancer surgery found that smoking status significantly negatively affected all postoperative outcomes.

Reduce Alcohol intake
This Review article found that reducing consumption to within recommended limits (14 units per week) reduces incidence of postoperative complications.

Engage in Rigorous Physical Exercise
One study involving 125 patients scheduled for major surgery. 62 patients who underwent a supervised rigurous exercise training program had 51% fewer postoperative complications as compared with the control group of 63 patients who did normal exercises.

Engage in Inspiratory muscle training
This study found that preoperative inspiratory muscle training (a form of resistance training for the respiratory muscles) demonstrated reductions in postoperative pulmonary complications in surgical populations.

Eat a healthy nutritious diet
Malnourished patients are at increased risk of post-operative complications, such as reduced wound healing, increased infection rates, and skin breakdown.

This study says pre-operative energy reserves, such as lean body mass, are required to support the body’s response to the stress of surgery. Surgical patients with low reserve, including malnourished, frail and sarcopaenic (muscle-depleted) patients, are vulnerable, with diminished capacity to respond to the added demands of a surgical insult.

Consume lots of fruit, vegetables, and water
This Livestrong.com articles reports: The Leukemia and Lymphoma Society says the best way to fill your bank prior to surgery is to eat 3-5 servings of fruits and vegetables every day, eat mostly whole grain (brown rice, quinoa) and include a protein at every meal. They also recommend you make water your go-to beverage and aim to drink 64 to 80 ounces each day.

Avoid fried foods, excess fat, and sugar
The Leukemia and Lymphoma Society adds: Avoid fried foods. Excess fat and sugar contain empty calories that do not provide the body with any nutrients. Too many empty calories and not enough nutritious food may have an effect on the immune system.

Engage in Mind-Body Practices Yoga.
This study looked at the effects of yoga on wound healing and other outcomes following surgery. Sixty-nine stage II and III breast cancer patients took part in a yoga program, while a control group of patients undertook supportive therapy and exercise. The results suggest a significant decrease in the duration of hospital stay, days of drain retention and days for suture removal in the yoga group as compared to the controls. There was also a significant decrease in plasma TNF alpha levels [high levels lead to inflammation and pain] following surgery in the yoga group, as compared to the controls.

Meditation.
This study says: In the present investigation, meditation reduced all subjects’ pain intensity and unpleasantness ratings with decreases ranging from 11 to 70% and from 20 to 93%, respectively.

Guided Imagery
has been shown to reduce blood loss during surgery, reduce opioid use after it, and many post-surgery patients leave the hospital sooner. Guided Imagery lowers anxiety and pain, according to Stanford Health Care.

This is from the American Psychological Association website: During guided imagery, patients think about what is happening to their bodies, and how their bodies should respond in order to be healthy. For example, in a classic study, psychologist Henry Bennett and colleagues gave three groups of spinal surgery patients three different sets of instructions before their operations. Patients in the control group learned only about some aspects of the surgery. Patients in the relaxation group also learned strategies for succumbing to and emerging from anesthesia. Patients in a third, “blood shunting” group not only learned these strategies, but were also taught the importance of not losing too much blood during the operation, and imagined that “the blood will move away” from the injury during surgery, but will return to the area after surgery. After all of the operations were completed, the researchers found that the patients who imagined the blood moving away from their injuries during surgery, but returning after surgery, lost only about half as much blood as patients who were not given these guided imagery instructions. [/su_spoiler]

See PREHABILITATION

2. POST-SURGERY PAIN MANAGEMENT

Acupuncture The technique of inserting thin needles through the skin at specific points on the body to control pain and other symptoms. It is a type of complementary and alternative medicine.
See Acupuncture page

Biofeedback is a technique you can use to learn to control your body’s functions, such as your heart rate. With biofeedback, you’re connected to electrical sensors that help you receive information (feedback) about your body (bio). This feedback helps you focus on making subtle changes in your body, such as relaxing certain muscles, to achieve the results you want, such as reducing pain. See Biofeedback page

Cannabis According to the National Cancer Institute, when cancer pain is severe and persistent, it is often resistant to treatment with opioids. Two studies examined the effects of oral delta-9-THC on cancer pain. The first, a double-blind, placebo-controlled study involving ten patients, measured both pain intensity and pain relief. It was reported that 15 mg and 20 mg doses of the cannabinoid delta-9-THC were associated with substantial analgesic effects, with antiemetic effects and appetite stimulation. See Cannabis  page 

Cesium Chloride Cesium chloride not only kills cancer cells, but it immediately stops the metastasis of the cancer, can shrink tumor masses within weeks, and almost always stops the pain of cancer within 12 to 36 hours. See Cesium Chloride page

Chiropractic Care Cancer and its treatments often cause stress on the musculoskeletal system. Some cancer patients experience peripheral neuropathy, aches and pains in the neck and/or back, muscle tension, headaches or difficulty walking. Chiropractic care may help to reduce stress and increase mobility, flexibility, strength and function. See Chiropractic Care page 

Hypnotherapy Hypnosis has been suggested to be a useful adjunct for pain reduction in cancer patients and can significantly reduce cancer-related pain, antiemetic use, nausea and emesis (vomiting) during medical procedures, as well as anxiety related to all of the mentioned symptoms occurring in cancer patients. See Hypnotherapy page 

Low dose Naltrexone
Evidence suggests that naltrexone, when used in low dose (1.75-4.5mg), shows inhibitory properties at the opioid receptors enabling the body to increase the production of endogenous opioids (endorphins) along with upregulating the immune system, according to this Study.
See Low dose Naltrexone page 

Massage Massage treatment is the manipulation of muscles and soft tissue through kneading, rubbing, pressing, etc. Studies have shown that a massage will decrease stress, anxiety, depression, pain, and fatigue. Therefore, it is very beneficial in any cancer protocol. The connection among physical well-being, touch, and relaxation is very strong and can enhance the body’s own abilities to heal.
See Massage page 

Methadone
This 2017 study says: Methadone has beneficial characteristics as an analgesic against cancer pain, including high bioavailability, multiple receptor affinities, and lack of active metabolites that might induce adverse side effects.

Progressive Muscle Relaxation Progressive Muscle Relaxation (PMR) therapy involves sequential tensing and relaxation of major skeletal muscle groups and aims to reduce feelings of tension, to lower perceived stress, and to induce relaxation. Reports of patients who participated in PMR training following cancer treatment indicate that they experienced reduced state anxiety, pain, and symptoms of depression, as well as improvements in sleep parameters and overall quality of life.
See Progressive Muscle Relaxation page 

Pulsed Electromagnetic Field (PEMF) therapy
Pulsed Electromagnetic Field (PEMF) therapy is a safe, and non-invasive way to reduce pain and inflammation. It can be used to supplement and enhance currently existing healthcare modalities. The PEMF apparatus includes various devices including full body mats, localized pad applicators, and pinpointed probe or “spot” applicators.
See Pulsed Electromagnetic Field (PEMF) therapy page

Reiki Reiki is a natural non-invasive therapy that promotes healing through stress reduction, relaxation and balancing of your energy systems. Reiki helps the muscles and tissues relax resulting in an increase in the blood flow to the treated area. This helps to reduce stress and pain and quickens the healing process.
See Reiki page 

Reflexology Reflexology is a therapy involving the physical application of pressure to the feet with the premise that massaging certain zones positively affects other areas of the body. A small study funded by the National Cancer Institute found that the ancient therapy may be an effective way to deal with cancer-related pain.
See Reflexology page 

Herbs Turmeric White Willow Bark California Poppy Corydalis Red Pepper Noni Root Kava / Kava Lactone [/su_spoiler]

3. WOUND HEALING

Aloe Vera
This study says: In terms of quality and speed of wound healing, Aloe vera is much more effective and less costly compared to the currently available alternative treatments.

Calendula officinalis  (an annual herb)
This study says the antibacterial activity of C.officinalis prevents secondary infections of wounds…Therefore, the C. officinalis extracts act in a positive form on the inflammatory and proliferative phases of the healing process of cutaneous wounds.

4. BRUISING / SWELLING / INFLAMMATION

Bromelain (pineapple stem)
According to this review article, Bromelain supplementation before and after surgery has been shown to reduce swelling, bruising, healing time, and pain…Presurgical administration of bromelain can accelerate visible signs of healing.

Quercetin (plant flavanoid derived from fruits)
This study says Quercetin has important biological activities related to the improvement of the wound healing process. 

Arnica montana (an herb)
This study says: Cumulative evidence suggests that both Arnica in gel formulation and in homeopathic dilutions are more effective than placebo in treating several inflammatory conditions, in pain management and postoperative settings. Its clinical efficacy in these fields and its high tolerability make it a potential therapeutic alternative target to non-steroidal anti-inflammatory drugs…

Curcumin
This study says: In several systems, curcumin has been described as a potent antioxidant and anti-inflammatory agent. Evidence has also been presented to suggest that curcumin can suppress tumor initiation, promotion and metastasis. Pharmacologically, curcumin has been found to be safe.…it is quite apparent that curcumin has tremendous potential for prevention and therapy of various cancers.

5. INFECTION PREVENTION

Honey (natural product)
Infection still poses a serious threat to postoperative surgical wound care and are a leading cause for postoperative illness and death, says this study. This study says: Manuka honey has been widely researched and its antibacterial potential is renowned worldwide. The potency of honeys, such as Tualang honey, against microorganisms suggests its potential to be used as an alternative therapeutic agent in certain medical conditions, particularly wound infection. This study says: The antimicrobial and anti-inflammatory activity of honey and its ability to accelerate wound healing make it an attractive option in surgical wound care…The healing process of the surgical wound and its final aesthetic result could be improved by using honey dressing.

Berberex (a patented formulation)
This study says BerbereX® appears to be a potent agent that positively affects cosmetic healing while protecting the wound from bacterial-affected wound infection…As such, it may serve as a candidate for routine post-operative incision site care.

According to the manufacturers website: BerbereX® Wound Cleanser will help to decolonize infected wounds. In antimicrobial tests, BerbereX® Wound Cleanser showed efficacy against standard and highly virulent strains of antibiotic-resistant bacteria such as Methicillin Resistant Staphylococcus Aureus (MRSA), Vancomycin Resistant Enterococcus (VRE), Group B Streptococcus (B-Strep) and E. Coli. BerbereX® is simple to use, requires no significant changes in current wound care protocols, and has no known side effects.

6. HEAL YOUR GUT

Your body has trillions of bacteria, viruses and fungi known collectively as the microbiome. While some bacteria are harmful, others are extremely important for your health. The human gut flora (microbiome) contains a total of about 100,000,000,000,000 organisms.

This review of 9 clinical trials found: Eight of nine trials showed a benefit with regards to infectious complications in patients who were treated with synbiotics or probiotics. Eight of nine also found beneficial effect on the gut flora. The review says there might be a relationship between the gut flora and the development of postoperative complications.

There are many ways to improve your gut microbiome, including:  Eat a diverse range of foods

The more diverse the diet, the more diverse the microbiome and the more adaptable it will be to disruptions, says this study.

Eat lots of Fiber.
Dietary fibers can be considered key ancestral compounds that preserve gut ecology and host physiology, says this study. 

According to the British Nutrition Foundation, fibre rich foods include:

• Wholegrain breakfast cereals, wholewheat pasta, wholegrain bread and oats, barley and rye
• Fruit such as berries, pears,  melon and oranges
• Vegetables such as broccoli, carrots and sweetcorn
• Peas, beans and pulses
• Nuts and seeds
• Potatoes with skin

Include Probiotics Probiotics are live bacteria or yeasts found in fermented foods that, when consumed, take up residence in the gut and improve health. 

Fermented foods include Yogurt (study), Sauerkraut (study), Kefir (study), Kombucha (study), Tempeh, Miso, Pickles, Natto and some types of cheese.

Eat prebiotic foods: 
Prebiotics are a type of fiber that stimulates the growth of healthy bacteria. Food sources include Oats (study), Apples (study), garlic, onions, leeks, asparagus, bananas, flaxseeds and wheat bran. This study says: Prebiotics play an important role in human health. They naturally exist in different dietary food products, including asparagus, sugar beet, garlic, chicory, onion, Jerusalem artichoke, wheat, honey, banana, barley, tomato, rye, soybean, human’s and cow’s milk, peas, beans, etc., and recently, seaweeds and microalgae. 

REDUCE RISK OF RECURRENCE

This study says: Given that evidence is continuously accumulating to support the hypothesis that surgery is a facilitator of the metastatic process, it is critical to consider the alarming clinical notion that surgery is a double-edged sword—it is necessary and life-saving; yet, has deleterious long-term impacts, potentially increasing the risk of metastases. We believe that surgery is indeed a major risk factor for the spread, establishment, and growth of malignancy…We believe that the integration of etodolac and propranolol into the preoperative setting of oncological surgery will improve postoperative well-being and decrease long-term recurrence rates in patients with breast, colon, and other types of cancer.

[ Etodolac is a nonsteroidal anti-inflammatory drug (NSAID)
Propranolol is a type of medicine called a beta blocker.]

Surgery and Biopsies can spread cancer
See Surgery page for more details

Cancer Side Effects

Updated 2024

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