Problems after bone cancer surgery
All operations for bone cancer are major operations. They take place in specialist bone cancer centres.
As with any operation, there is a risk of complications. A complication is anything that happens after surgery that makes your recovery more difficult. For example, chest infections and blood clots are possible complications after any surgery.
Before offering surgery to you, your doctors make sure the benefit of having the operation outweighs the possible risks.
Your doctors talk to you about the possible complications of the surgery and 
before you sign the consent form. Your doctors and nurses monitor you very closely after the operation to check for problems.
Some complications can be serious and life threatening. But they are becoming less common. This is because you have surgery at specialist centres where the surgeons do more of these operations.
Some of the possible problems after having surgery for bone cancer include:
Infection and fluid collection
Major surgery can cause extra fluid to collect near the wound. Your surgeon might put a drain in during the operation. This helps to prevent fluid collecting inside your body. If fluid collects, it may become infected. You have antibiotics through a drip if you develop an infection.
Wound infection is also a risk. After your operation your nurse and surgeon will check for signs or infection. These include:
- red, sore, or hot skin around the wound or drain
- discharge such as pus coming from the site
- generally feeling unwell
- a high temperature (fever)
Let your nurse or doctor know if you have any of these symptoms.
Chest infection
A chest infection is a common complication of many operations. It happens because you are not moving around or breathing deeply enough after your surgery.
You can help to prevent this by doing your deep breathing exercises.
Your and nurses will get you up as soon as possible to help you get moving.
Below is a video lasting just over 2 minutes 30 showing breathing and circulation exercises after surgery.
Breathing and circulation exercises after surgery
These exercises help prevent you developing a chest infection or blood clots in your legs after surgery. These problems are more likely when you are not moving around as you would normally.
You can do these breathing exercises while sitting up in a chair or in a bed or whilst lying down.
Relax your shoulders and upper chest.
Take a slow, deep, comfortable breath in and hold for a couple of seconds, then slowly breathe out.
Repeat this 3 times.
You can start these breathing exercises as soon as you come round from your anaesthetic.
You should try to do them every hour when awake until you are fully mobile.
If you need to cough, support your wound with your arms, a pillow or a rolled up towel.
If you are struggling to clear any phlegm, try a hu. This is where you breathe out in a short, sharp manner as if you were trying to steam up a mirror.
You should move about as soon as possible after your operation. But while you are not as mobile, try to keep your legs moving to encourage better circulation.
You can do these exercises in a bed or in a chair.
One foot at a time point your toes away from you then pull your toes towards your chin.
Try to do 10 of these on both feet at least 2-3 times an hour.
The next exercise is circling your ankles. One at time circle your ankles, clockwise and then anticlockwise. Repeat this 10 times with each ankle 2-3 times an hour.
Phantom limb pain
If you have had an amputation, you may feel pain in an arm or leg which is no longer there. This is called phantom pain. It is very real, although not everyone has it. The pain can be tingling, burning, itching or cramping.
Doctors are starting to understand how and why phantom pain happens. Many different things can trigger phantom sensations. It can differ from person to person. Common triggers are swelling, muscle spasms, temperature changes, emotional changes or changes in the weather.
For most people, it settles down with time. But for some people they have long term problems. There are ways of helping to control it, including certain types of painkillers that control nerve pain. Some people might be prescribed painkillers before they have their amputation.
Let your doctor or nurse know if you are having any phantom pain.
Bleeding
There is a risk that you will bleed after your operation. The team looking after you will monitor you closely for signs of bleeding. The treatment you need depends on what is causing the bleeding and how much blood you lose. Some people might need a .
Blood clots
Blood clots (deep vein thrombosis, DVT) are a possible complication of surgery. This is because you might not move about as much as usual. Clots can block the normal flow of blood through the veins. Let your doctor or nurse know if you have an area in your leg that is swollen, hot, red or sore.
There is a risk that a blood clot can become loose and travel through the bloodstream to the lungs. This can cause a blockage in the lungs. This is known as a pulmonary embolism. Symptoms include:
- shortness of breath
- chest pain
- coughing up blood
- feeling dizzy or lightheaded
If you have any symptoms of a blood clot when you are at home, you should contact a doctor immediately. This might be your emergency GP service. Or call 999 or go to your nearest accident and emergency department (A&E).
To prevent clots it's important to do the leg exercises that your nurse or physiotherapist taught you. Your nurse might also give you an injection just under the skin to help lower the risk whilst you are in hospital. You might need to carry on having these injections for 4 weeks, even after you go home. This depends on the type of operation you had.
Your nurse might teach you to do these injections yourself before you go home. Or a district nurse might come to your home to do them.
It's important to continue wearing compression stockings if you have been told to by your doctor.
Falls
You are more at risk of having a fall after having an amputation. This is because your balance changes. You might also feel as though your limb is still there (phantom limb) so you automatically use it. Your physiotherapist and nurses with go through everything with you and how to safely get about. They will also cover how to deal with a fall.
You may get a . Until you are used to using this, it may also increase your risk of falling.
Coping and support after surgery for bone cancer
Having limb sparing surgery or an amputation is a lifechanging event. It will take time to adjust emotionally and physically. Talk to your healthcare team if you find it hard to cope. They can offer advice and support.
Your feelings
You might have a number of different feelings when you're told you have cancer.
You may feel a range of powerful emotions at first such as feeling shocked, upset and find it difficult to take in anything else that is being said to you. Other emotions include feeling:
- numb
- frightened and uncertain
- confused
- angry and resentful
- guilty
- sad
You may have some or all of these feelings. Or you might feel totally different. You may feel them a few at a time or altogether, leaving you feeling exhausted.
Everyone reacts in their own way. Sometimes it's hard to take in the fact that you have cancer at all. You need to do what’s right for you to help you cope.
Your surgeon will try to save your limb where appropriate (limb sparing surgery). But there are some people who need an amputation. The loss of a limb can be very difficult to cope with. Some people have emotions of grief and bereavement. It is important to remember that coming to terms with your feelings about having an amputation may need as much attention as the practical changes.
There is no set way of handling your news, but experiencing different feelings is a natural part of coming to terms with having cancer. These feelings are likely to come and go, some may even come up when you are not expecting it.
Changes in how you look
How you look is an important part of how you feel about yourself. It can be very hard to accept sudden changes in your looks that you are not happy with.
It is not unusual for people to feel confused and upset for some time after their operation. You may feel worried about how your friends and family see you. You may feel that you are no longer as physically attractive. Going back to work, meeting new people and going for job interviews can all be more of a struggle if you are coping with changes in your appearance.
The important thing to remember is that the people closest to you will want to help and support you. Try and talk to them, they can help to support you when they know how you feel.
Changes to your appearance might affect how you feel about sex.
Support after having a amputation
It can seem to take a long time before you can move around normally again and this may make you feel very low. It can take many months before you can put a lot of weight comfortably on your false leg. Or use your arm properly. And it may take a while before your limb is completely comfortable. Most people get there within a year of their surgery.
There is help and support available if you need it. Your doctor could arrange counselling for you.
Talking to your friends and relatives about your cancer can help and support you. You might find it easier to talk to someone other than your own friends and family. We have cancer information nurses you can call on freephone 0808 800 4040, from 9am to 5pm, Monday to Friday.
Follow up appointments
You have follow up appointments to check your recovery and sort out any problems. They are also your opportunity to raise any concerns you have about your progress.
Tell your doctor or specialist nurse (CNS) if you’re worried or notice any new symptoms before your follow up appointment.
