Before your operation for mouth and oropharyngeal cancer
Before surgery, you have tests to check your fitness and you meet members of your treatment team. You usually go into hospital on the morning of your operation.
The length of your hospital stay depends on what operation you have.
Tests to check you are fit for surgery
You have tests before your operation to check:
- your fitness for an anaesthetic, if you need one
- that you’ll make a good recovery from surgery
You might have some or all of the following tests:
- blood tests to check your general health and how well your kidneys are working
- a swab test to rule out some infections
- an
ECG 
to check that your heart is healthy - breathing tests (called lung function tests)
- an
echocardiogram - a chest x-ray to check that your lungs are healthy
- a cardio pulmonary exercise test (which checks your heart and lung function when you're resting and exercising)
Pre assessment clinic
Your pre assessment appointment prepares you for your operation. You usually have it 1 to 2 weeks before your surgery.
You meet members of your treatment team at this appointment and you can sign the consent form to agree to the operation.
Ask lots of questions. It helps to write down all your questions beforehand to take with you. The more you know about what is going to happen, the less frightening it will seem.
You can ask more questions when you go into hospital so don’t worry if you forget to ask some. At the hospital you will meet:
A nurse or healthcare assistant
At the pre assessment clinic a nurse or health care assistant nurse checks your:
- general health
- weight
- blood pressure
- pulse
- temperature
They will ask you questions to check your fitness for the operation and explain what to expect when you come into hospital for your operation.
They also ask about any medicines you are taking. They will let you know if you need to stop taking certain medicines before your operation.
Tell them if you usually take medicines to thin your blood or have other medical conditions, such as diabetes.
They may give you a leaflet to teach you leg and breathing exercises to do after your operation to help with recovery.
Other people you may meet at your appointment
Your surgeon (oral surgeon)
A member of the surgical team will tell you about:
- the operation you are going to have
- the benefits of having surgery
- the possible risks
- what to expect afterwards
Your surgeon will also explain whether you are going to have a hole made into your neck (a tracheostomy) - and what this involves.
Your anaesthetist
The anaesthetist gives you the anaesthetic and looks after you during the operation. They make sure you’re fit enough for the surgery.
Your clinical nurse specialist
Your nurse specialist checks what help and support you have to see what you will need when you go home. They are usually your point of contact and care for you throughout your treatment.
In case you need to have a tracheostomy, the clinical nurse specialist will also tell you how you can look after it.
Your dietitian
The dietitian gives you help and advice about managing your diet. They:
- help you get as well as possible before your operation
- explain how the surgery affects your diet
- give useful tips on how to increase your nutrients and calories
- might give you nutritional supplement drinks to have before surgery
Some people need a feeding tube in their stomach or small bowel. This makes sure you get the nutrition you need before your surgery.
Your physiotherapist
The physiotherapist assesses how well you can move around. They let the doctors know if there is anything that could affect your recovery.
They also teach you leg and breathing exercises to do after your operation to help with recovery. Learning how to do the exercises beforehand makes it easier afterwards.
Your speech and language therapist
Sometimes having surgery to the mouth and oropharynx can cause problems with speech and swallowing. Your speech and language therapist plays an important role during your treatment. They will help you with your speech and any swallowing difficulties you might have.
Removing teeth and putting in dental implants
An oral surgeon may need to remove some or all of your teeth before surgery. They will talk this through with you before your operation and answer your questions you may have.
They will let you know about any restorative implant surgery might have and when you will have it.
Learning breathing and leg exercises
Breathing exercises help to stop you from getting a chest infection after surgery. If you smoke, it helps if you can stop at least a few weeks before your operation.
Leg exercises help to stop blood clots forming in your legs. You might also have medicines to stop the blood from clotting. You have them as small injections under the skin.
You start the injections after your operation. You might also wear compression stockings and pumps on your calves or feet to help the circulation.
Your nurse and physiotherapist will get you up out of bed quite quickly after your surgery. This is to help prevent chest infections and blood clots forming.
This 3-minute video shows you how to do the breathing and leg exercises.
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 huff. 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.
Going into hospital
You usually go into hospital on the day of your operation. Or you might go in the night before. Your doctor or nurse will tell you when to stop eating and drinking before your operation.
What to take with you
Take in:
- nightgowns or pyjamas
- underwear
- dressing gown
- slippers
- contact lenses, solution, glasses and a case
- wash bag with soap, a flannel or sponge, toothbrush and toothpaste etc
- sanitary wear or tampons
- towel
- small amount of money
- medicines you normally take
- magazines, books, playing cards
- headphones and music to listen to
- a tablet or smartphone for web browsing, entertainment and phone calls
- chargers for electronic devices
- a copy of your last clinic letter (if you have one)
Family and friends
Before you go into hospital, it might be worth checking:
- whether the ward is allowing visitors
- if they have set visiting times
- the best number for friends and family to phone, to find out how you are
The letter you receive before your operation may contain this information. But if not, you can phone the ward or hospital reception to find out.
You can use your mobile phone in hospital. But there may be some time before and after your operation when you won’t have your mobile nearby. And you may not feel like talking.
Before you go into hospital
It’s worth sorting out a few things before you go into hospital. These might include:
- taking time off work
- care for children or other loved ones
- care for your pets
- care for your house
- cancelling your milk or newspapers
Smoking
Smoking is a main risk factor for mouth and oropharyngeal cancer. And continuing smoking increases your risk of the cancer coming back. Smoking can also slow down wound healing and make complications more likely after surgery.
Your doctor will encourage you to stop smoking before the surgery. But it can be difficult if you have smoked for a long time.
