After nasopharyngeal cancer surgery
It takes a few weeks for you to recover after your operation. You will need to spend a few days in the hospital and you will need to give yourself time to recover once you are home.
When you wake up after your operation
After your operation, you wake up in the recovery room. Your recovery nurse looks after you until you are awake and well enough to go back to the ward.
If you have had a big operation, you might wake up in an 
or a , instead of the ward you were on before the surgery. You usually move back to the ward within a day or so.
In intensive care you have one to one nursing care. In the high dependency unit you have very close nursing care. Your surgeon and anaesthetist also keep a close eye on your progress.
These units are busy and often noisy places that some people find strange and disorienting. You'll feel drowsy because of the anaesthetic and painkillers.
Tubes, drains and drips
When you wake up, you might have several tubes in you, this depends on the type of operation you had. This can be frightening, so it helps to know what they’re for.
You might have:
- drips to give you fluids, painkillers and antibiotics until you are eating and drinking again, and a blood transfusion if you need one
- a tube into your bladder (catheter) to collect and measure your urine
- a thin tube into your stomach to give liquid foods
- one or more wound drains coming from your neck or near your wound
Wound drains
The wound drains stop blood and fluid collecting in the area of the operation. This helps your wound to heal and prevents infection. The wound drains connect to suction bottles, which help to draw out the fluid gently. Your nurses will check the amount of drainage regularly. They usually change the bottles attached to them daily, or more often if needed. When the fluid stops coming out, your nurse takes the drains out. This is usually a few days after the operation.
A clip on your finger (pulse oximeter)
When you first wake up, you have a little clip on your finger called a pulse oximeter. This is to measure your pulse and blood oxygen levels. Your nurse also measures your temperature and blood pressure often during the first few hours.
Oxygen mask
You might have an oxygen mask on for a while.
Helping you to breathe
After your surgery, you might wake up with a breathing tube (tracheostomy tube) in a hole in your neck. The hole is called a stoma.
This is usually temporary. You breathe through the tube for 3 or 4 days. Then your doctor or someone from your healthcare team removes it. The hole then closes up on its own.
Pain control
You usually have some pain and discomfort for the first week or so. But it is possible to control your pain. There are different painkillers you can have.
Tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.
You might have an electric pump called a PCA pump (patient controlled analgesia). It is a way of giving painkillers after surgery. It attaches to your drip. You have a hand control with a button to press to give yourself extra painkillers when you need them. Use it whenever you need to.
You can’t overdose because the machine is set to prevent giving too high a dose. But tell your nurse if you need to press the button very often. You might need a higher dose in the pump.
You get painkillers to take home. Follow the instructions your nurse gives you about how often and when to take them. Contact your specialist nurse or hospital advice line if you still have pain or if it gets worse.
Your wounds
Some surgery for nasopharyngeal cancer is done through the mouth, so the wound will have stitches but no dressing. You might have a dressing if your wound is on the neck or face. Your surgeon may have sprayed the wound with a protective clear spray.
Your surgeon and nurses will check your wound regularly to make sure it is healing well. If you have a skin graft or flap there is a risk that it may break down and not heal properly. They also check for signs of infection.
Stitches or clips
If you have stitches or clips they might stay in for up to 10 days. If your wound hasn't healed and you feel otherwise well, you might go home with your stitches. You can go back to the hospital to have them taken out. Your district nurse may be able to visit you at home to remove them or you can see a nurse at your GP practice.
Your surgeon uses stitches that dissolve for wounds inside your mouth or throat so they don’t need to be taken out.
Having a skin graft
For some types of surgery for nasopharyngeal cancer you might have a skin graft or flap. While the skin graft or flap is healing, it will be very delicate. Your healthcare team will be very careful to protect your wound from infection.
Your surgeon will tell you more about having a skin graft if you have one.
Eating and drinking
Eating and swallowing can be difficult until you recover, and any swelling goes down. You might be fed liquid food through a fine tube into your stomach.
After surgery to remove the tumour from your nasopharynx, you are most likely to have a gastrostomy (PEG or RIG) tube. This goes directly through the skin into your stomach.
Your nurse puts liquid food down the tube to keep you nourished. The hospital dietitian will visit you regularly. They work with your nurses and doctors to decide when to increase the amount of feed you are having through the tube. They build it up slowly until you have the same number of calories as you would have in your normal diet.
Starting to eat and drink
Once your wound has healed, you can gradually increase the amount you can drink. And then you start to eat a light, soft diet.
Swallowing
You might have some problems swallowing after surgery. Your speech and language therapist will check that you can swallow properly. You can then start drinking or eating. As you start eating more, you can cut down the liquid tube feeds. Your dietitian will guide you on this.
Once your diet improves, your feeding tube will come out. Your nurse and dietitian will continue to check your progress. They can answer any questions that you might have.
Maintaining your weight after surgery
It is important to maintain your weight after your surgery. Let your dietician or nurse know if you find that you are not eating well or off your food. They can help in lots of ways. For example, if you have lost weight and find it hard to put the weight back on, they can give you high calorie liquid supplements.
These drinks have vitamins, protein and carbohydrates. They provide you with what you need for a balanced diet. You can sip them during the day as well as having regular meals.
Getting up
Getting up might seem quite difficult at first. Moving about helps you to get better, and it helps to start gradually. Your nurses and physiotherapists help you to move around as soon as possible, usually from the day after your operation. Over the next few days after your surgery, your nurse takes out most of the tubes and drains. So it gets much easier to move around.
Your physiotherapist shows you how to do breathing and leg exercises and checks you regularly. They usually show you some gentle neck and shoulder exercises to do several times a day. You might need to carry on doing these for some time after surgery. Your healthcare team will explain how often and how long you need to continue your exercises.
Feeling tired and weak
Most people feel weak and lack strength for some time after their surgery. How long this lasts varies but you can feel tired for several weeks or months after your surgery.
It often helps to do a little each day. This can build up your strength. What you can do depends on how fit you were before your surgery and any problems you have afterwards. Talk to the physiotherapist or nurse if you’re unsure about what you should be doing, they can suggest things to help.
Changes to your appearance
Surgery for nasopharyngeal cancer can change the way you look. How you look is an important part of your self esteem. It can be very hard to accept sudden changes in your appearance.
If you have had facial surgery, it might be hard to look at yourself in the mirror at first. You might feel very angry, confused and upset for some time afterwards.
You might have a scar, depending on the type of surgery you had. Scars can be quite noticeable at first and might look red or raised, but they usually fade over time.
Before your operation you will see your specialist head and neck doctor and nurse. They will discuss all the possible changes to your appearance and how these might make you feel and offer support to you and your family.
How you might feel
You are likely to have times when you feel sad and very low in mood. Try to be patient with yourself while you fully recover from your operation.
You have had your cancer diagnosis to come to terms with and you have been through a big operation. You may need a lot of support from your doctors and nurses, family and friends.
Going home
Your doctor will let you know when you can go home, how soon depends on the type of surgery you’ve had. You’ll need some help when you first go home. Your dietician, specialist nurse and other members of your healthcare team can help you prepare for going home.
Follow up
After you have had surgery, you have regular appointments to check your recovery and sort out any problems. This is called follow up. Your appointments are a good opportunity to raise any concerns you have about your progress.
The first appointment is usually within two weeks. Your doctor checks for any issues following your operation. Your appointments gradually get further apart as you recover.
