Before your operation for oesophageal 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 or the day before.
The length of your hospital stay depends on what operation you have. You are usually in hospital for around 10 to 14 days after surgery to remove your oesophagus.
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
Before your surgery, you have an appointment at the hospital pre assessment clinic. This prepares you for your operation.
You might meet some members of your treatment team at this appointment. They will ask you questions about your general health. It is important to take a list of any medications you use.
Your doctor and nurses might tell you about the enhanced recovery programme. This is a way of caring before, during and after your surgery to help you recover faster after a big operation. It includes advising you about:
- being physically active
- eating well before your surgery
- stopping smoking and drinking less alcohol if this applies to you
Your healthcare team
A team of doctors and other healthcare professionals will be involved in your treatment. You will meet them before your surgery.
The 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 ask you to sign the consent form.
The clinical nurse specialist (CNS)
Your clinical nurse specialist (CNS) is a qualified nurse who has specialist knowledge of cancers of the oesophagus. They help to organise care between doctors and the other health professionals you need to see. They also support you through your treatment, and make sure you have the information you need to understand your cancer and treatment. Your CNS will support you through any treatment you have.
The 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
- give you advice about eating after your surgery
They 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.
The anaesthetist
The anaesthetist gives you the anaesthetic and they look after you during the operation. The anaesthetic is the medicine that keeps you asleep during your operation. They make sure you’re fit enough for the surgery.
Nurse or health care assistant
They will check your:
- general health
- weight
- blood pressure
- pulse
- temperature
They also check what help and support you have to see what you will need when you go home.
The 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 exercises to help you recover from your operation.
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 might go into hospital the evening before or the morning of your surgery.
Your nurse might give you a carbohydrate-rich drink to have the evening before the operation. You might also have it the following morning. The drink gives you energy and can speed up your recovery.
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
