Preparing for Surgery: What to Expect

Facing surgery for bowel cancer can feel overwhelming, especially if you’re navigating this as a younger adult when life plans and routines can suddenly come to a halt. Knowing what to expect before, during, and after your operation can help you feel more in control and less anxious. This guide covers practical advice for Australians with early-onset bowel cancer preparing for bowel surgery, so you can feel as ready as possible for the road ahead.

Understanding the Types of Bowel Cancer Surgery

The type of surgery recommended will depend on the location, size, and stage of your bowel cancer. Your surgeon and team will explain exactly what’s planned, but here’s a general overview:

Common Types of Bowel Cancer Surgery

• Polypectomy or Local Excision – Removal of small cancers or polyps via colonoscopy.
• Colectomy (or Hemicolectomy) – Removal of part (or all) of the bowel containing the tumour, often with lymph nodes.
• Low Anterior Resection (LAR) – Removal of part of the rectum with rejoining of the bowel (anastomosis).
• Abdominoperineal Resection (APR) – Removal of the rectum and anus, often requiring a permanent colostomy.
• Liver or Lung Surgery – If bowel cancer has spread (metastasised), surgery might target other organs.

Your team may also talk about minimally invasive techniques like laparoscopic (keyhole) surgery or robotic-assisted surgery.

Will I Need a Stoma?

Not everyone who has bowel surgery will need a stoma (an opening on the abdomen to divert waste). But sometimes a temporary or permanent stoma is essential to allow healing or remove the cancer safely.

Your surgeon or a stomal therapy nurse will guide you through:

• What type of stoma you may need (colostomy or ileostomy)
• Whether it will be temporary or permanent
• How to care for it
• Support available, including through Bowel Cancer Australia’s Stoma Nurse Service

Meeting Your Healthcare Team

Ahead of surgery, you’ll meet with several health professionals, including:

• Surgeon – to explain the procedure and answer questions
• Anaesthetist – to discuss your medical history and pain management plan
• Specialist Nurses – including stomal therapy nurses if relevant
• Dietitian – to support nutrition before and after surgery
• Physiotherapist – to help with breathing exercises or mobilisation

Make a list of questions to take with you. Some useful things to ask include:

• What exactly will be removed during surgery?
• Will I need a stoma?
• How long is recovery expected to take?
• What side effects or complications should I watch for?
• What will pain management involve?
• When can I eat and drink after surgery?
• How long will I be in hospital?

How to Prepare Your Body for Surgery

Getting in the best possible shape before surgery is sometimes called “prehabilitation”. It doesn’t mean you need to be super fit, it’s about doing what you can to support recovery.

Things that may help include:

• Optimising nutrition – Eating well to maintain your strength
• Gentle movement – Walking or light exercise if possible
• Breathing exercises – Especially if you have lung issues or smoke
• Stopping smoking – Seek help from Quitline or your GP
• Limiting alcohol – Discuss with your care team
• Managing stress – Mindfulness, meditation, or relaxation apps can help

Pre-Surgery Appointments and Tests

Before surgery, expect to have:

• Blood tests
• Imaging scans (CT, MRI, or PET)
• Heart and lung checks (especially if you have existing health conditions)
• COVID-19 screening (depending on hospital policy)
• Bowel preparation instructions (often a special drink to empty your bowel)
• Pre-admission paperwork and fasting instructions

Follow all instructions carefully, including when to stop eating or drinking before surgery.

Packing for Hospital

Hospitals can feel unfamiliar, but packing a few home comforts can make a difference.

Consider bringing:

• Comfortable clothes, including loose pants or pyjamas
• Slip-on shoes or slippers
• Toiletries
• Phone charger
• Lip balm and moisturiser
• Earplugs or headphones
• Books, puzzles, or entertainment
• A small pillow or cushion for support when moving or coughing

If you’re having a stoma, your stomal therapy nurse may provide extra supplies for practice.

The Day of Surgery

On the day of surgery:

• You’ll change into a hospital gown
• You may have compression stockings fitted to prevent clots
• An intravenous (IV) line will be inserted
• You’ll meet your anaesthetist again
• You’ll be taken to theatre

Anaesthesia will ensure you’re completely asleep and pain-free during surgery.

After Surgery: What to Expect

Waking up after surgery can feel strange. You may be in a recovery unit for close monitoring before moving to a ward.

Common things you may have include:

• A catheter (tube to drain urine)
• Drains (small tubes to remove fluid from the surgical area)
• A drip for fluids and medications
• Oxygen
• Dressings or bandages
• A stoma bag (if you’ve had stoma surgery)

Pain is expected, but it should be well managed. Speak up if you’re uncomfortable.

Pain Management

Hospitals use various strategies to manage post-surgery pain, including:

• Patient-controlled analgesia (PCA) pumps
• Epidural pain relief
• Oral medications like paracetamol or opioids
• Anti-nausea medications

Managing pain well helps you move sooner, which aids recovery.

Getting Moving Again

As soon as it’s safe, nurses or physiotherapists will encourage you to:

• Sit up in bed
• Dangle your legs over the edge
• Stand or walk (with help)

Movement supports:

• Blood circulation
• Lung function
• Bowel recovery
• Reducing risk of clots

Eating and Drinking After Surgery

Your return to food will depend on the type of surgery you’ve had and your recovery.

Initially, you may have:

• Ice chips or sips of water
• Clear fluids
• Light foods

Dietitians will guide you, especially if you have a stoma or altered digestion.

Going Home

Discharge from hospital usually happens once you can:

• Move around safely
• Eat and drink enough
• Pass stool or stoma output is stable
• Manage pain with oral medication
• Understand your wound or stoma care

Discharge timing varies, for major bowel surgery, expect 5–10 days, but this can differ.

At-Home Recovery

Recovery continues long after you leave hospital. Be patient with yourself and listen to your body.

Things that can help recovery include:

• Gentle walking daily
• High-protein, nourishing meals
• Hydration
• Rest and sleep
• Avoiding heavy lifting (usually 6–8 weeks)
• Caring for wounds or stoma
• Watching for complications like infection or bowel obstruction

Follow-Up Care

After surgery, your healthcare team will arrange:

• Pathology results from the removed tissue
• Stoma care follow-up (if applicable)
• A post-op check with your surgeon
• Ongoing monitoring and tests
• Possible referral to oncology for chemotherapy or further treatment

Emotional Recovery

Surgery isn’t just physically demanding, it can take a mental toll too. It’s completely normal to feel:

• Exhausted
• Frustrated
• Anxious about test results
• Sad about body changes

Reach out to:

• Bowel Cancer Australia’s Peer-to-Peer Support Network
• A psychologist or counsellor
• Online forums or support groups
• Your GP for a mental health care plan

Financial and Practical Help

Surgery can impact work, finances, and daily life. Consider exploring:

• Centrelink sickness allowance or disability support
• Early access to superannuation on compassionate grounds
• Private health insurance claims
• Travel subsidies for rural patients
• Help from Bowel Cancer Australia’s Patient Services

Tips for Loved Ones and Carers

If you’re supporting someone having surgery:

• Be patient, recovery takes time
• Offer practical help like meals, transport, or childcare
• Encourage rest but also gentle activity
• Look after your own wellbeing

Final Thoughts

Preparing for bowel cancer surgery in Australia is a big step, physically, emotionally, and mentally. Knowing what to expect can help you feel empowered rather than fearful. Every patient’s experience will be different, but remember there is help available every step of the way. I’ve been through surgery myself, and while it wasn’t easy, I got through it and you will too. Don’t hesitate to ask questions, seek support, and be kind to yourself as you navigate surgery and recovery.