Soft tissue sarcoma

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Side effects of surgery for soft tissue sarcoma

Side effects can happen with any type of treatment for soft tissue sarcoma, but everyone’s experience is different. Some people have many side effects, others have few or none at all.

Side effects can develop any time during, immediately after, or a few days or weeks after surgery. Sometimes side effects develop months or years after surgery. Most side effects go away on their own or can be treated, but some may last a long time or become permanent.

Side effects of surgery will depend mainly on:

  • the type of surgery
  • your overall health
  • the effect of other cancer treatments given before surgery (for example, radiation therapy given before surgery can affect healing after surgery)

Tell your healthcare team if you have these side effects or others you think might be from your surgery. The sooner they are aware of any problems, the sooner they can suggest ways to help you deal with them.

Pain

Pain often occurs because tissue is damaged during surgery. It may take time for pain to go away after surgery, depending on the procedure done and how well the person heals or tolerates pain. Pain-relieving medicines are used to control pain. Check with your healthcare team if pain does not go away or pain medicines do not relieve your pain.

Some people feel pain or sensations in a limb that has been amputated. This is called phantom limb pain or phantom limb phenomenon. It happens because nerves are damaged during surgery. Phantom limb pain may include burning, itching, cramping and throbbing. It can occur up to 4 weeks after surgery and usually goes away during the first year after surgery.

Different medicines may be used to manage phantom limb pain. You can also apply or use a stump shrinker, which puts pressure on the stump. If the symptoms of phantom limb pain continue longer than expected, you can talk to a chronic pain specialist to try to find ways to manage the pain.

Find out more about pain.

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Infection

Some people develop a wound infection after surgery. This is not a common side effect, but it can occur after any type of surgery. Sometimes the surgeon may place tubes in or open the wound to drain extra fluid. Antibiotics may be used to help prevent or treat an infection.

Tell your healthcare team if you have signs of infection, including redness, pus or foul-smelling drainage, increased swelling or tenderness at the incision site and increased temperature (fever).

Find out more about infection.

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Swelling

Swelling may occur because of a build up of fluid at the incision site after removal of the tumour. Tubes may be placed during surgery to drain the fluid and lessen the risk of infection. The healthcare team will apply a compressive dressing to the stump after amputation to control swelling.

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Bleeding

Bleeding can occur if a blood vessel is not sealed off during surgery or if you have a blood clotting disorder. Nursing staff frequently check bandages and drains for large amounts of bleeding right after surgery. If bleeding occurs and is severe enough, you may need surgery to find out where the bleeding is coming from and stop it.

A small amount of bloody drainage may be expected after surgery. Report large amounts to your healthcare team.

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Wound separation

The edges of a wound are usually held in place with stitches or staples until it heals enough to remove them. The edges of the wound may separate after surgery, which is called dehiscence. Minor separation of the skin edges may not be a serious problem. Separation of underlying muscle or fat edges can be more serious. It might result in a hernia for example, which is when organs or tissues comes through the abdominal wall. Strenuous physical activity is usually avoided for 8 weeks or longer after surgery to help prevent wound separation.

Tell your healthcare team about gaping of the incision, an incision that doesn’t heal or a feeling that the incision is separating.

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Poor wound healing

Radiation therapy given before surgery can cause poor wound healing. It can also increase the chance of other complications, such as infection. Diabetes, arteries that are narrowed due to a buildup of plaque (atherosclerosis) and smoking are other factors that can cause poor wound healing. You can help improve wound healing by controlling your blood glucose and quitting smoking.

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Blood clots

A blood clot in the legs is called a deep vein thrombosis (DVT). Right after surgery, you can’t move around much and blood can collect in the legs, which can lead to DVT. Other factors, such as smoking, can also increase you risk for DVT. In the most serious cases, a blood clot can break off and travel to the lungs, which is called a pulmonary embolus, or PE. PE causes shortness of breath and low oxygen levels.

Stopping smoking before surgery helps lower the risk of blood clots. Frequent position changes, leg and ankle exercises and moving around as soon as possible also help reduce the risk of blood clots. Most people who have surgery are given blood thinners to prevent blood clots after surgery. These blood thinners are usually stopped when you leave the hospital. If a blood clot develops, you will be given a higher dose of blood thinner over a longer time period (for example, for a few months).

Report any redness, swelling, pain or cramps in the calf of the leg to your healthcare team.

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Stiffness or weakness in the limb

Surgery can cause stiffness or weakness of the arm, shoulder, leg or hip. There may also be limited movement in the limb that was operated on. This is usually caused by the position the limb had to be placed in during the operation and should go away a short time after surgery.

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Nerve damage

Nerves may be damaged or cut during surgery in order to remove the whole tumour. This can cause a loss of feeling (numbness), tingling in the limb or changes in sensation. Nerve damage can appear long after surgery is over and may last a long time.

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Changes to body image and self-esteem

Having surgery for soft tissue sarcoma can affect body image and self-esteem in different ways. The removal of a large amount of tissue can cause obvious changes to the body’s appearance. For example, people with soft tissue sarcoma in a limb may need amputation and a prosthesis. Soft tissue sarcoma in the breast may be removed with mastectomy. Some people who have surgery for a tumour in the abdomen may need to have an ostomy, such as a colostomy.

Find out more about self-esteem and body image, living with an ostomy, prosthesis and reconstruction after mastectomy. Support from family, friends and the healthcare team can help you cope with these changes.

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Scarring

Removing a large amount of tissue or an amputation usually results in a certain amount of scarring. The redness of the scar will fade in time.

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prosthesis

An artificial device used to replace a part of the body.

Examples of prostheses include an artificial leg or breast prosthesis.

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