About Your Esophagectomy Surgery

About Your Surgery

This guide will help you prepare for your esophagectomy surgery at Memorial Sloan Kettering Cancer Center, and help you understand what to expect during your recovery. Read through this guide at least once before your surgery and then use it as a reference in the days leading up to your surgery. Bring this guide with you every time you come to MSK, including the day of your surgery, so that you and your healthcare team can refer to it throughout your care.

An esophagectomy is a surgery to remove part of the food pipe between your mouth and stomach, which is called the esophagus (see Figure 1). Your surgeon may also remove part of your stomach to make sure all of the cancer is taken out. The remaining part of your stomach will be reconstructed and attached to what is left of your esophagus.
There are different ways to perform esophagectomy surgery. Your surgeon will talk with you about which approach is best for you.

  • During an Ivor-Lewis esophagectomy, also known as a transthoracic esophagogastrectomy, an incision is made in the center of the abdomen and along your side, toward the back. After the tumor is removed, the stomach is reattached to the remaining part of the esophagus.
  • During a transhiatal esophagectomy, the esophagus is removed through 2 incisions, one in the neck and one in the abdomen. After the tumor is removed, the stomach is attached to the remaining part of the esophagus through the neck incision.
  • During a 3-hole esophagectomy, also known as McKeown, incisions are made in the abdomen, neck, and right upper back.
  • During a minimally invasive esophagectomy, a tiny camera called a laparoscope is inserted into the belly through multiple small incisions in the abdomen and back, below the shoulder. A robot may be used to assist.
Figure 1. Your esophagus
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Before Your Surgery

The information in this section will help you prepare for your surgery. Read through this section when your surgery is scheduled and refer to it as your surgery date gets closer. It contains important information about what you need to do before your surgery. Write down any questions you have and be sure to ask your doctor or nurse.

Preparing for Your Surgery

You and your healthcare team will work together to prepare for your surgery.

About Smoking

People who smoke can have breathing problems and a higher risk of getting an infection when they have surgery. Stopping even for a few days before surgery can help. If you smoke, your nurse will refer you to our Tobacco Treatment Program. You can also reach the program at 212-610-0507.

About Sleep Apnea

Sleep apnea is a common breathing disorder that causes a person to stop breathing for short periods while sleeping. The most common type is obstructive sleep apnea (OSA). This means that the airway becomes completely blocked during sleep, so no air can get through. OSA can cause serious problems when you have surgery. Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing machine (such as a CPAP) for sleep apnea, bring it with you the day of your surgery.


Do aerobic exercise, such as walking, swimming, or biking, for 45 minutes to an hour every day. If it is cold outside, use stairs in your home or go to a mall or shopping market. Walking will help your body get into its best condition for your surgery and make your recovery faster and easier.

About Drinking Alcohol

The amount of alcohol you drink can affect you during and after your surgery. It is important that you talk with your healthcare providers about your alcohol intake so that we can plan your care.

  • Stopping alcohol suddenly can cause seizures, delirium, and death. If we know you are at risk for these complications, we can prescribe medication to help prevent them.
  • If you drink alcohol regularly, you may be at risk for other complications during and after surgery. These include bleeding, infections, heart problems, greater dependence on nursing care, and longer hospital stay.

Here are things you can do to prevent problems before your surgery:

  • Be honest with your healthcare provider about how much alcohol you drink.
  • Try to stop drinking alcohol once your surgery is planned. If you develop a headache, nausea, increased anxiety, or cannot sleep after you stop drinking, tell your doctor right away. These are early signs of alcohol withdrawal and can be treated.
  • Tell your healthcare provider if you cannot stop drinking.
  • Ask us any questions you have about drinking and surgery. As always, all of your treatment information will be kept confidential.

Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you aren’t sure.

  • I take a blood thinner. Some examples are heparin, warfarin (Coumadin®), clopidogrel (Plavix®), and tinzaparin (Innohep®). There are others, so be sure your doctor knows all the medications you’re taking.
  • I take prescription medications.
  • I take any over-the-counter medications, herbs, vitamins, minerals, or natural or home remedies.
  • I have a pacemaker, automatic implantable cardioverter-defibrillator (AICD), or other heart device.
  • I have sleep apnea.
  • I have had a problem with anesthesia in the past.
  • I have allergies, including to latex.
  • I am not willing to receive a blood transfusion.
  • I drink alcohol.
  • I smoke.
  • I use recreational drugs.

Within 30 Days of Your Surgery

Presurgical Testing

Before your surgery, you will be given an appointment for presurgical testing (PST). The date, time, and location of your PST appointment will be printed on the appointment reminder from your surgeon’s office.

You can eat and take your usual medications the day of your PST appointment. During your appointment, you will meet with a nurse practitioner who works closely with anesthesiology staff (doctors and specialized nurses who will be giving you medication to put you to sleep during your surgery). He or she will review your medical and surgical history with you. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests necessary to plan your care. Your nurse practitioner may also recommend you see other healthcare providers.

Your nurse practitioner will talk with you about which medications you should take the morning of your surgery. To help you remember, we’ve left space for you to write these medications down in the “Morning of Your Surgery” section of this guide.

It is very helpful if you bring the following with you to your PST appointment:

  • A list of all the medications you are taking, including patches and creams.
  • Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram (echo), or carotid doppler study.
  • The name(s) and telephone number(s) of your doctor(s).

Complete a Health Care Proxy Form

If you haven’t already completed a Health Care Proxy form, we recommend you complete one now. A health care proxy is a legal document that identifies the person who will speak for you if you are unable to communicate for yourself. The person you identify is called your health care agent. If you are interested in completing a Health Care Proxy form, talk with your nurse. If you have completed one already, or if you have any other advanced directive, bring it with you to your next appointment.

Do Breathing and Coughing Exercises

Practice taking deep breaths and coughing before your surgery. You will be given an incentive spirometer to help expand your lungs. For more information, please read How to Use Your Incentive Spirometer, located in the “After Your Surgery” section of this guide. If you have any questions, ask your nurse or respiratory therapist.

Eat a Healthy Diet

You should eat a well-balanced, healthy diet before your surgery. If you need help with your diet talk to your doctor or nurse about meeting with a dietitian.

10 Days Before Your Surgery

Stop Taking Vitamin E

If you take vitamin E, stop taking it 10 days before your surgery, because it can cause bleeding. For more information, read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

Figure 2. Hibiclens skin cleanser

Purchase Hibiclens® Skin Cleanser

Hibiclens is a skin cleanser that kills germs for 24 hours after using it (see Figure 2). Showering with Hibiclens before surgery will help reduce your risk of infection after surgery. Hibiclens is available at your local pharmacy without a prescription.

Purchase Supplies for Your Bowel Preparation

Your surgeon may instruct you to clean out your bowels before your surgery. Your nurse will tell you how. Use the area below to write down the supplies you’ll need.

  • 1 (10-ounce) bottle of magnesium citrate
  • 1 saline enema, such as Fleet®

Purchase a Wedge Pillow

Purchase a 12 inch wedge pillow from your local pharmacy or health supply store. You will need this pillow when you go home after your surgery to keep your torso raised. It is not safe to lay flat after espohagectomy surgery.

7 Days Before Your Surgery

Stop Taking Certain Medications

If you take aspirin, ask your surgeon if you should continue. Aspirin and medications that contain aspirin can cause bleeding. For more information, read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs).

Stop Taking Herbal Remedies and Supplements

Stop taking herbal remedies or supplements 7 days before your surgery. If you take a multivitamin, talk with your doctor or nurse about if you should continue. For more information, read Herbal Remedies and Cancer Treatment.

Watch a Virtual Tour

This video will give you an idea of what to expect when you come to Memorial Sloan Kettering’s main hospital on the day of your surgery.

2 Days Before Your Surgery

Drink Only Clear Liquids

Stop eating solid foods. Drink at least 10 (8-ounce) glasses of clear liquids every day.

While you are on this diet:

  • Do not eat any solid foods.
  • Make sure to drink plenty of liquids other than water, coffee, and tea. Try to drink at least 1 (8-ounce) glass of clear liquid every hour while you’re awake.



Do Not Drink


  • Clear broth, bouillon

  • Clear consommé

  • Clear packaged vegetable, chicken, or beef broth-mix

  • Any products with particles of dried food or seasoning

Sweets and Desserts

  • Gelatin, such as Jell-O®

  • Flavored ices

  • Ice pops that contain pieces of fruit


  • Clear fruit juices, such as cranberry, grape, or apple

  • Soda, such as ginger ale, 7-Up®, Sprite®, ginger ale, seltzer, Gatorade®

  • Black coffee (no cream)

  • Tea

  • Juices with pulp

  • Nectars

  • Milk (or cream)

  • Alcoholic beverages

Stop Taking Certain Medications

Stop taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (e.g., Advil®, Motrin®) and naproxen (e.g. Aleve®). These medications can cause bleeding. For more information, please read Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs), located in this section.

1 Day Before Your Surgery

Note the Time of Your Surgery

A clerk from the Admitting Office will call you after 2:00 pm the day before your surgery. He or she will tell you what time you should arrive at the hospital for your surgery. If you are scheduled for surgery on a Monday, you will be called on the Friday before. If you do not receive a call by 7:00 pm, please call 212-639-5014.

Presurgical Center (PSC)
1275 York Avenue (between East 67th and East 68th Streets)
New York, NY 10065
B elevator to 6th Floor

Take Magnesium Citrate

If you were instructed to drink magnesium citrate to clean out your bowels before surgery, drink it at 2:00 pm. Continue to drink clear liquids.

Give Yourself an Enema

If you were instructed to use a saline enema (such as Fleet) to clean out your bowels before surgery, use it at 8:00 pm. Follow the instructions on the box.

Shower With Hibiclens

The night before your surgery, shower using Hibiclens. To use Hibiclens, open the bottle and pour some solution into your hand or a washcloth. Move away from the shower stream to avoid rinsing off the Hibiclens too soon. Rub it gently over your body from your neck to your waist and rinse.

Don’t let the solution get into your eyes, ears, mouth, or genital area. Don’t use any other soap. Dry yourself off with a clean towel after your shower.


Go to bed early and get a full night’s sleep.

Instructions for eating and drinking before your surgery

12 ounces of water

  • Do not eat anything after midnight the night before your surgery. This includes hard candy and gum.
  • Between midnight and up until 2 hours before your scheduled arrival time, you may drink a total of 12 ounces of water (see figure).
  • Starting 2 hours before your scheduled arrival time, do not eat or drink anything. This includes water.

Shower With Hibiclens

Shower using Hibiclens just before you leave for the hospital. Use the Hibiclens the same way you did the night before. Do not use any other soap.

Take Your Medications as Instructed

Your doctor or nurse practitioner may have told you to take certain medications the morning of your surgery. If so, list them below. Take only those medications with a small sip of water the morning of your surgery.


Things to Remember

  • Do not put on any lotions, creams, deodorants, makeup, powders, or perfumes.
  • Remove nail polish and nail wraps.
  • Do not wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
  • Leave valuables, such as credit cards, jewelry, or your checkbook at home.
  • Before you are taken into the operating room, you will need to remove your eyeglasses, hearing aids, dentures, prosthetic device(s), wig, and religious articles, such as a rosary.
  • Wear something comfortable and loose-fitting.

  • This guide. Your healthcare team will use this guide to teach you how to care for yourself after your surgery.
  • Sneakers that lace up. You may have some swelling in your feet. Lace-up sneakers can accommodate this swelling.
  • An iPod or other electronic device, if you choose. However, someone will need to hold these items for your when you go into surgery.
  • Your breathing machine for sleep apnea (such as your CPAP), if you have one.
  • If you usually wear contact lenses, wear your glasses instead. Remember to bring a case for them.
  • Your Health Care Proxy form, if you have completed one.
  • Your toothbrush and other toiletries, if you wish.

Parking When You Arrive

Parking at MSK is available in the garage on East 66th Street between York and First Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that connects the garage to the hospital. If you have questions about prices, call 212-639-2338. 

There are also commercial garages nearby on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Once You’re in the Hospital

You will be asked to state and spell your name and date of birth many times. This is for your safety. People with the same or similar name may be having surgery on the same day.

Meet With Your Nurse

Your nurse will meet with you before your surgery. Tell him or her the dose of any medications (including patches and creams) you took after midnight and the time you took them.

Get Dressed for Surgery

You will be given a hospital gown, robe, and nonskid socks.

Prepare for Surgery

Once your nurse has seen you, 1 or 2 visitors can keep you company as you wait for your surgery to begin. When it is time for your surgery, your visitor(s) will be shown to the waiting area. Your visitors should read Information for Family and Friends for the Day of Surgery, located in this section.

Your anesthesiologist will place an intravenous (IV) line into a vein, usually in your arm or hand. The IV line will be used to give you fluids and anesthesia (medication to make you sleep) during your surgery.

Your anesthesiologist may also put an epidural catheter (thin, flexible tube) in your spine (back). This will be used to give you pain medication. The medication is delivered into your epidural space, which is the area just outside your spinal cord. It will give you pain relief with fewer side effects, such as nausea, vomiting, and sleepiness. This is similar to what is given to women when they have babies.

You will be taken into the operating room on a stretcher. A member of your surgical team will help you onto the operating bed. Compression boots will be placed on your lower legs. These gently inflate and deflate to help circulation in your legs.

Once you are fully asleep, a breathing tube will be placed through your mouth and into your windpipe to help you breathe. You will also have a urinary catheter placed to drain urine from your bladder. The length of your surgery depends on which type of surgery and incision you have. Your doctor will discuss this with you before your surgery. Once your surgery is finished, your incisions will be closed with stitches that will absorb as you are healing. Steri-Strips™ (thin pieces of tape) or staples will be placed directly on your incision(s) and covered with a bandage. Your breathing tube is usually taken out while you are still in the operating room.

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After Your Surgery

The information in this section will tell you what to expect after your surgery, both during your hospital stay and after you leave the hospital. You will learn how to safely recover from your surgery. Write down any questions you have and be sure to ask your doctor or nurse.

What to Expect

When you wake up after your surgery, you will be in the Post Anesthesia Care Unit (PACU). You might have an oxygen mask covering your nose and mouth. Your nurse will be monitoring your temperature, pulse, blood pressure, and oxygen levels. You will have tubes and drains to help your body recover from the surgery.

  • You will have 1 or 2 tubes in your chest, which will be attached to a draining device.
  • You will have a tube in your nose called a nasogastric, or NG tube. This tube goes down to your stomach to keep your stomach empty.
  • You will have a urinary (Foley®) catheter to monitor the amount of urine you are making.
  • You will have compression boots on your lower legs to help your circulation.
  • You may have other tubes and drains. If so, your nurse will explain why and take care of them while you’re in the hospital.
  • If you have an epidural catheter, you will have a pain pump called a patient-controlled analgesia (PCA) device. For more information, please read Patient-Controlled Analgesia (PCA), located in this section. If you do not have an epidural catheter, your pain medication will be given through an IV line.

Once you are fully awake, your oxygen mask will be taken off. You will receive oxygen through a thin tube that rests below your nose called a nasal cannula.

Your visitors can see you briefly in the PACU, usually within 90 minutes after you arrive there. A member of the nursing staff will explain the guidelines to them. Depending on the type of surgery you had, you may stay in the PACU overnight. After your stay in the PACU, you will be taken to your hospital room. There, your nurse will tell you how to recover from your surgery. Below are examples of ways you can help yourself recover safely.

  • It is important to walk around after surgery. Walking every 2 hours is a good goal. This will help prevent blood clots in your legs.
  • Use your incentive spirometer. This will help your lungs expand, which prevents pneumonia. For more information, please read How to Use Your Incentive Spirometer, located in this section.
  • Continue to perform your breathing and coughing exercises every 1 to 2 hours while you are awake.
  • Please see the Esphagectomy Pathway to see what to expect daily while you are in the hospital after your surgery.

Commonly Asked Questions: During Your Hospital Stay

Figure 3. A chest tube with a drainage device

The following section covers common questions patients ask after esophageal surgery. Speak with your doctor or nurse if you have any questions or concerns.

Will I have pain after my surgery?

You will have some pain after your surgery. Your doctor and nurse will ask you about your pain often. You will be given medication to manage your pain as needed. If your pain is not relieved, please tell your doctor or nurse. It is important to control your pain so you can cough, breathe deeply, use your incentive spirometer, and get out of bed and walk.

What is a chest tube?

A chest tube is a hollow, flexible tube that is used to drain blood, fluid, and air from your lung after surgery. The tube enters your body between your ribs and goes into the space between the inner lining and the outer lining of your lung (see Figure 3). This is called the pleural space.

When will my chest tube be removed?

Your doctor will decide when your chest tube will be removed based on how much fluid is draining. The area will be covered with a bandage. Keep the
bandage on for at least 48 hours, unless your nurse gives you other instructions.

Will I be able to eat?

Your healthcare team will talk with you about when it is safe for the nasogastric (NG) tube to be taken out. Once that tube is out, your surgeon will tell you if it’s safe to start eating and drinking. At first you will be given swabs to wet your mouth, then ice chips and water, then clear liquids.

You may have a tube in your belly that goes into your small intestine. This tube is called a jejunostomy or J tube.

The tube will be used to give you nutrition after your surgery.

Why is it important to walk?

Walking will help prevent blood clots in your legs. It also decreases your risk of having other complications such as pneumonia. Walking 1 mile, which is 14 laps around the unit while you’re still in the hospital, is a good goal.

Commonly Asked Questions: After You Leave the Hospital

Will I be able to eat when I go home?

Your doctor will tell you whether you will be able to eat when you go home from your surgery. You may go home with a feeding tube. If you have a feeding tube, your dietitian will tell you what kind of formula you will use when you go home. Your case manager will help you work with your insurance company to see what is covered under your plan. Not all insurance companies will pay for formula.

Will I have pain when I am home?

You should expect to have some discomfort after you leave the hospital, but how much varies from person to person. You may have incisional soreness, tightness, or muscle aches for 6 months or longer. This does not mean that something is wrong. To manage your pain, follow the guidelines below.

  • Call your doctor if the medication prescribed for you doesn’t relieve your pain.
  • Do not drive or drink alcohol while you are taking prescription pain medication.
  • As your incisions heal, you will have less pain and need less pain medication. A mild pain reliever such as acetaminophen (Tylenol®) or ibuprofen (Advil) will relieve aches and discomfort.
  • Pain medication should help you as you resume your normal activities. Take enough medication to do your exercises comfortably. Pain medication is most effective 30 to 45 minutes after taking it.
  • Keep track of when you take your pain medication. It will not be as effective if you allow your pain to increase. Taking it when your pain first begins is more effective than waiting for the pain to get worse.

Can I shower?

You may shower 48 hours after your chest tube is removed. Taking a warm shower is relaxing and can help decrease muscle aches. Do not take tub baths until you discuss it with your doctor at the first appointment after your surgery.

Use soap when you shower and gently wash all of your incisions. Pat the areas dry with a towel after showering, and leave your incisions uncovered (unless there is drainage). Call your doctor if you see any redness or drainage from your incision.

How can I prevent constipation?

Your usual bowel pattern will change after surgery. You may have trouble passing stool (feces). This is a common side effect of pain medication. Talk with your nurse about how to manage constipation. Information is available in the patient education resource titled Constipation.

To avoid constipation, take a stool softener such as docusate sodium (Colace®) 3 times a day and 2 tablets of senna (a laxative) at bedtime. Continue taking the stool softener and laxative until you are no longer taking pain medication. If you feel boated, avoid foods that can cause gas, such as beans, broccoli, onions, cabbage, and cauliflower.

How can I help my lungs heal?

  • Continue to exercise. This will help you get stronger, feel better, and heal your lung. Make a daily walk part of your routine. Keep using your incentive spirometer and do your coughing and deep breathing exercises at home.
  • Avoid sources of infection, such as contact with people with colds, sore throats, or the flu.
  • Do not smoke. Smoking cigarettes is harmful to your health at any time. It is even more so at this time. Smoking causes the blood vessels in your lungs to become narrow. This decreases the amount of oxygen in the lungs. It can cause problems with breathing and regular activities. It is also important to avoid places that are smoky. Your nurse can also give you information to help you deal with other smokers or situations where smoke is present. Remember, if you need help quitting, MSK’s Tobacco Cessation Program can help.
  • Do not drink alcohol, especially while you are taking pain medication.

How do I care for my incisions?

You will have more than 1 incision after your surgery. The location of your incisions will depend on the type of surgery you had. There will be incisions from the surgical site and the chest tube. You may have some numbness below and in front of your incisions. This is because your ribs were spread apart and some nerves were affected.

Surgical incision

  • By the time you are ready to leave the hospital, your surgical incision will almost be healed.
  • You or your caregiver should look at your incision with your nurse before you leave the hospital so you know what it looks like.
  • If any liquid is draining from your incision, you should write down the amount and color.
  • If you go home with Steri-Strips on your incisions, they will loosen and fall off by themselves. If they haven’t fallen off within 10 days, you may remove them. If you have staples in your incision, they will be removed during your first appointment after surgery.

Chest tube incision

  • You will have a bandage covering your chest tube incision.
  • Keep the bandage on your incision for 48 hours after your chest tube is removed, unless it gets wet. If it gets wet, change it as soon as possible.
  • You may have some thin, yellow or pink-colored drainage from this area, which is normal. Place a Band-Aid® or dry piece of gauze over the area and change the bandage as needed.
  • Change your bandages at least once a day and more often if they become wet with drainage. When there is no longer any drainage coming from your incisions, they can be left uncovered.

Call your surgeon’s office if you have any signs of infection, such as redness, swelling, or drainage that is foul smelling or pus-like.

Is it normal to feel tired after surgery?

It is common to have less energy than usual after your surgery. Recovery time varies with each person. Increase your activities each day as much as you can. Always balance activity periods with rest periods. Rest is a vital part of your recovery.

Can I resume my activities?

It is important for you to resume your activities after surgery. Spread them out over the course of the day. Walking and stair climbing are excellent forms of exercise. Gradually increase the distance you walk. Climb stairs slowly, resting or stopping as needed. You can do light household tasks. Try dusting, washing dishes, preparing light meals, and other activities as you are able.

You may return to your usual sexual activity as soon as your incisions are well healed and you can do so without pain or fatigue.

Your body is an excellent guide for telling you when you have done too much. When you increase your activity, monitor your body’s reaction. You may find that you have more energy in the morning or the afternoon. Plan your activities for times of the day when you have more energy.

When is it safe for me to drive?

You can begin driving again after you have:

  • Regained full movement of the arm and shoulder on the side of your surgery
  • Stopped taking pain medication

Can I travel by plane?

Do not travel by plane until you have discussed this with your doctor at your first appointment after your surgery.

When can I return to work?

The time it takes to return to work depends on the type of work you do, the type of surgery you had, and how fast your body heals.

What exercises can I do?

Use the arm and shoulder on the side of your surgery in all of your activities. Use them when you bathe, brush your hair, and reach up to a cabinet shelf.

Slowly resume your normal activities to help restore full use of your arm and shoulder. The exercises shown below will help you to regain full arm and shoulder movement. You should begin these exercises as soon as your chest tube is removed.

Figure 4. Axillary stretch
Axillary stretch
  1. Sit in a straight-backed chair with your feet flat on the floor.
  2. Clasp your hands together (see Figure 4).
  3. Lift your arms up and over your head.
  4. Slide your hands down to the back of your neck.
  5. Slowly twist the upper part of your body to the right side. Hold this position for 5 seconds while bringing your elbows as far back as possible.
  6. Return to the starting position.
  7. Slowly twist the upper part of your body to the left side. Hold this position for 5 seconds while bringing your elbows as far back as possible.
  8. Return to the starting position.

Repeat _______

Figure 5. Stretching up
  1. Figure 6. Stretching back
    Stand comfortably with your feet about 6 inches apart.
  2. Put your arms in front of your body and hold 1 end of a hand towel in each hand (see Figure 5).
  3. Bring your arms over your head, straighten your elbows, and stretch toward your upper back. Do not arch your back and do not force the movement if it is difficult. Try to hold the position for 5 seconds.
  4. Relax and return to the starting position.
  5. Stand as in Step 1.
  6. Grasp the towel behind your back and lift upward as far as possible (see Figure 6). Be sure to stand straight. Try to hold the position for 5 seconds.
  7. Return to the starting position.

Repeat ______

When can I lift heavy objects?

Check with your doctor before you do any heavy lifting. Normally, you should not lift anything heavier than 10 pounds for at least 6 weeks. Ask your doctor how long you should avoid heavy lifting. This depends on the type of surgery you had.

When can I resume sports?

Do not play contact sports until your doctor tells you it is safe. When you resume, remember that it will take time for you to return to your previous level of activity. Start out slowly and increase your activity as you feel better.

How can I cope with my feelings?

After surgery for a serious illness, you may have new and upsetting feelings. Many people say they felt weepy, sad, worried, nervous, irritable, and angry at one time or another. You may find that you cannot control some of these feelings. If this happens, it’s a good idea to seek emotional support.

The first step in coping is to talk about how you feel. Family and friends can help. Your nurse, doctor, and social worker can reassure, support, and guide you. It is always a good idea to let these professionals know how you, your family, and your friends are feeling emotionally. Whether you are in the hospital or at home, the nurses, doctors, and social workers are here to help you and your family and friends handle the emotional aspects of your illness.

When is my first appointment after my surgery?

Your first appointment after surgery will be in 1 to 3 weeks after you leave the hospital. Your nurse will give you instructions on how to make this appointment, including the phone number to call.
During this appointment, your doctor will discuss the pathology results with you in detail.

  • Difficulty swallowing
  • Nausea or vomiting
  • New or worsening shortness of breath
  • A temperature of 101° F (38.3° C) or higher
  • Pain that does not get better with your medications
  • Redness, swelling, or drainage from your incisions that is foul smelling or pus-like
  • No bowel movement for 3 days or longer
  • Any new symptom or physical change
  • Any questions or concerns

After 5:00 pm, during the weekend, and on holidays, call 212-639-2000. Ask to speak to the thoracic surgeon on call.

Calorie Count Log

You may find it helpful to keep a log of what you eat and drink after your surgery.

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This section includes a list of MSK support services, as well as the resources that were referred to throughout this guide. These resources will help you prepare for your surgery and recover safely. Write down any questions you have and be sure to ask your doctor or nurse.

MSK Support Services

Call the Admitting office to discuss private room or luxury suite options. If you want to change your room choice after your Presurgical Testing visit, call (212) 639-7873 or 7874.

Blood Donor Room
If you are interested in donating blood or platelets, call for more information.

Bobst International Center
MSK welcomes patients from around the world. If you are an international patient, call the International Center for help coordinating your care.

Chaplaincy Service
Spiritual and religious resources provide comfort and strength for many patients. The chaplains at MSK are available to help you access those resources. They can provide spiritual support for anyone. If you have a specific religious need, please call the number above. The interfaith chapel is located near the main lobby of 1275 York Avenue. It is open 24 hours a day. If there is an emergency, please call the hospital operator and ask for the chaplain on call.

Counseling Center
Many people find counseling helpful. We provide counseling for individuals, couples, families, and groups, as well as medications to help if you feel anxious or depressed.

Integrative Medicine Service
Integrative Medicine Service offers patients many services to complement traditional medical care, including music therapy, mind/body therapies, dance and movement therapy, yoga, and touch therapy.

Nutrition Services
Our Nutrition Service offers nutrition counseling with one of our certified dietitians, who will review your current eating habits and give advice on what to eat while you’re going through treatment.

Patient-to-Patient Support Program
You may find it comforting to speak with a cancer survivor or caregiver who has been through a similar treatment. Through our Patient-to-Patient Support Program, we are able to offer you a chance to speak with former patients and caregivers.

Patient Billing
Call Patient Billing with any questions regarding preauthorization with your insurance company. This is also called preapproval.

Patient Representatives
Call the Patient Representatives office if you have any questions about the Health Care Proxy form or if you have any concerns about your care.

Perioperative Clinical Nurse Specialist
Call if you have any questions about MSK releasing any information while you are having surgery.

Private Nursing Options
Patients may request private nurses or companions. Call for more information.

Resources for Life After Cancer (RLAC) Program
At MSK, care doesn’t end after active treatment. The RLAC Program is for patients and their families who have finished treatment. This program has many services, including seminars, workshops, support groups, counseling on life after treatment, and help with insurance and employment issues.

Social Work
Social workers help patients, family, and friends deal with issues that are common for cancer patients. They provide individual counseling and support groups throughout the course of treatment, and can help you communicate with children and other family members. Our social workers can also refer you to community agencies and programs, as well as financial resources if you’re eligible.

Tobacco Treatment Program
If you want to quit smoking, MSK has specialists who can help. Call for more information.

Virtual Programs: Esophageal Cancer
MSK offers a live, online support and education group for people who have had surgery for esophageal cancer. You can talk about issues that come up during and after treatment, share your experiences, and to provide practical and emotional support for others. Discussions are led by a social worker and a nurse.

External Resources

The following are resources outside of MSK that you may find helpful:

American Cancer Society (ACS)

National Cancer Institute

For additional online information, visit LIBGUIDES on MSK’s library website at http://library.mskcc.org or the Lung Cancer section of MSKCC.org. You can also contact the library reference staff at 212-639-7439 for help.

Additional Resources

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