How Does Stress Affect Surgery Recovery?

How Does Stress Affect Surgery Recovery?

Your doctor may have told you that your bladder cancer is going to be treated with a surgical procedure, and you feel stressed and anxious about the upcoming surgery. It’s common for many patients to experience stress and anxiety before a major surgery. In a survey of patients undergoing a radical cystectomy, almost 50% of patients experienced some form of psychological distress, including depression and anxiety.1 When these same patients were surveyed after their surgery, almost 35% continued to experience significant amounts of distress. It is also notable that in this study women were more likely to have higher pre- and post-surgery related stress scores than men.

How stress affects the healing process

While stress around surgery is not uncommon, did you know that psychological stress, such as anxiety and depression, can actually interfere with your body’s healing process?2 Researchers at Ohio State University found that patients who regularly experienced stressful situations had wounds that took almost 25% longer to heal than those who did not regularly experience high amounts of stress. The researchers recruited a group of dental students who volunteered to have biopsies taken just before final exams and again just before summer vacation. The biopsies taken just before final exams healed 40% slower than the biopsies taken just before summer vacation.

Stress can also increase a patient’s chance of getting an infection.2 In multiple studies with patients and research animals, it was found that patients with depression-related symptoms and/or high levels of stress were more likely to have an infection or infection-related complication, and have a longer hospital stay or readmission.

Protecting yourself from surgery-related stress

If stress, anxiety, and depression are unfavorable factors to the healing process, what can you do to protect yourself from surgery-related stress?

Tell your doctor

Tell your doctor that you are experiencing stress and anxiety related to your surgery. Your healthcare team should have many resources to help you, including counseling, medication, and physical and occupational therapists to help you both before and after your surgery. Many people are averse to medication, but there are temporary medications that can help with surgery-related depression and anxiety.2 Speaking with a counselor can help alleviate surgery-related stress and anxiety as well.3

Exercise

Exercise prior to your surgery, and talk to your care team about exercising as soon as you can after surgery. A British study found that patients who exercised regularly after undergoing a cystectomy had better postoperative outcomes than patients who did not.4 Patients who exercise also have wounds that heal faster than those who do not.3 Finally, exercise can be a great stress reliever, even if it’s just a walk to clear your head.

Rely on your social support network

Tell your friends, family and loved ones that you are feeling stressed about your upcoming surgery. Patients who have social support have better health outcomes than those who don’t.2 Don’t be afraid to ask your friends and family to visit you in the hospital. Having good company goes a long way, so try not to isolate yourself, especially if you are feeling depressed. You can also ask your health care team about support groups. Talking to people who are in a similar health situation as you can help relieve a lot of stress and anxiety.

Quit smoking

If you are a smoker, it’s easy to rely on cigarettes when you feel anxious. However, smoking delays wound healing, and can complicate your overall healing process.4 Talk to your doctor about nicotine replacement therapies or smoking cessation programs, preferably as much in advance of your surgery as possible.

Being your own advocate

Be open with your care team about your questions, concerns, and state of mind. Your care team should have many resources to help you deal with your pre- and post-operative stress, anxiety, and depression; however, they can’t help you if they don’t know what you are going through. Make sure you be your own advocate in your surgery and healing process.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The BladderCancer.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.
View References
  1. PALAPATTU G, HAISFIELD-WOLFE M, WALKER J et al. ASSESSMENT OF PERIOPERATIVE PSYCHOLOGICAL DISTRESS IN PATIENTS UNDERGOING RADICAL CYSTECTOMY FOR BLADDER CANCER. J Urol. 2004;172(5):1814-1817. doi:10.1097/01.ju.0000141245.08456.1
  2. Gouin J, Kiecolt-Glaser J. The Impact of Psychological Stress on Wound Healing: Methods and Mechanisms. Immunol Allergy Clin North Am. 2011;31(1):81-93. doi:10.1016/j.iac.2010.09.010
  3. Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. What can help relieve anxiety before surgery? 2006 Feb 14 [Updated 2018 Feb 8]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279557/
  4. Quirk H, Rosario D, Bourke L. Supportive interventions to improve physiological and psychological health outcomes among patients undergoing cystectomy: a systematic review. BMC Urol. 2018;18(1). doi:10.1186/s12894-018-0382-z

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