Impact of secondary lymphedema after head and neck cancer treatment on symptoms, functional status, and quality of life

Abstract

Background Lymphedema may disrupt local function and affect quality of life (QOL) in patients with head and neck cancer. The study aim was to examine the associations among severity of internal and external lymphedema, symptoms, functional status, and QOL in patients with head and neck cancer. Methods The sample included 103 patients who were ≥3 months post head and neck cancer treatment. Variables assessed included severity of internal and external lymphedema, physical/psychological symptoms, functional status, and QOL. Results Severity of internal and external lymphedema was associated with physical symptoms and psychological symptoms. Patients with more severe external lymphedema were more likely to have a decrease in neck left/right rotation. The combined effects of external and internal lymphedema severity were associated with hearing impairment and decreased QOL. Conclusions Lymphedema severity correlates with symptom burden, functional status, and QOL in patients post head and neck cancer treatment.

A Prospective Study of the Lymphedema and Fibrosis Continuum in Patients with Head and Neck Cancer

“…[24][25][26][27] Our previous cross-sectional work supports the association between the severity of lymphedema and symptom severity. 10 Therefore, patients with moderate to severe lymphedema or fibrosis probably have significant symptom burden. Symptom presentation and functional deficits are commonly related to the site of involved tissue.…”

“…9 Data indicate that lymphedema correlates with the symptom burden and functional deficits that have plagued HNC survivors. 10 Despite the potential of lymphedema and fibrosis to negatively influence patients' outcomes, they remain underrecognized and undertreated by clinicians. In addition, little is known about their prevalence and trajectories over time in the post-treatment HNC population.…”

Internal Lymphedema Correlates with Subjective and Objective Measures of Dysphagia in Head and Neck Cancer Patients

“…2 Lymphedema correlated with decreased quality of life, impaired functional status, and increased symptom burden. 6 Dysphagia is a common and often debilitating complication of HNC and its treatment. Potential underlying mechanisms of dysphagia include surgical removal of tissue critical to deglutition, radiation-associated complications (including edema, fibrosis, xerostomia, thickened secretions), muscular atrophy, and neurosensory alterations.…”

Differences of symptoms in head and neck cancer patients with and without lymphedema

“…These reports have described symptom burden, functional deficits, and long-term psychosocial sequela associated with breast cancer-related arm lymphedema [4][5][6]. However, limited literature exists to describe and report the symptom burden associated with secondary lymphedema in individuals with head and neck cancer (HNC) [7][8][9]. Recent publications have specified that HNC patients are at risk for developing secondary lymphedema after aggressive multi-modality cancer therapy [9][10][11][12].…”

“…However, limited literature exists to describe and report the symptom burden associated with secondary lymphedema in individuals with head and neck cancer (HNC) [7][8][9]. Recent publications have specified that HNC patients are at risk for developing secondary lymphedema after aggressive multi-modality cancer therapy [9][10][11][12]. Head and neck lymphedema may involve external anatomical sites (e.g., face and neck) and internal structures (e.g., oral cavity and pharynx) [11,12].…”