Editorial introductions

Abstract

Purpose of review Head and neck lymphedema (HNL) is a common and often debilitating cancer treatment effect that is under-researched and ill defined. We examined current literature and reviewed historical treatment approaches. We propose a model for evaluation and treatment of HNL used at The University of Texas M. D. Anderson Cancer Center (MDACC) for patients with head and neck cancer (HNC). Recent findings Despite the morbidity associated with HNL in patients with HNC, to our knowledge, no article has been published within the past 18 months whose primary focus is HNL. Eight publications included HNL but only as a secondary focus related to treatment effect, risk of dysphagia, prognostic indicator of underlying disease, and quality of life. A potential benefit of Selenium treatment to reduce HNL was reported. Summary This article highlights the recent literature regarding HNL in patients treated for HNC. Although HNL is reported as a potential complication of HNC treatment, no clear definition of the disease or its management are published. Our early experience using an objective evaluation and treatment protocol holds promise for a better understanding of HNL in patients treated for head and neck malignancy.

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

“…Similar findings were reported in a recent publication; that is, individuals with arm or leg lymphedema frequently reported heaviness and numbness as their major symptoms [26,27]. Our findings were also congruent with recent reports of head and neck lymphedema [11,13].…”

“…A cross-sectional study reported that 75.3 % of patients had secondary external and internal head and neck lymphedema post-HNC treatment, and increased lymphedema severity was associated with substantial symptom burden, functional impairments, and decreased quality of life [9]. Studies have also indicated that patients with head and neck lymphedema may experience a broad range of physical and psychological symptoms and functional deficits [9,11,13], some of which are unique to this physiological phenomenon. For example, patients may describe soft tissue swelling and tightness within head and neck lymphedema-affected areas [8].…”

“…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].…”

“…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]. A cross-sectional study reported that 75.3 % of patients had secondary external and internal head and neck lymphedema post-HNC treatment, and increased lymphedema severity was associated with substantial symptom burden, functional impairments, and decreased quality of life [9].…”

“…For example, patients may describe soft tissue swelling and tightness within head and neck lymphedema-affected areas [8]. Patients may complain of physical symptoms such as swallowing and breathing difficulty due to soft tissue swelling of the upper aerodigestive tract [8,11,14]. Because of the high visibility, external head and neck lymphedema may result in psychological symptoms (e.g., body image disturbance) [7,9].…”