Berlin, Germany—Although little is known about the prevalence of lymphedema in patients with head and neck cancer, a series of studies showed that 75% of patients with head and neck cancer have problematic lymphedema internally and externally.
“Lymphedema is a significant problem affecting a majority of patients with head and neck cancer. Treatments such as surgery, chemotherapy, radiation, and combined modality therapy can damage lymphatic structures leading to scar tissue and fibrosis. Lymphedema can be detected noninvasively, and this can inform clinical practice,” stated Sheila H. Ridner, PhD, RN, MSN, Martha Rivers Ingram Professor, Vanderbilt University School of Nursing, Nashville, TN, at the 2013 Multinational Association of Supportive Care in Cancer.
Dr Ridner reviewed a series of studies that measured prevalence, symptoms, measurement techniques, and symptom assessment tools for head and neck cancer.
Study 1 included 81 patients who were at least 3 months after treatment. After a median posttreatment interval of 17.7 months, 75.3% of the patients had late-effect lymphedema; of these, 9.8% had external lymphedema exclusively, 39.4% had internal edema exclusively, and 50.8% had both types.
Study 2 included 25 patients with head and neck cancer. Swelling, internal and external, was measured pretreatment and posttreatment at 6 weeks and 12 weeks. Internal swelling was identified at baseline in 10 patients, and only 4 patients had been treated with surgery.
Study 3 included 100 patients and followed the time course and patterns of internal and external swelling over 36 weeks. The preliminary findings regarding external lymphedema, using 3 different tools, show that by 36 weeks posttreatment for head and neck cancer, more than 50% of patients have lymphedema.
Internal lymphedema is present in 10% to 20% of patients before treatment in a few structures. At 36 weeks posttreatment, approximately 30% of patients have internal lymphedema.
Study 4 included 30 patients and showed that 10 major symptoms were reported by more than 50% of them.