Essential Tips for Managing Head and Neck Cancer Lymphedema
Head and neck cancer (HNC) lymphedema is a common side effect of cancer treatment, affecting most people who undergo radiation therapy or surgery for head and neck cancers. Lymphedema can be uncomfortable, inconvenient, and even disabling if untreated. Fortunately, there are steps that you can take to manage the symptoms of HNC lymphedema. This blog post will cover essential tips for managing HNC lymphedema that you can start doing today.
What is Lymphedema?
Lymphedema is a condition caused by an accumulation of lymphatic fluid, and it often occurs after treatment for HNC. This is because when undergoing radiation therapy or surgery to treat cancer, lymph nodes and lymph vessels may be removed or damaged, leading to lymphedema. Because lymphedema is a chronic and progressive condition, it's important to diagnose it early and start treatment before it progresses. To learn more about the progression of lymphedema, read my blog post, "What is lymphedema?"
Signs and Symptoms of HNC Lymphedema
Research has found that as many as 98% of HNC survivors experience lymphedema, including external and internal lymphedema. Unfortunately, even though lymphedema is a common side effect of cancer treatment, it is often overlooked and underdiagnosed. Knowing the signs and symptoms of HNC lymphedema is essential for screening and ultimately helps with diagnosis.
The signs and symptoms of HNC lymphedema may be subtle initially but, if not treated, can progress. Symptoms are primarily experienced at the head and neck, but your shoulders may also be impacted. Symptoms may include:
Swelling in the face, neck, or tongue
Feeling tightness or heaviness in the affected areas
Difficulty swallowing, chewing, speaking, or breathing
Change in voice
Limited range of motion in the neck or arms
Recurrent skin or tissue infections
Redness or warmth around affected areas
Pain, tingling, or numbness
Skin hardening in the neck
Risk Factors for HNC Lymphedema
The primary risk factors for developing HNC lymphedema include:
Radiation therapy, especially if both sides of the face/neck were treated
Number of lymph nodes removed during surgery
Presence of other comorbidities such as diabetes or heart disease, history of prior deep vein thrombosis (DVT)
Strategies for Managing HNC Lymphedema
Elevate your upper body when sleeping
If you sleep flat on your side, back, or belly, the lymphedema will pool, and you'll wake up puffier. Instead, use a sleep wedge or bed blocks to elevate your upper body, which can help naturally drain the head and neck swelling.
Hold items like your phone and books at eye level
Like most people, you probably hold your phone low with your head bent over to read it. Doing this throughout the day can cause pooling of swelling at the front of the neck and face. Make a small change of bringing your phone, book, magazine, laptop, or anything else you're reading up to eye level.
Practice risk reduction practices
Avoid tight clothing and jewelry around the neck, maintain a healthy weight/BMI, keep the skin in the affected area moisturized, and wear sunscreen and insect repellent.
Stay Active
Doing gentle head and neck exercises will help with pumping the lymphatic system and reduce swelling. If you are looking for exercises you can do daily, watch my YouTube video.
Work with a Certified Lymphedema Therapist (CLT)
CLTs are healthcare professionals trained in the diagnosis and treatment of lymphedema. They specialize in helping patients manage their symptoms and reduce their risk of further lymphedema-related complications. To reduce lymphedema, CLTs utilize an intervention called Complete Decongestive Therapy (CDT). If you have been diagnosed with HNC, consulting with a CLT is a critical step toward managing your health and lymphedema long-term. Learn more about what to expect with lymphedema treatment in my blog post, "How is Lymphedema Treated?"
HNC treatments have come a long way over the years, but they still have side effects that can impact your daily life - like lymphedema. By understanding what it is, its signs and symptoms, risk factors, and strategies for managing it, you can protect yourself against further complications related to lymphedema. Remember, if you think you may have developed HNC lymphedema, speak up! Talk to your medical provider about it so they can refer you to a CLT who can provide proper management strategies tailored specifically for you.
References
Cohen EE, LaMonte SJ, Erb NL, Beckman KL, Sadeghi N, Hutcheson KA, Stubblefield MD, Abbott DM, Fisher PS, Stein KD, Lyman GH, Pratt-Chapman ML. American Cancer Society Head and Neck Cancer Survivorship Care Guideline. CA Cancer J Clin. 2016 May;66(3):203-39. doi: 10.3322/caac.21343. Epub 2016 Mar 22. Erratum in: CA Cancer J Clin. 2016 Jul;66(4):351. PMID: 27002678.
Jeans C, Brown B, Ward EC, Vertigan AE, Pigott AE, Nixon JL, Wratten C. Comparing the prevalence, location, and severity of head and neck lymphedema after postoperative radiotherapy for oral cavity cancers and definitive chemoradiotherapy for oropharyngeal, laryngeal, and hypopharyngeal cancers. Head Neck. 2020 Nov;42(11):3364-3374. doi: 10.1002/hed.26394. Epub 2020 Jul 31. PMID: 32735033.
