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Head and Neck Lymphedema Education

What is Lymphedema?

Lymphedema is swelling in the body caused by damage to the lymphatic system.

What is your Lymphatic system?

The lymphatic system is an essential part of your immune system. It is a large network of lymphatic vessels and lymph nodes that work together to move “lymph” throughout the body. Lymph is a watery fluid that circulates throughout the body, in a similar way to blood.

“Lymph nodes” are small pea-sized glands that monitor and clean lymph. There are about 600 lymph nodes in the human body. Areas with greater amounts of lymphnodes are the neck, armpits, and groin.

The lymphatic system is complex and very important. It helps transport and remove waste from the body, filters harmful substances to protect you from infection, and maintains your body's fluid levels.

What are signs and symptoms of Head and Neck Lymphedema?

• Swelling of the neck, face, tongue, or inside of the mouth
• Change in appearance of the head or neck
• Sensations of tightness, heaviness, firmness
• Skin feels different/hard

Lymphedema of the head and neck can contribute to difficulty swallowing, breathing, or easily moving your head or neck muscles (such as looking over your shoulder).

If you notice any of these signs or symptoms, contact your health care provider. Not all swelling is lymphedema. It is important for you to be fully evaluated.

What causes lymphedema to occur in the head and neck?

Lymphedema is common following HNC treatments due to the large number of lymph nodes found in the head and neck. When lymph nodes are removed or blocked it causes a build up of lymph fluid. This results in swelling.

The two main causes of lymphedema in the head and neck are:

1. Surgery
   
   • Purposeful removal of lymph nodes
   • Scar tissue from surgical removal of structures in the head & neck
2. Radiation Treatment
   • Damage to lymphatic vessels
   • Increases presence of scar tissue
   • Causes fibrosis over time (stiffening of tissue, lymph vessels, and lymph nodes)

Will my head and neck lymphedema go away on its own?  

Lymphedema is considered a "chronic" side effect of head & neck cancer surgery or radiation treatment. "Chronic" means long-term. Although there is no cure for lymphedema, it can be effectively treated and managed long-term. Lymphedema may decrease as your body heals. However, it will not significantly improve without treatment. After surgery or radiation treatment, your head and neck surgeon will evaluate for signs and symptoms of head and neck lymphedema. You will be referred to a speech-language pathologist or an occupational therapist to help treat and manage your lymphedema.

How do you treat Lymphedema in the head and neck?

Complete Decongestive Therapy (CDT) is the gold standard for lymphedema treatment.

CDT consists of four main parts:

1. Manual Lymph Drainage (MLD): MLD is a skin stretching massage that helps promote the movement of lymphatic fluid out of the blocked area. The goal is to improve the flow of lymphatic fluid. This will be completed by a trained therapist. You will learn how to complete this at home with the help of a family member.
2. Compression Therapy: Compression therapy is a critical part of lymphedema treatment. Use of a daily compression garment helps manage lymphedema long-term. Compression garments apply gentle pressure and promote proper lymph drainage. This helps reduce your swelling. Your speech therapist or occupational therapist will help find the proper compression garment specific for your needs.
3. Head and Neck Exercises: Range of motion exercises help increase mobility and decrease stiffening of muscles and tissues in the head and neck. These exercises will help promote lymph drainage in the head and neck. Your speech-language pathologist will teach these exercises to you.
4. Good Skin Care and Hygiene: It is very important to keep your skin healthy and clean to prevent infection. Patients with lymphedema are at a higher risk for skin infections. Bacteria can enter the body through dry areas or cracks in the skin. Moisturizers and lotions should be used daily to keep your skin clean and moist to prevent this from occurring.

Sleeping elevated

Elevation can improve your lymphedema directly after surgery or radiation treatment. Gravity helps your lymphedema.

Lymphedema often appears worse in the mornings. Elevating your head above your heart will allow the fluid to drain towards your chest. Elevation may also help decrease aches or pain associated with the fluid build up.

When am I allowed to start treatment?

You will be cleared to start CDT treatment once your tissue has completely healed from surgery or radiation therapy.

This generally occurs about 6-8 weeks after treatment.

Your surgeon or speech-language pathologist will let you know when you are cleared to begin lymphedema treatment.

Who can help answer questions I have about mylymphedema?

You can reach out to your head & neck surgeon, speech-language pathologist, occupational therapist, or clinic nurse.

 

For questions or concerns, call our head and neck cancer coordinator at (601) 984-5160.