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Improving the lives of patients with lymphoedema in the head and neck

Published:Wednesday | July 1, 2015 | 12:00 AMDr Bernadette Bryan-Frankson

Commonly seen as a side effect of cancer treatment to the face, mouth and neck regions, lymphoedema can be quite depressing for the patient who may be embarrassed and frustrated by the disfigurement that the swelling can cause.

The effects of head and neck lymphedema are not just cosmetic. When lymphoedema affects the lips, tongue, eyes, or throat, it can cause functional problems that could be life-threatening. Swelling of the face, mouth and neck can substantially impede speaking and swallowing. Swelling around the eyes may affect reading, writing and even walking. Lymphoedema that affects the airway may result in difficulty breathing.

Lymphoedema is commonly associated with swelling associated with breast cancer patients and genitourinary cancer and the condition known as 'elephantiasis', which is a more advanced swelling which often affects the legs.

It can, however, also involve the head and neck region.

Treating Head and Neck Lymphoedema

Complete Decongestive Therapy is the gold standard for the treatment of lymphoedema. Its goal is to move lymphatic fluid away from congested areas through unimpaired pathways. This therapy combines manual lymph drainage, which uses gentle manual techniques; compression to prevent swelling from recollecting; exercises to maintain tissue flexibility; and range of motion and skin care education.

Compression garments are fitted early during the treatment phase, as they help to reduce swelling which tends to collect overnight and is usually worse in the morning and reduce during the day.

Whereas the goal is to eliminate swelling, there is usually improvement in almost all cases, leading to a more confident patient with improved quality of life and functional ability. Lymphoedema in the neck and head is very responsive to treatment.

In Jamaica, lymphoedema of the head and neck is managed by a trained physical therapist who has specialised in lymphoedema.

It is recommended that if swelling hasn't settled within a month of completing medical or surgical treatment, they should be referred to the Lymphoedema therapist.

Treatment is undertaken for approximately six months, but the patient is actively a part of the process, as he or she has to learn how to control the swelling.

n Dr Bernadette Bryan-Frankson PT MBA DPT CPT is a trained lymphoedema

therapist who operates out of Physical Therapy Solutions.