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

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Abstract

Purpose

Head and neck cancer (HNC) patients are at risk for developing external and internal lymphedema. Currently, no documentation of symptom differences between individuals with and without head and neck lymphedema is available. The purpose of this analysis was to examine symptom differences among HNC patients with and without lymphedema.

Methods

Data were drawn from three cross-sectional studies of HNC patients >3 months post-cancer treatment (total N = 163; 128 patients with lymphedema, 35 without lymphedema). External lymphedema was evaluated via physical examination; internal lymphedema was identified through endoscopic examination. Participant’s head and neck lymphedema status was categorized into two groups: no indication of external or internal lymphedema and at least some indication of external or internal lymphedema. Lymphedema Symptom Intensity and Distress Survey-Head and Neck (LSIDS-H&N) was used to assess symptom burden. Descriptive statistics, McNemar, chi-squared, Wilcoxon signed-ranks, and Mann-Whitney tests were used.

Results

Twenty-three pairs of patients were identified and matched on the age, primary tumor site, tumor stage, and time since end of cancer treatment. Relative to patients without lymphedema, matched patients with lymphedema reported either increased symptom prevalence or severity or distress level for the following symptoms (prevalence differences of at least 15 % between the matched groups and p < 0.05): (1) numbness; (2) tightness; (3) heaviness; (4) warmth; (5) pain without head/neck movement; (6) problems swallowing mashed or pureed foods; (7) trouble breathing; (8) blurred vision; (9) feel worse when flying in an airplane; and (10) swelling.

Conclusions

Findings suggest that HNC-related lymphedema may be associated with substantial symptom burden. Studies with larger sample sizes are needed to replicate the findings.

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Acknowledgments

This research was supported by the Oncology Nursing Society Foundation and the Vanderbilt Office of Clinical and Translational Scientist Development.

Conflict of interest

None to declare

Funding

This research was supported by the Oncology Nursing Society Foundation and the Vanderbilt Office of Clinical and Translational Scientist Development.

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Authors and Affiliations

  1. School of Nursing, Vanderbilt University, 461 21st Ave. South, GH 516, Nashville, TN, 37240, USA

    Jie Deng, Mary S. Dietrich & Sheila H. Ridner

  2. Vanderbilt-Ingram Cancer Center, Nashville, TN, USA

    Barbara A. Murphy, Mary S. Dietrich, Robert J. Sinard, Kyle Mannion & Sheila H. Ridner

Authors
  1. Jie Deng
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  2. Barbara A. Murphy
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  3. Mary S. Dietrich
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  4. Robert J. Sinard
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  5. Kyle Mannion
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  6. Sheila H. Ridner
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Correspondence to Jie Deng.

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Deng, J., Murphy, B.A., Dietrich, M.S. et al. Differences of symptoms in head and neck cancer patients with and without lymphedema. Support Care Cancer 24, 1305–1316 (2016). https://doi.org/10.1007/s00520-015-2893-4

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  • DOI: https://doi.org/10.1007/s00520-015-2893-4

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