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The effects of lymphoedema in the head and neck are not simply cosmetic - they can cause psychological distress and problems with communication, respiration, alimentation and movement.
Staff at the lymphoedema clinic at Singleton Hospital in Swansea found that people with head and neck cancer| who had swelling also had poor skin care, decreased range of movement in cervical spine and impaired shoulder movement.
The clinic had already established award-winning lymphoedema rehabilitation schemes for people with breast and gynaecological cancer, so we decided to set up a similar scheme for head and neck cancers. The scheme is for patients undergoing partial or full lymph node removal via neck dissection.
We have seen 26 patients to date. At the post-operative follow-up assessment, 82% of patients had limited range of movement, 24% had pain and 71% had swelling. These symptoms were managed accordingly. Of course these measures may change at the patient’s second follow-up. It was interesting to see the high percentages of limited range of movement and swelling.
Since coming into post, speech and language therapists have commented on the improvement in their patients’ swallowing and speech since my early intervention, and I have had positive feedback from the ear, nose and throat consultants.
Although lymphoedema is a significant complication of treatment for head and neck cancer, its presence in this population is generally under recognised and, in most cases, undertreated. The paucity of literature reflects this. Greater awareness through education is needed and we need to implement prevention schemes for this patient group.
We have more information about lymphoedema|.
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