Swelling in the head and neck region is a common later effect of head and neck cancer treatment. Lymphedema is described as a chronic swelling that results from damage to the lymphatic system. When the flow of lymphatic fluid is disrupted, it can result in a build-up of lymphatic fluid, causing swelling. 

For head and neck cancer patients, this is commonly seen under the chin and in the neck, but can also occur on the face and even inside the mouth or throat.

Radiation to lymph nodes as well as removal of lymph nodes during surgery can lead to head and neck lymphedema. Estimates vary, but it has been estimated that roughly 50% of head and neck cancer patients will develop some level of lymphedema after treatment.

The main symptom of head and neck lymphedema is swelling. Lymphedema often arises between two and six months after cancer treatment. This is usually beyond the time that normal post-treatment swelling or inflammation is expected. 

Lymphedema can impact breathing, speaking, swallowing and neck mobility. It can also alter the appearance of the face and neck which can be distressing.

Often, the first sign of lymphedema is a feeling of 'heaviness' in the affected area. At later stages, obvious swelling, which may fluctuate throughout the day, may be present. In severe cases, the swelling can be hard and constant.

Treatment of lymphedema often includes manual lymphatic drainage techniques (a special form of massage), combined with compression garments and behavioural strategies.

A specially trained Speech-Language Pathologist can provide lymphedema treatment and educate regarding management strategies. There are also specially trained registered massage therapists (RMTs) who can provide this service. It is best to seek treatment as soon as possible to control lymphedema.

Strategies for Management:

• Seek professional treatment as soon as possible. Contact your Speech-Language Pathologist. If there is no specially trained therapist is available, the SLP can guide you towards other appropriate professionals
• Avoid wearing tight clothing around the neck
• Sleep with the head of the bed slightly elevated. Gravity helps to keep lymphatic fluid draining overnight. Often head and neck lymphedema is worst in the morning
• Maintain a healthy body weight
• Avoid overly hot showers and baths
• Stay active. Moderate exercise can help promote lymphatic drainage