title: Differences of symptoms in head and neck cancer patients with and without lymphedema.
abstract: OBJECTIVE
  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.
authors: School of Nursing, Vanderbilt University, 461 21st Ave. South, GH 516, Nashville, TN, 37240, USA. jie.deng@vanderbilt.edu.
authors: Jie
authors: J
authors: Deng
authors: Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
authors: Barbara A
authors: BA
authors: Murphy
authors: School of Nursing, Vanderbilt University, 461 21st Ave. South, GH 516, Nashville, TN, 37240, USA.|Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
authors: Mary S
authors: MS
authors: Dietrich
authors: Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
authors: Robert J
authors: RJ
authors: Sinard
authors: Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
authors: Kyle
authors: K
authors: Mannion
authors: School of Nursing, Vanderbilt University, 461 21st Ave. South, GH 516, Nashville, TN, 37240, USA.|Vanderbilt-Ingram Cancer Center, Nashville, TN, USA.
authors: Sheila H
authors: SH
authors: Ridner
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications* / Q000628:therapy; D006801:Humans; D008209:Lymphedema / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged
keywords: Head and neck cancer; Head and neck lymphedema; Secondary lymphedema; Symptom