Lymphedema in head and neck cancer survivors From diagnosis to daily life

This thesis describes research on lymphedema following head and neck cancer (HNC) treatment, focusing on its prevalence, impact, measurement, and clinical practice variations. It is divided into three sections:
Living with Head and Neck Lymphedema: This section explores patient experiences and quality of life impacts through qualitative and quantitative studies. Key findings include the difficulty in distinguishing lymphedema from other symptoms and its limited impact on the quality of life and body image of the patients included in these studies.
Measuring Head and Neck Lymphedema: This section includes a systematic review and studies on measurement instruments. The revised Patterson scale is highlighted as a reliable tool for internal lymphedema. The following two studies focus on measuring the Percentage Water Content (PWC), as measured with the LymphScanner, which is one way in which lymphedema could be quantified with good clinical applicability. The test-retest study showed good reliability, and a healthy reference values study highlighted the importance of considering sex in comparisons.
Clinical Implications: Chapter 7 describes an international Delphi study among experts in the field of head and neck lymphedema. There is strong practice variation and a lack of consensus on almost all of the investigated topics. This calls for more robust evidence and guidelines. The last two studies focus on internal lymphedema: the first on the relationship between obstructive sleep apnea (OSA) and internal lymphedema, and the second on differences in lymphedema severity after unilateral or bilateral radiotherapy.