{"id":16076,"date":"2014-06-02T11:03:51","date_gmt":"2014-06-02T18:03:51","guid":{"rendered":"http:\/\/oralcancernews.org\/wp\/?p=16076"},"modified":"2014-06-02T11:03:51","modified_gmt":"2014-06-02T18:03:51","slug":"internal-lymphedema-causes-swallow-dysfunction-among-patients-with-head-and-neck-cancer","status":"publish","type":"post","link":"https:\/\/oralcancernews.org\/wp\/internal-lymphedema-causes-swallow-dysfunction-among-patients-with-head-and-neck-cancer\/","title":{"rendered":"Internal lymphedema causes swallow dysfunction among patients with head and neck cancer"},"content":{"rendered":"
Author: Bryant Furlow<\/address>\n
Source: oncologynurseadvisor.com<\/address>\n
\u00a0<\/address>\n

CHICAGO, IL\u2014 Treatment-related dysphagia symptoms are likely caused by internal lymphedema among patients with head and neck cancer, according to research presented at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting.<\/p>\n

\u201cInternal lymphedema (correlated with subjective and objective measures of swallow dysfunction,\u201d said lead author Leanne Kolnick Jackson, MD, at the Vanderbilt University Medical Center, Nashville, Tennessee. \u00a0\u201cMost of the time patients have silent aspiration, which is most dangerous. So if a patient ever says they have dysphagia, it warrants an exam\u201d including imaging as well as endoscopy, Jackson said.<\/p>\n

External lymphedema is visible and recognizable, but internal lymphedema\u2014which occurs in up to 90% of cases of external lymphedema\u2014can go undetected, the coauthors noted.<\/p>\n

\u201cExternal lymphedema is just the tip of the iceberg,\u201d said senior author Barbara A. Murphy, MD, of Vanderbilt University Medical Center. \u201cOnly 10% of patients with lymphedema have only external lymphedema.\u201d<\/p>\n

Secondary lymphedema and fibrosis are \u201cubiquitous and underreported\u201d late effects among patients with head and neck cancers, Jackson reported.<\/p>\n

Using the Vanderbilt Head and Neck Symptom Survey (VHNSS) version 1.0, the researchers collected patient-reported swallow dysfunction among study participants undergoing treatment for head and neck cancer. They subsequently studied patients’ swallow function and internal lymphedema, using endoscopic assessments, modified-barium videofluoroscopy, the Dysphagia Outcome and Severity Scale (DOSS), and National Outcomes Measurement System (NOMS).<\/p>\n

Endoscopy does not detect internal lymphedema well \u201cfor every site,\u201d Jackson noted. \u201cSome sites are not well evaluated by endoscopy.\u201d<\/p>\n

At 18 months posttreatment, VHNSS swallow\/nutrition scores correlated with \u201cmaximum grade of swelling for any single structure\u201d but VHNSS and NOMS score correlations were strongest for inflammation of the aryepiglottic and pharyngoepiglottic folds, epiglottis, and pyriform sinus, (P<\/i>s < .004). Internal lymphedema was more strongly correlated with the NOMS than the DOSS, Jackson noted.<\/p>\n

Longitudinal analysis of the trajectory and impact of lymphedema on dysphagia is ongoing, with 100 patients enrolled to date, she said.<\/p>\n

Abstract\u00a0#6051<\/p>\n

Clinical trial information:\u00a0NCT01187173<\/p>\n<\/address>\n
\u00a0<\/address>\n
* This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.<\/span><\/address>\n
\u00a0<\/address>\n
\u00a0<\/span><\/p>\n<\/address>\n","protected":false},"excerpt":{"rendered":"

Author: Bryant Furlow Source: oncologynurseadvisor.com \u00a0 CHICAGO, IL\u2014 Treatment-related dysphagia symptoms are likely caused by internal lymphedema among patients with head and neck cancer, according to research presented at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting. \u201cInternal lymphedema (correlated with subjective and objective measures of swallow dysfunction,\u201d said lead author Leanne Kolnick Jackson, MD, at the Vanderbilt University Medical Center, Nashville, Tennessee. \u00a0\u201cMost of the time patients have silent aspiration, which is most dangerous. So if a patient ever says they have dysphagia, it warrants an exam\u201d including imaging as well as endoscopy, Jackson said. External lymphedema is visible and recognizable, but internal lymphedema\u2014which occurs in up to 90% of cases of external lymphedema\u2014can go undetected, the coauthors noted. \u201cExternal lymphedema is just the tip of the iceberg,\u201d said senior author Barbara A. Murphy, MD, of Vanderbilt University Medical Center. \u201cOnly 10% of patients with lymphedema have only external lymphedema.\u201d Secondary lymphedema and fibrosis are \u201cubiquitous and underreported\u201d late effects among patients with head and neck cancers, Jackson reported. Using the Vanderbilt Head and Neck Symptom Survey (VHNSS) version 1.0, the researchers collected patient-reported swallow dysfunction among study participants undergoing treatment for head and neck cancer. They subsequently studied patients’ swallow function and internal lymphedema, using endoscopic assessments, modified-barium videofluoroscopy, the Dysphagia Outcome and Severity Scale (DOSS), and National Outcomes Measurement System (NOMS). Endoscopy does not detect internal lymphedema well \u201cfor every site,\u201d Jackson noted. \u201cSome sites are not well evaluated by endoscopy.\u201d At 18 months posttreatment, […]<\/p>\n","protected":false},"author":41,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[1014,4784,4785,256,4781],"class_list":["post-16076","post","type-post","status-publish","format-standard","hentry","category-oral_cancer_news","tag-american-society-of-clinical-oncology","tag-dysphagia-symptoms","tag-external-lymphedema","tag-head-and-neck-cancer","tag-internal-lymphedema"],"_links":{"self":[{"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/posts\/16076","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/users\/41"}],"replies":[{"embeddable":true,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/comments?post=16076"}],"version-history":[{"count":3,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/posts\/16076\/revisions"}],"predecessor-version":[{"id":16078,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/posts\/16076\/revisions\/16078"}],"wp:attachment":[{"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/media?parent=16076"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/categories?post=16076"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/tags?post=16076"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}