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Leading the way on lymphoedema research 

Tuesday 09 March 2021

Research into head and neck lymphoedema to date is limited but a PA Research Foundation funded project will not only change that, but also the way the condition is treated.

Affecting some cancer patients, head a neck lymphoedema can impact functions of the neck and face, such as neck movement, swallowing, speaking, opening and closing eyes, and even breathing.

Lymphoedema is soft tissue swelling that can occur in patients who have had their lymph nodes removed or damaged during surgery or radiation therapy, preventing lymph fluid from draining properly.

Inspired by a patient helped through a particularly bad case of head and neck lymphoedema, and thanks to receiving a PA Research Foundation research award, PA Hospital (PAH) Occupational Therapist Amanda Pigott is on a quest to redefine the way the condition is treated in the future – work that will untimely help patients across Queensland.

PAH Occupational Therapist Amanda Pigott

"We had a patient present for treatment with extremely severe head and neck lymphoedema. This young man's swelling was so severe it restricted him opening his eyes or using his mouth," Amanda said.

"The lymphoedema treatment we provided reduced his swelling and he was able to see his children and start to communicate again. The impact on the treating team and the patient was profound and we were driven to learn more about this condition and how we could best manage it."

Importantly for the Amanda, the study may guide the future of treatment for head and neck lymphoedema, as well as helping to identify why and when patients get head and neck lymphoedema.

The team's project entitled Head and neck lymphoedema: An examination and development of current standards of care aims to improve the standard of care for people with the condition. Firstly through developing a greater understanding of the development of internal and external head and neck lymphoedema and also by identifying effective treatments.

As a part of the project the team has used a novel head and neck imaging technology called an ICG lymphography to inform their work which has already produced encouraging results.

"ICG lymphatic imaging enables us to visualize a person's lymphatic system through the skin, a dye is injected into the body and a hand-held infra-red camera is used to watch this dye travel through the lymphatic system," Amanda said.

"The imaging helps us work out which parts of the lymphatic system are working well, and which parts are being obstructed. Before ICG lymphatic imaging, each person with head and neck, lymphoedema received the same treatment which was based on the way we assumed the lymphatic system drained fluid through the body.

"What we found was that after cancer treatment, people with head and neck lymphoedema can have very different lymphatic drainage pathways, it has allowed us to understand how each individual's anatomy is different. The ICG lymphatic imaging has facilitated the development of a personalised treatment program for each research participant to maximise the impact of their treatment."

Though impacted by Covid-19, the project also sought to share their findings among the wider health community of Queensland so that patients with the condition right across the state can benefit from their findings.

Lymphoedema therapists who include both Occupational Therapists and Physiotherapists, use a variety of treatment methods to reduce swelling including massage, compression, exercise, skin care, taping, and laser treatment. The team hopes to train more allied health professionals to become lymphoedema therapists so more patients can be treated closer to their own homes.

Though it can be distressing for patients due to its impact on their quality of life, lymphoedema remains a largely unknown condition among the general public which makes the research conducted at the PAH all the more vital.

Amanda had a simple message for anyone considering supporting her team's research.

"Thank you for considering supporting lymphoedema research. Your generosity will help improve people's quality of life and their ability to participate in activities and they are passionate about," she said.

"Lymphoedema can be a life-long condition and research in improving its management can have a lasting impact on people's lives. Without Foundation funding, this research would not have been possible."

Donate to support research into head and neck lymphedema here.