Fox Chase and Temple University Hospital to Participate in Study on Management of Head and Neck Cancer Lymphedema

Jeffrey Liu, MD, FACS, surgeon in the Division of Head and Neck Surgery and an associate professor in the Department of Surgical Oncology.
Jeffrey Liu, MD, FACS, surgeon in the Division of Head and Neck Surgery and an associate professor in the Department of Surgical Oncology.

PHILADELPHIA (April 28, 2022)—Researchers at Fox Chase Cancer Center and Temple University Hospital will participate in a $3 million multisite study on the use of telehealth for lymphedema management in head and neck cancer survivors.

“Patients with head and neck cancer treated with radiation alone or in combination with surgery sometimes develop a side effect called lymphedema after treatment,” said Jeffrey C. Liu, MD, FACS, an associate professor in the Department of Surgical Oncology at Fox Chase, director of  Head and Neck Oncologic Surgery at Temple University Hospital and associate professor of Otolaryngology – Head and Neck Surgery at the Lewis Katz School of Medicine at Temple University.

“The radiation destroys the natural draining of the lymphatic system, and this damage and the resulting scar tissue can lead to a buildup of fluid that doesn’t drain,” he added.

Patients with lymphedema may have a swollen jaw or neck and can experience a great deal of discomfort and pain. The lymphedema can limit head movement and alter physical appearance, Liu said.

Lymphedema can be effectively treated with complete decongestive therapy (CDT). With CDT, a patient sees a certified lymphedema therapist who can help to massage the damaged tissue—either with their hands or a device—to move the buildup of fluid and reduce swelling. The therapist can also teach the patient techniques to do at home.

A similar technique is frequently used for extremities in other conditions like breast cancer, but treatment of lymphedema of the head and neck requires specialized knowledge and training by lymphedema therapists. 

The funding award from the Patient-Centered Outcomes Research Institute was also awarded to researchers at the Perelman School of Medicine at the University of Pennsylvania; the study will also include researchers from Jefferson Health.

They will conduct a randomized clinical trial comparing two ways to administer lymphedema therapy to survivors of head and neck cancer. Patients will be assigned to either the standard clinic-based lymphedema therapy or a hybrid home-based lymphedema therapy initiated after an on-site evaluation and setup.

“The problem with this specialized therapy is that it involves a lot of appointments, which can be demanding on a patient who has just completed cancer therapy. We are trying to reduce the burden of treatment by exploring if lymphedema therapy can be delivered just as effectively using telehealth and a hybrid platform,” Liu said.

“We will be looking at the physical reduction of the lymphedema and several patient-reported outcomes like symptom relief,” he added.

If the hybrid model is as effective or more effective than the clinic-based model, this will help guide ways to provide this specialized care to a greater number of patients, especially those who don’t live near sites where such therapy is available. 

“Lymphedema therapy is a specialized and effective therapy in the survivorship space that can help patients reduce their symptom burden after their head and cancer treatment,” Liu said. “We hope to be able to help more patients by expanding the radius of access, but want to ensure it works just as well or better than clinic-based therapy.”

Fox Chase Cancer Center (Fox Chase), which includes the Institute for Cancer Research and the American Oncologic Hospital and is a part of Temple Health, is one of the leading comprehensive cancer centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase is also one of just 10 members of the Alliance of Dedicated Cancer Centers. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence six consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.

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