Photobiomodulation Therapy for the Treatment of Lymphedema in Head and Neck Cancer Survivors

Inclusion Criteria

• > 18 years of age
• Biopsy proven head and neck cancer
• No evidence of cancer at the time of study enrollment, between 12 and 60 months post-cancer treatment
• Chronic lymphedema (defined as lymphedema persisting for a minimum of 6 months)
• A minimum of 2 sites of external lymphedema
• At least 1 site with lymphedema of moderate severity as assessed using the Head and Neck - External Lymphedema and Fibrosis (HN-LEF) assessment criteria
• Failed lymphedema therapy (defined as any of the following: incomplete response to therapy, progression of lymphedema after therapy, inability to perform effective self-care resulting in fluid re-accumulation; and inability to complete treatment due to systems barriers)
• Patients must be able to understand English in order to complete questionnaires and to provide informed consent

Exclusion Criteria

• Patients will be excluded if they have any of the following medical conditions that would prohibit the safe implementation of PBMT: women of childbearing age and potential; acute cellulitis within the soft tissues in the head and neck region; chronic inflammatory diseases; venous thrombosis; carotid artery stenosis; requiring ongoing use of diuretics and corticosteroids for head and neck edema; or pre-existing skin rash, ulceration, open wound in the treatment area; active lymphedema or physical therapy (including hyperbaric oxygen) for head and neck lymphedema and fibrosis); and allergic and other systemic skin diseases * Rational for exclusion of women of childbearing age and potential: Head and neck cancer is more common in men than in women. Furthermore, the average age of diagnosis of head and neck cancer is between 55 and 65 years. We will exclude women of childbearing age and potential due to the challenges of monitoring pregnancy over the protracted period of study conduct. Specifically, woman who are post-menopausal for > 1 year or status post hysterectomy will be considered candidates
• Acute infection: Individuals with a diagnosis of acute cellulitis within the soft tissue in the head and neck region will be excluded from the study until such time as the infection resolves
• Patients requiring ongoing use of diuretics and corticosteroids for head and neck edema will be excluded