Assessing Impact of Early Physiotherapy on Lymphatic Dysfunction in Head and Neck Cancer Survivorship

Inclusion criteria

• Participants must be 18 years of age or older
• Participants must have previously been diagnosed with head and neck cancer and undergone surgery and radiation as part of their standard-of-care treatment plan
• Participants must be ≥ 4 weeks but less than 3 months post-radiation therapy at enrollment
• Female participants of childbearing potential must have a negative urine pregnancy test ≤ 36 hours prior to study drug administration
• Female participants of childbearing potential must agree to use a medically accepted method of contraception for a period of one month after each imaging session
• Male participants must agree to shave facial hair on imaging days
• Participants must be willing and able to independently use the pneumatic compression device at home daily for up to 12 months as directed by study personnel.

Exclusion criteria

• Persons who are pregnant or breast-feeding
• Females of child-bearing potential, who do not agree to use an approved contraceptive for one month after each imaging session
• Persons who do not meet inclusion criteria
• Iodine allergy
• Persons with a chest circumference of 150 cm or more
• Uncontrolled hyperthyroidism or parathyroidism (for which an endocrinologist recommends against neck compression)
• Carotid sinus hypersensitivity syndrome
• Symptomatic carotid artery disease, as manifested by a recent transient ischemic attack (within 30 days), ischemic stroke or amaurosis fugax (monocular visual ischemic symptoms or blindness)
• Symptomatic bradycardia in the absence of a pacemaker or internal jugular venous thrombosis (within 3 months)
• Increased intracranial pressure or other contraindication to internal or external jugular venous compression
• Acute radiation dermatitis, unhealed surgical scar, unhealed or open wound(s), surgical flap less than 6 to 8-weeks post-operative
• Facial or head and neck dermal metastasis
• Acute facial infection (e.g., facial, or parotid gland abscess)
• Heart failure (acute pulmonary edema, decompensated acute heart failure)
• Acute venous disease (acute thrombophlebitis, acute deep venous thrombosis, acute pulmonary embolism)
• Severe peripheral artery disease (critical limb ischemia including ischemic rest pain, arterial wounds, or gangrene)
• Active skin or limb infection/inflammatory disease (acute cellulitis, other uncontrolled skin, or untreated inflammatory skin disease)
• Any condition where increased venous and lymphatic return is undesirable