TY - JOUR
T1 - The development and treatment of lymphatic dysfunction in cancer patients and survivors
AU - Aldrich, Melissa B.
AU - Rasmussen, John C.
AU - Fife, Caroline E.
AU - Shaitelman, Simona F.
AU - Sevick‐Muraca, Eva M.
N1 - Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2020/8
Y1 - 2020/8
N2 - Breast‐cancer‐acquired lymphedema is routinely diagnosed from the appearance of irreversible swelling that occurs as a result of lymphatic dysfunction. Yet in head and neck cancer survivors, lymphatic dysfunction may not always result in clinically overt swelling, but instead contribute to debilitating functional outcomes. In this review, we describe how cancer metastasis, lymph node dissection, and radiation therapy alter lymphatic function, as visualized by near-infrared fluorescence lymphatic imaging. Using custom gallium arsenide (GaAs)‐intensified systems capable of detecting trace amounts of indocyanine green administered repeatedly as lymphatic contrast for longitudinal clinical imaging, we show that lymphatic dysfunction occurs with cancer progression and treatment and is an early, sub‐clinical indicator of cancer‐acquired lymphedema. We show that early treatment of lymphedema can restore lymphatic function in breast cancer and head and neck cancer patients and survivors. The compilation of these studies provides insights to the critical role that the lymphatics and the immune system play in the etiology of lymphedema and associated co‐morbidities.
AB - Breast‐cancer‐acquired lymphedema is routinely diagnosed from the appearance of irreversible swelling that occurs as a result of lymphatic dysfunction. Yet in head and neck cancer survivors, lymphatic dysfunction may not always result in clinically overt swelling, but instead contribute to debilitating functional outcomes. In this review, we describe how cancer metastasis, lymph node dissection, and radiation therapy alter lymphatic function, as visualized by near-infrared fluorescence lymphatic imaging. Using custom gallium arsenide (GaAs)‐intensified systems capable of detecting trace amounts of indocyanine green administered repeatedly as lymphatic contrast for longitudinal clinical imaging, we show that lymphatic dysfunction occurs with cancer progression and treatment and is an early, sub‐clinical indicator of cancer‐acquired lymphedema. We show that early treatment of lymphedema can restore lymphatic function in breast cancer and head and neck cancer patients and survivors. The compilation of these studies provides insights to the critical role that the lymphatics and the immune system play in the etiology of lymphedema and associated co‐morbidities.
KW - Breast cancer‐related lymphedema
KW - Head and neck cancer
KW - Indocyanine green
KW - Lymphatic imaging
KW - Lymphedema
KW - Near‐infrared fluorescence imaging
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U2 - 10.3390/cancers12082280
DO - 10.3390/cancers12082280
M3 - Review article
C2 - 32823928
AN - SCOPUS:85090254419
SN - 2072-6694
VL - 12
SP - 1
EP - 25
JO - Cancers
JF - Cancers
IS - 8
M1 - 2280
ER -