Prevalence of lymphedema symptoms across cancer diagnoses and association with depression, pain interference and health-related quality of life

Authors

  • Gitte Sone Larsen Danish Cancer Society National Cancer Survivorship and Late Effects Research Center (CASTLE), Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark https://orcid.org/0009-0008-1347-9715
  • Christoffer Johansen Danish Cancer Society National Cancer Survivorship and Late Effects Research Center (CASTLE), Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark https://orcid.org/0000-0002-4384-206X
  • Annika von Heymann Danish Cancer Society National Cancer Survivorship and Late Effects Research Center (CASTLE), Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark https://orcid.org/0000-0002-0900-5575
  • Bolette Skjødt Rafn Danish Cancer Society National Cancer Survivorship and Late Effects Research Center (CASTLE), Department of Oncology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark https://orcid.org/0000-0001-8269-3100

DOI:

https://doi.org/10.2340/1651-226X.2025.42203

Keywords:

cancer-related late-effects, cancer survivorship, swelling, heaviness

Abstract

Background and purpose: Lymphedema is a debilitating late effect of cancer treatments, yet its prevalence beyond breast cancer remains understudied. This study examined the prevalence of lymphedema symptoms across cancer diagnoses and their association with depression, pain interference, and health-related quality of life (HRQoL).

Patients/Material and methods: This cross-sectional study was conducted at the Department of Oncology, Copenhagen University Hospital, from February to April 2021, as part of a broader investigation into cancer-related late effects. Here, we present data from patients in follow-up who received online lymphedema symptom assesments (swelling, heaviness, or tightness). Utilized questionnaires were the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, the Major Depression Inventory, and the Brief Pain Inventory. Associations between lymphedema symptoms and depression, pain interference, and HRQoL were examined via multiple linear regression.

Results: Of 1,901 patients in follow-up who received the lymphedema symptom items, 1,296 responded. Most participants had breast cancer (48%), followed by testicular (17%), gynecological (16%), and head/neck cancer (11%). One-third (n = 397) reported lymphedema symptoms, with 38% (n = 152) reporting moderate/severe symptoms. The highest symptom prevalence was seen in gynecological cancer (59%), followed by head/neck (41%), breast (21%), and testicular cancer (19%). Participants with moderate/severe lymphedema symptoms were significantly more likely to report higher depression and pain interference scores and lower HRQoL scores compared to those with no/mild symptoms.

Interpretation: Lymphedema symptoms are highly prevalent among patients who have completed treatment for diverse cancers and associated with higher scores for depression and pain interference, and lower HRQoL

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Additional Files

Published

2025-01-21

How to Cite

Larsen, G. S., Johansen, C., von Heymann, A., & Rafn, B. S. (2025). Prevalence of lymphedema symptoms across cancer diagnoses and association with depression, pain interference and health-related quality of life. Acta Oncologica, 64, 87–95. https://doi.org/10.2340/1651-226X.2025.42203