What causes ‘turkey’ neck after cancer treatment?

“Turkey neck”, “puffy neck”, “jelly neck”, and “waddle” are common ways patients describe secondary lymphedema.  After head and neck cancer treatment, someone may experience swelling in the cheeks, lips, neck, under the chin, and inside the mouth. Physical appearance of swelling that feels fluid-like under the skin accompanied by patient sensation of the affected area feeling heavy and tight typically warrant a referral for a lymphedema evaluation which can be completed by OT, ST, or PT. It’s important the physician rules out other underlying causes so that it can be treated safely and effectively. 

Secondary lymphedema occurs when there is a disruption to the lymphatic system which can occur following cancer treatment from radiotherapy and surgery. The lymphatic system is part of the body’s immune system and includes lymph fluid and lymph nodes. This system acts as a filter to keep the body healthy.  A recent literature review reports secondary head and neck lymphedema is often underdiagnosed and impacts anywhere from 12-54% of patients treated for head and neck cancer (Anand, 2018). 

When lymph nodes are removed or radiated this impacts the body’s ability to move or pump lymphatic fluid. When the fluid is not moved, it begins to build up resulting in lymphedema. 

Taylour Campbell, MS CCC-SLP