Some patients have surgery to remove lymph nodes in one or both sides of the neck. This is called neck dissection(s). This can cause changes in the neck and shoulder. After surgery, the skin in the area becomes tighter and thicker as the scar heals. Radiotherapy, especially after surgery, can also cause tightness in the skin and tissue in the neck area. Your neck may feel stiff when you move your head. It may be numb in places, especially around the scar and ear lobe. This often improves over time but does not always recover completely. As the scar heals, you may feel pricking, tingling or numbness on the skin as the nerves repair. Your neck may also be more sensitive to touch, heat or cold. Gentle massage with a non-perfumed cream or oil will keep. This can also help make the scar line smoother.

Your specialist team, especially the physiotherapist will talk to you about:

• neck and shoulder exercises
• changes to your posture
• massage
• safe ways of returning to physical activity.

Lymphoedema (swelling of the face or neck)

After surgery, it is common to have some swelling to your face or neck, but this usually goes away within a few weeks.   You are more likely to have longer-term swelling if you have an operation to remove lymph nodes from your neck or had radiotherapy after your surgery.

This swelling happens because the channels (lymphatic system), which normally drain fluid away is distributed by the treatment and it can lead to a build-up of fluid.  This is called lymphoedema.

One of the main ways of treating lymphoedema is massage and exercises.  The massage is called manual lymphatic drainage (MLD), which encourages and improves the movement of fluid from the swollen area. This leaflet from the British Lymphoedema Society provides some advice on managing lymphoedema (Folder titled Section 8 Treatment – BLS Lymphoedema adviceYour physiotherapist may also give you advice following your surgery on how best to manage this, or your cancer specialist team can refer you to a lymphoedema therapist.  There is also more information on Lymphoedema provided by Macmillan Cancer Support: https://www.macmillan.org.uk/cancer-information-and-support/impacts-of-cancer/lymphoedema