Overview
Salivary gland cancer is a type of cancer that originates in the salivary glands. Salivary glands are responsible for producing saliva that aids in digestion, keeps the mouth moist, and supports healthy teeth. Salivary gland tumors can develop in any of the three major pairs of salivary glands located under and behind the jaw (parotid, sublingual, and submandibular), as well as in numerous smaller salivary glands throughout the mouth and throat. Salivary gland tumors can be either benign (noncancerous) or malignant (cancerous). Benign tumors do not spread to other parts of the body and are typically less concerning than cancerous tumors. However, cancerous tumors can invade nearby tissues and potentially spread to other parts of the body, making them more dangerous. Some of the types of cancerous (malignant) salivary gland tumors include acinic cell carcinoma, adenocarcinoma, adenoid cystic carcinoma, clear cell carcinoma, malignant mixed tumor, mucoepidermoid carcinoma, oncocytic carcinoma, polymorphous low-grade adenocarcinoma, salivary duct carcinoma, squamous cell carcinoma, and others. The exact cause of salivary gland cancer is not clear, but factors such as older age, radiation exposure (e.g., from previous cancer treatments), and workplace exposure to certain substances may increase the risk of developing these tumors. If you have any persistent signs or symptoms, such as a lump or swelling near your salivary gland, numbness, muscle weakness, pain, difficulty swallowing, or trouble opening your mouth widely, it is important to consult with your doctor for proper evaluation and management.
Understanding the disease
Symptoms
Symptoms of salivary gland cancer may include:
- A lump or swelling on or near your jaw or in your neck or mouth
- Numbness in part of your face
- Muscle weakness on one side of your face
- Persistent pain in the area of a salivary gland
- Difficulty swallowing
- Trouble opening your mouth widely It is important to note that having a lump or an area of swelling near your salivary gland is the most common sign of a salivary gland tumor, but it doesn't necessarily mean you have cancer. Many other noncancerous conditions may lead to a swollen salivary gland, including infections or stones in a salivary gland duct.
Risk Factors
The risk factors for developing salivary gland cancer include older age, radiation exposure, and workplace exposure to certain substances. Radiation treatments for cancer, such as radiation used to treat head and neck cancers, may increase the risk of salivary gland tumors. Jobs associated with increased risk include those involved in rubber manufacturing, asbestos mining, and plumbing.
Development
Salivary gland tumors develop when cells in the salivary glands acquire genetic mutations in their DNA. These mutations cause the cells to grow and divide uncontrollably, forming a tumor. Salivary gland tumors can be either benign (noncancerous) or malignant (cancerous). The various types of salivary gland tumors are classified based on the type of cells involved in the tumor. Some common types of salivary gland tumors include pleomorphic adenoma, basal cell adenoma, canalicular adenoma, Oncocytoma, Warthin tumor, acinic cell carcinoma, adenocarcinoma, adenoid cystic carcinoma, clear cell carcinoma, malignant mixed tumor, mucoepidermoid carcinoma, oncocytic carcinoma, polymorphous low-grade adenocarcinoma, salivary duct carcinoma, and squamous cell carcinoma. Risk factors for salivary gland tumors include older age and previous exposure to radiation, such as from radiation therapy for head and neck cancers. Workplace exposure to certain substances, like those found in rubber manufacturing, asbestos mining, and plumbing, may also increase the risk of salivary gland tumors.
Assessment and Diagnosis
Triage
If you suspect salivary gland cancer, you should see a doctor if you have any persistent signs or symptoms that worry you. These may include:
- A lump or swelling on or near your jaw or in your neck or mouth
- Numbness in part of your face
- Muscle weakness on one side of your face
- Persistent pain in the area of a salivary gland
- Difficulty swallowing
- Trouble opening your mouth widely Your doctor will likely investigate other more common causes for your signs and symptoms first, such as an infection. If salivary gland cancer is suspected, you may be referred to a specialist such as an otolaryngologist or head and neck surgeon for further evaluation and treatment.
Diagnosis
To diagnose salivary gland cancer, your doctor will typically perform a physical exam, which includes feeling your jaw, neck, and throat for lumps or swelling. Other diagnostic tests may include imaging tests, such as MRI, CT, PET, ultrasound, or X-ray, to determine the size and location of the tumor. In some cases, a biopsy is recommended to collect a sample of tissue for testing. This can be done through fine-needle aspiration or a core needle biopsy. Once the cancer is diagnosed, your doctor will determine the extent (stage) of the cancer using staging tests like endoscopy, imaging tests, or other procedures as appropriate. Treatment for salivary gland cancer usually involves surgery to remove the tumor, with additional options like radiation therapy and chemotherapy for some cases.
Management and Treatment
Complications
Complications of salivary gland cancer may include:
- Spread (metastasis) of cancer to nearby tissues or other parts of the body, such as the lymph nodes, bones, or lungs.
- Invasion of cancer into nearby structures, such as the nerves or blood vessels, which can cause pain or functional damage.
- Infection: Salivary gland cancer can make it difficult for saliva to drain properly, increasing the risk of infections in the affected gland or surrounding area.
- Nerve damage: The tumor or treatment procedures, such as radiation therapy, may cause damage to the nerves in the head and neck region, leading to problems with facial movement, speech, or hearing.
- Nutritional problems: Difficulty swallowing or the presence of a tumor in the gland can interfere with the proper functioning of the digestive system, potentially leading to weight loss, dehydration, or malnutrition.
- Treatment side effects: Treatments for salivary gland cancer, such as surgery, radiation therapy, or chemotherapy, can cause complications like skin reactions, hair loss, fatigue, nausea, or vomiting. It is essential to work closely with a healthcare professional and follow their recommendations for managing these potential complications.
Home Remedies
It is important to consult with a healthcare professional for proper diagnosis and treatment recommendations for salivary gland cancer.
Treatment
Treatment for salivary gland tumors, including cancerous (malignant) tumors, usually involves surgery to remove the tumor. Depending on the size and location of the tumor, different surgical approaches may be used. Some possible surgical options include:
- Simple excision: This involves removing the tumor along with some surrounding healthy tissue.
- Radical excision: In this procedure, the surgeon removes the tumor along with a margin of healthy tissue around it, as well as the lymph nodes in the area. This is typically done for more aggressive tumors or those that have spread to nearby structures.
- Endoscopic surgery: In some cases, a surgeon may use an endoscope, a thin, lighted instrument, to access and remove smaller tumors through small incisions in the mouth or throat. In addition to surgery, people with salivary gland cancer may require further treatments, such as:
- Radiation therapy: This involves using high-energy X-rays or other types of radiation to kill cancer cells. Radiation therapy may be given externally (from a machine outside the body) or internally (using radioactive substances placed inside the body near the tumor).
- Chemotherapy: This involves using drugs to kill cancer cells. Chemotherapy may be given systemically (through the bloodstream to reach cells throughout the body) or locally (applied directly to the tumor).
- Targeted therapy: This involves using drugs or other substances to identify and attack specific types of cancer cells with less harm to normal cells. The choice of treatment depends on various factors, including the type and stage of the tumor, the patient's overall health, and personal preferences. Your healthcare provider will help determine the best treatment plan for your specific situation.
Preparing for medical consultation
To prepare for an appointment for salivary gland cancer, you should:
- Write down a list of questions to ask your doctor, prioritizing the most important ones.
- Provide your doctor with a detailed medical history, including any symptoms you've experienced, any medications you are taking, and any previous medical procedures you've undergone.
- Prepare a list of your current medications and supplements to share with your doctor.
- Bring any relevant medical records, imaging results, or test reports to your appointment.
- Be ready to discuss any concerns you may have about your diagnosis, treatment options, and potential side effects.
- Consider bringing a family member or friend along for support, if needed. Remember to be open and honest with your doctor about your health concerns and any questions you may have. This will help ensure that you receive the best possible care and treatment for your condition.