Salivary Gland Cancer

The salivary glands produce saliva and release it into small ducts from which the saliva drains into the mouth.

The three major pairs of salivary glands are parotid glands (the largest of the salivary glands), sublingual glands, and submandibular glands. There are also hundreds of minor salivary glands in the mouth, nose, and throat.

Salivary gland cancer, a type of head and neck cancer, is rare. However, because there are so many salivary glands and diverse types of cells in each of them, there are hundreds of this type of cancer. The cause of most cancers of the salivary glands has not yet been determined.

Most salivary gland tumors form in the parotid glands. Fortunately, over half of salivary gland tumors are benign (noncancerous). Some factors that increase the risk of developing salivary gland cancer include:

• Working around plumbing, lead, asbestos, or manufacturing of plastics or rubber
• Radiation treatments to the head and neck
• Infection with the Epstein-Barr virus and HIV
• Aging

Cancer of the salivary gland may be present without any symptoms. It may be discovered during a medical or dental exam. However, if the following symptoms do occur, it is advisable to consult with an otolaryngologist who can properly test and render a diagnosis:

• A lump where the glands are found: inside the mouth, on the lip, jaw, cheek or near the ear
• Difficulty or discomfort with opening the mouth widely or swallowing
• Fluid draining from the ear

Upon diagnosing the presence of salivary gland cancer, a team of doctors headed by a medical oncologist will develop a plan for treatment. Ideally, this team will include physicians who have expertise in treating head and neck cancers. The doctors will consider the following factors to determine the prognosis and best course for recovery:

• The stage, grade, size, and type of tumor
• The type of salivary gland affected
• The type of cancerous cells – how they appear under a microscope
• The presence of cancer in other parts of the patient’s body
• The patient’s age, overall health and medical history

Among standard treatments, surgery is the most commonly prescribed, especially for slow-growing and early-stage tumors. It may entail excising an entire gland or a portion of it and taking out nearby lymph nodes. The doctor may remove other salivary glands if the cancer has spread to them. Chemotherapy and radiation are normally reserved for advanced cases or as a precaution to eradicate any trace cancer cells that were missed during surgery.

Other treatments involve clinical trials. A clinical trial is a study designed to gain information to help improve standard treatments and develop new treatments for cancer patients. If new treatments are successful, they could become standard treatments.

A salivary gland cancer patient may require assistance dealing with treatment and its side effects. The oncologist may refer the patient to an otolaryngologist who specializes in reconstructive surgery and rhinoplasty. The patient may also need to see other doctors such as dentists, speech therapists, and dietitians.