Salivary Gland Cancer

Signs and Symptoms

Salivary gland cancer may involve two primary glands:

• Parotid gland, the largest of the salivary glands in the upper portion of each cheek, close to the ear, with ducts that empty into the upper inside of the cheek
• Submandibular glands, in the floor of the mouth with ducts that empty near the lower front teeth.

Most cancers of these glands occur as painless lumps, either in front of the ear or under the jaw. Parotid cancers are more common than submandibular cancers. Some lumps can enlarge rapidly or be painful. Other symptoms may include facial weakness, fixation of the lump, sensory loss, ulceration, difficulty opening the jaw and tongue numbness or weakness.

Diagnosis

Needle biopsy is effective for diagnosis and is commonly recommended. Imaging studies including computerized tomography (CT) scan or magnetic resonance imaging (MRI) help delineate the tumor extent and status of neck lymph nodes.

Treatment

Surgery

Surgery is the mainstay of treatment for salivary gland cancers. The extent of surgery depends upon tumor type, size and location. A neck dissection is performed for removal of neck lymph nodes if they harbor tumor spread.

Radiation Therapy

Radiation therapy, also called radiotherapy, is the use of high-energy rays to damage cancer cells and stop them from growing. Like surgery, radiation therapy is local therapy. It affects only the cells in the treated area. The energy may come from a large machine, or external radiation. Patients with large tumors may need both surgery and radiation therapy. Radiation therapy is given after surgery for advanced or aggressive tumors.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Researchers are looking for effective drugs or drug combinations to treat salivary gland cancer. They are also exploring ways to combine chemotherapy with other forms of cancer treatment to help destroy the tumor and prevent the disease from spreading. Chemotherapy is given at the time of radiation therapy in select tumors usually in the setting of a therapeutic clinical trial. Chemotherapy is sometimes recommended if the cancer has spread to other locations in the body.