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What is Salivary Gland Cancer?
Salivary gland cancer starts in one of the salivary glands. It’s not just a single disease. There are actually several different salivary glands found inside and near your mouth. Many types of cancer and benign (non-cancerous) tumors can develop in these glands.
Salivary Gland Cancer facts
Salivary gland cancer facts medically edited by Charles Patrick Davis, MD, PhD
- Salivary gland cancer is a type of head and neck cancer that involves abnormal (malignant) growth of salivary gland cells.
- Factors that increase the risk of salivary gland cancer include older age, radiation therapy to the head and neck, or exposure to cancer-causing chemicals at work.
- Symptoms and signs of salivary gland cancer include painless lump(s) in the area of the ear, cheek, jaw, lips, or mouth and/or fluid draining from the ear, trouble swallowing, difficulty opening the mouth, numbness or weakness to the face, and/or facial pain.
- The following exams and tests are used to detect and diagnose salivary gland cancer: physical exam and history, MRI, CT scan, PET scan, ultrasound, endoscopy, and biopsy of tissue suspected to be cancerous.
- The prognosis for salivary gland cancer is variable and depends on the size of the tumor, the type of cancer, the type of salivary gland tissue involved, and the patient’s age and general health.
- CT and MRI scans are usually done to determine if salivary gland cancer has spread to other tissues.
- Salivary gland cancer cells can spread directly to adjacent tissues or spread to other organs by going through the lymphatic system or through the blood.
- Salivary gland cancer has four stages: stage I being confined to the salivary glands and is 2 cm or smaller; stage II is larger than 2 cm but not larger than 4 cm; stage III has spread to a lymph node or to soft tissue around the affected gland; and stage IV has spread further.
- Three types of standard treatment are used for salivary gland cancer surgery, radiation therapy, and chemotherapy some patients may receive more than one type of treatment.
- Staging affects choices of therapy; the higher the stage, the more likely the patient will require multiple and more aggressive therapies described above.
Sign & Symptoms of Salivary Gland Cancer
Signs and 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
Causes of Salivary Gland Cancer
The salivary glands are located around the mouth. They produce saliva, which moistens food to help with chewing and swallowing.
There are three main pairs of salivary glands. The parotid glands are the largest. They are located in each cheek above the jaw in front of the ears. Two submandibular glands are at the back of the mouth. They are on both sides of the jaw. Two sublingual glands are under the floor of the mouth. There are also thousands of small salivary glands around the rest of the mouth.
Salivary glands empty saliva into the mouth through ducts that open at various places in the mouth.
Salivary gland tumors are rare, especially in children. Swelling of the salivary glands is mostly due to:
- Abdominal surgery
- Cirrhosis of the liver
- Other cancers
- Salivary duct stones
- Salivary gland infections
- Sjogren syndrome
The most common type of salivary gland tumor is a slow-growing noncancerous (benign) tumor of the parotid gland. The tumor gradually increases the size of the gland. Some of these tumors can be cancerous (malignant).
What are the Treatment Options for Salivary Gland Cancer?
This is normally the primary form of treatment for salivary gland cancer. The degree of surgery entirely depends on the size and location of the tumor. If the tumor is large, the whole salivary gland may need to be removed along with any nerves and ducts that the cancer may have spread to. If the cancerous area is small and easy to get to, then the surgeon may only need to remove the tumor and a small amount of surrounding tissue.
Here is some more detail of the types of surgery used to treat salivary gland cancer, and when they may be used:
- Parotid gland surgery – this gland is the most common place to find salivary gland tumors. It is difficult to perform surgery on this gland because the facial nerve passes right through it. The surgeon would enter by making a small incision on the side of the face just in front of the ear. If the cancer has spread, the entire gland would need removing (total parotidectomy) and possibly even the facial nerve and surrounding tissue.
However it is quite often in this type of salivary gland cancer that the tumors occur in the superficial lobe, located near the outside of the gland. As long as the cancer hasn’t spread, removing this lobe can solve the problem (superficial parotidectomy), and means the surgeon can avoid damaging the facial nerve.
- Submandibular gland surgery – also known as sublingual gland surgery, this surgery is performed if the tumor is in the sublingual glands or the submandibular glands. In this case the entire gland would need to be removed, and possibly some of the neighboring bone and/or tissue. There is also a chance that some nerves that control the tongue may need to be removed.
- Minor salivary gland surgery – Minor forms of salivary gland cancer can appear in parts of the mouth such as the tongue, lips and throat. During surgery, the cancer is removed along with some surrounding tissue.
- Reconstructive surgery – As some of the above surgeries involve dissection of the facial muscles, bones and/or parts of the throat, the patient may need reconstructive surgery. A plastic surgeon would need to replace or repair parts of the face to aid in breathing or chewing. This may involve skin/tissue grafts and even nerve grafts depending on the location and scale of the original surgery.