Salivary Gland Cancer

Overview of Salivary Gland Cancer

Salivary gland cancer is a rare type of head and neck cancer that occurs in the salivary glands. The most common places for these cancers to develop are in the three major salivary glands: the parotid glands (in front of the ears), the submandibular glands (under the jaw), and the sublingual glands (below the tongue).

Cancer is when cells in the body start to grow unchecked. In the case of salivary gland cancer, this process begins in the cells of one of these glands. The exact cause of this unchecked and abnormal growth is not always clear. Factors like smoking, specific environmental exposures, and previous radiation treatment of the neck and head can increase the risk.

Symptoms of salivary gland cancer might include a lump or swelling in or near your jaw, neck, or mouth; pain in your face, chin, or neck that does not go away; numbness in part of your face; muscle weakness on one side of your face; or trouble swallowing. However, these symptoms can be caused by other, less serious conditions. If you experience any of these symptoms, it’s essential to see a doctor so they can determine the cause.

Typically, the diagnosis of salivary gland cancer involves a physical examination, imaging tests like MRI or CT scans, and possibly a biopsy, where a small sample of tissue is taken from the tumor and examined under a microscope for cancer cells.

Treatment for salivary gland cancer depends on several factors, including the size and location of the tumor, whether the cancer has spread, and your overall health. Options might include surgery to remove the tumor, radiation therapy, chemotherapy, or a combination of these treatments.

While the prospect of facing any cancer can be daunting, it’s important to remember that treatment advances have improved outcomes for many people with salivary gland cancer. Working closely with your healthcare team to understand your diagnosis and treatment options is the best strategy for managing your health.

Overview of Salivary Glands and Salivary Disease

Salivary glands are located in your head and neck and produce saliva, which is vital for food digestion and oral health. There are numerous minor salivary glands and three major salivary glands:

1. Parotid glands (in front of your ears)
2. Submandibular glands (under your jaw)
3. Sublingual glands (below your tongue)

Salivary gland disease can take the form of from inflammation and infections, stones that can block the flow of saliva, and tumors (both benign and cancerous). An ENT surgeon can treat stones, blockages, and inflammation of a salivary gland with minimally invasive techniques such as sialoendoscopy. Tumors and cancers, however, may require more complex treatment. 

Types of Salivary Gland Tumors

Salivary gland cancer isn’t just one type; it’s a group of different cancers that can start in any of your salivary glands. The main forms include:

• Mucoepidermoid Carcinoma is the most common type. It can vary significantly in how fast it grows and how seriously it can affect your health. Some of these cancers grow slowly and are less aggressive, while others can grow more quickly and be more challenging to treat.
• Adenoid Cystic Carcinoma grows slowly but is challenging to treat because it can spread along the nerves. This means it can reach into areas that are hard to see or treat, like a plant’s roots growing under the ground. Even though it grows slowly, it’s known for being quite stubborn and can sometimes come back after treatment.
• Carcinoma ex Pleomorphic Adenoma begins as a benign (non-cancerous) tumor called a pleomorphic adenoma but becomes cancerous over time. While these tumors may look harmless initially, they can become dangerous.
• Adenocarcinoma includes various cancers that start in the cells that line your glands. They can occur in almost any type of glandular tissue (for example, the pancreas and prostate), including the salivary glands.
• Acinic Cell Carcinoma starts in the cells that make the digestive enzymes in saliva. It usually has a better outlook than other types because it usually grows slowly and is less likely to spread.
• Polymorphous Low-Grade Adenocarcinoma mainly occurs in the minor salivary glands, which are the smaller glands scattered throughout the mouth and throat. It generally grows slowly and has a good chance of being cured, especially if it has not spread.

Additional, though less common, forms of salivary gland cancer include:

• Adenosquamous carcinoma
• Basal cell adenocarcinoma
• Carcinosarcoma
• Clear cell carcinoma
• Cystadenocarcinoma
• Lymphoepithelial carcinoma
• Lymphomas
• Myoepithelial carcinoma
• Oncocytic carcinoma
• Poorly differentiated carcinoma
• Salivary duct carcinoma
• Sebaceous adenocarcinoma
• Secretory analogue carcinoma (similar to a type of breast cancer)
• Squamous cell carcinoma

Each type of salivary gland cancer is unique, with its own behavior and treatment strategies. Doctors determine the best course of action based on the type of cancer, its location, and whether or not it has spread to other parts of the body. The goal is to choose the treatment that offers the best chance of removing or controlling the cancer while minimizing side effects.

About the Salivary Glands

Your salivary glands make saliva, the watery liquid you feel in your mouth. Saliva has several essential functions, including:

• Moistening food, making it easier to chew and swallow
• Helping you taste your food
• Protecting your mouth
• Aiding food digestion by breaking down starches

Even when you’re not eating, your salivary glands produce a small amount of saliva to keep your mouth moist and healthy.

Other, less serious conditions can also cause these symptoms. If you or someone you know is experiencing these signs, particularly if they persist or worsen, it’s a good idea to check in with a doctor to find out what’s happening. They can help figure out if it’s something like an infection or if it’s something more serious like cancer that needs more attention.

Radiation Therapy

Radiation therapy uses super-focused beams of energy to target the cancer cells and destroy them or stop them from growing, all while trying to avoid harming the healthy cells around them. It’s often used after surgery to catch any cancer cells that might have been missed or as the primary treatment if surgery isn’t an option.

Chemotherapy

Chemotherapy is the use of specialized medicine that travels throughout your body to find and attack cancer cells wherever they are. It’s not used as often for salivary gland cancer as for other types of cancer. Still, it can be helpful in certain situations, mainly if the cancer has spread to other body parts.

Targeted Therapy

Targeted therapy uses drugs designed to seek out and attack specific parts of cancer cells that make them different from normal cells. Your doctor can use this treatment if the cancer has a particular characteristic the drug can target.

Immunotherapy

Immunotherapy is a way of helping your immune system identify and neutralize cancer cells more effectively. It’s like giving your body’s natural defenses an upgrade or a boost to fight the cancer.

The choice of treatment depends on various factors, including the type and stage of cancer and your overall health and preferences. Doctors often use a combination of these treatments to get the best results. The goal is always to remove or destroy as much of the cancer as possible and to help you feel better and live longer.