Salivary gland cancer
Located under the tongue, in the lower jaw, and just below each ear, the main salivary glands produce the saliva that keeps the mouth moist and begins the digestive process. There are also hundreds of microscopic salivary glands all over the mouth that produce saliva in smaller amounts. Though rare, it is possible for malignant cancer cells to form in any of these glands just as they do in other parts of the body, which is called salivary gland cancer or salivary cancer.
Definition & Facts
Cancer of the minor salivary glands usually starts on the roof of the mouth. When cancer occurs in one of the major salivary glands, it is most often found in the parotid glands just below the ears. Fortunately, most tumors of the salivary glands are benign but it is important to have any abnormalities checked. The odds of developing salivary cancer increase with age and are higher among smokers. There are many different types of salivary gland cancer, including the following:
- Mucoepidermoid carcinomas: This is the most common type of salivary gland cancer and is often a low-grade, highly-treatable cancer. This cancer typically occurs in the parotid glands under the ears.
- Acinic cell carcinoma: Also frequently starting in the parotid gland, this type of cancer tends to grow slowly but appears in younger patients more often than most cancers. Prognosis depends upon how far this type of cancer has spread.
- Polymorphous low-grade adenocarcinoma (PLGA): This type of salivary gland cancer is the most curable, starting in the minor salivary glands located throughout the mouth.
- Secondary salivary gland cancers: Sometimes cancer starts somewhere else in the body and then spreads to the salivary glands. Treating this type of cancer involves treating the salivary glands as well as the cancer's original source.
Symptoms & Complaints
In some cases of salivary gland cancer, fluid leaks from the ear. Like many other cancers, salivary gland cancer may not create any symptoms at all. This is one of the reasons many dentists check for oral cancers during dental checkups. Catching all types of cancer early increases the odds of successful treatment.
Unfortunately, the cause of most salivary gland cancers is impossible to determine. Cancer risk increases, however, when a person is exposed to carcinogens. A carcinogen is any agent known to cause cancer such as certain chemicals or cigarette smoke. Patients are also at an increased risk of developing salivary gland cancer if their head and neck have been exposed to certain medical treatments that required radiation.
HIV and the Epstein-Barr virus have also been linked to salivary gland cancer and the condition may occur in conjunction with non-Hodgkin's lymphoma. Salivary glands include immune system cells as well as cells from blood vessels, muscles, and connective tissue. Because of this, they are vulnerable to many different types of cancer.
Diagnosis & Tests
To diagnose salivary gland cancer, doctors first perform a thorough physical examination, looking and feeling for tumors and bumps. CT scans, MRIs, PET scans, and other body scans are then used to look for signs of cancer in the head and neck.
If these tests are inconclusive or don't provide enough information, a biopsy or tissue sample may be acquired using a small needle. This sample is then tested for the presence of cancerous cells. If a needle biopsy isn't possible, a small incision will be made to more easily access a tissue sample. In some instances, the entire tumor will be surgically removed and tested. This is rare, however, and not typically a cause of concern.
Treatment & Therapy
The treatment a doctor recommends for cancer in the salivary glands depends on how advanced the cancer is and where it is. Sometimes surgical intervention is suggested. Surgery may involve removing the affected part of the salivary gland or removing the entire gland altogether. The lymph nodes of the neck will also be removed if cancer is present there. Reconstructive surgery will be performed if necessary to restore a patient's facial appearance if surgical intervention alters bone structure or other anatomy.
Instead of surgery, doctors may attempt to kill the cancer cells with radiation therapy by directing energy beams at them. Sometimes radiation therapy is used in conjunction with surgery to target any cells surgery may have missed. Chemotherapy may also be an option, and uses drugs to kill cancer cells. The use of chemotherapy is rare in salivary gland cancer however unless the cancer has metastasized.
Prevention & Prophylaxis
Avoiding smoking or quitting smoking is a preventative method. During cancer treatment, acupuncture, massage therapy, meditation, and mouth moisteners such as hard candy can be used to combat the side effects of cancer treatment.
A diagnosis of salivary gland cancer can be frightening, but treatment options are available and many have a high success rate. Those facing this diagnosis should consider joining a cancer support group and pursue treatment and therapy options for maintaining mental health.
Patients are encouraged to ask questions and understand their options in order to make informed healthcare choices. A second opinion is always welcome and often encouraged prior to undergoing any significant surgeries or treatments.