Salivary Gland Cancer


General Information

What is cancer of the salivary gland?

Cancer of the salivary gland is a disease in which cancer (malignant) cells are found in the tissues of the salivary glands. The salivary glands make saliva, the fluid that is released into the mouth to keep it moist and to help dissolve food.

Major clusters of salivary glands are found below the tongue, on the sides of the face just in front of the ears, and under the jawbone. Smaller clusters of salivary glands are found in other parts of the upper digestive tract. The smaller glands are called the minor salivary glands.

Many growths in the salivary glands do not spread to other tissues and are not cancer. These tumors are called "benign" tumors and are not usually treated the same as cancer.

A doctor should be seen if there is a swelling under the chin or around the jawbone, the face becomes numb, muscles in the face cannot move, or if there is pain that does not go away in the face, chin, or neck.

If there are symptoms, a doctor will examine the throat and neck using a mirror and lights. The doctor may order a special x-ray called a computed tomographic or CT scan, which uses a computer to make a picture of the inside of parts of the body. Another type of scan, called a magnetic resonance imaging or MRI scan, uses magnetic waves to make a picture of the head may also be ordered. If tissue that is not normal is found, the doctor will need to cut out a small piece and look at it under the microscope to see if there are any cancer cells. This is called a biopsy.

The chance of recovery (prognosis) depends on where the cancer is in the salivary glands, whether the cancer is just in the area where it started or has spread to other tissues (the stage), how the cancer cells look under a microscope (the grade), and the patient's general state of health.

Stage Information

Stages of cancer of the salivary gland:

Once cancer of the salivary gland is found, more tests will be done to find out if cancer cells have spread to other parts of the body. This is called staging. A doctor needs to know the stage of the disease to plan treatment. Salivary gland cancers are also classified by "grade", which tells how fast the cancer cells grow, based on how the cells look under a microscope. Low-grade cancers grow more slowly than high-grade cancers.

The following stages are used for cancer of the salivary gland:

Stage I
The cancer is no more than 4 centimeters in diameter (about 1 1/2 inches) and has not spread into the tissue around it or to the lymph nodes in the area (lymph nodes are small bean-shaped structures that are found throughout the body; they produce and store infection-fighting cells).

Stage II
Either of the following may be true:

The cancer is no more than 4 centimeters in diameter and has spread into the skin, soft tissue, bone, or nerve around the gland. The cancer has not spread to lymph nodes in the area.

The cancer is between 4 and 6 centimeters in diameter (a little over 2 inches) and has not spread into the tissue around it or to lymph nodes in the area.

Stage III
The cancer is no more than 4 centimeters in diameter and has not spread into the skin, soft tissue, bone, or nerve around the gland, but has spread to a single lymph node in the same area.

Stage IV
Any of the following may be true:

The cancer is more than 6 centimeters in diameter and has spread into the skin, soft tissue, bone, or nerve around the gland. The cancer may or may not have spread to the lymph nodes.

The cancer is any size and has spread to more than one lymph node on the same side of the neck as the cancer, to lymph nodes on one or both sides of the neck, or to any lymph node and measures more than 6 centimeters in diameter.

The cancer has spread to other parts of the body.

Recurrent
Recurrent disease means that the cancer has come back (recurred) after it has been treated. It may come back in the salivary gland or in another part of the body.

Treatment Option Overview

How cancer of the salivary gland is treated:

There are treatments for all patients with cancer of the salivary gland. Three kinds of treatment are used:

-surgery (taking out the cancer)
-radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
-chemotherapy (using drugs to kill cancer cells)

Surgery is often used to remove cancers of the salivary gland. Depending on where the cancer is and how far it has spread, a doctor may need to cut out tissue around the cancer. If cancer has spread to lymph nodes in the neck, the lymph nodes may be removed (lymph node dissection).

Radiation therapy is also a common treatment of cancer of the salivary gland. Radiation therapy uses high-energy x-rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external radiation therapy) or from putting materials that produce radiation (radioisotopes) through thin plastic tubes in the area where the cancer cells are found (internal radiation therapy). A special type of radiation therapy using tiny particles called neutrons has been shown to be effective in treating some salivary gland cancers. The use of drugs with the radiation therapy to make cancer cells more sensitive to radiation (radiosensitization) is being tested in clinical trials.

Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be taken by pill, or it may be put into the body by a needle in a vein or muscle. Chemotherapy is called a systemic treatment because the drug enters the bloodstream, travels through the body, and can kill cancer cells throughout the body. Chemotherapy for cancer of the salivary gland is still being tested in clinical trials.

Because the salivary glands help digest food and are close to the jaw, a patient may need special help adjusting to the side effects of the cancer and its treatment. A doctor will consult with several kinds of doctors who can help determine the best treatment. Trained medical staff can also help in recovery from treatment. Plastic surgery may be needed if a large amount of tissue or bone around the salivary glands is taken out.

Treatment By Stage

Treatment of cancer of the salivary gland depends on where the cancer is, the stage of the disease, and the patient's age and overall health.

Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. Clinical trials are ongoing in some parts of the country for patients with cancer of the salivary gland. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.

Stage I Salivary Gland Cancer
Treatment depends on whether the cancer is low grade (slow growing) or high grade (fast growing).

If the cancer is low grade, treatment will probably be surgery.

If the cancer is high grade, treatment may be one of the following:

1. Surgery.
2. Surgery followed by radiation therapy.
3. A clinical trial of new chemotherapy drugs.

Stage II Salivary Gland Cancer
Treatment depends on whether the cancer is low grade (slow growing) or high grade (fast growing).

If the cancer is low grade, treatment may be one of the following:

1. Surgery possibly followed by radiation therapy.
2. Chemotherapy (if surgery or radiation is refused or if the cancer does not
respond to surgery or radiation therapy).

If the cancer is high grade, treatment may be one of the following:

1. Surgery.
2. Surgery followed by radiation therapy.
3. Radiation therapy.
4. A clinical trial of radiosensitization drugs (drugs given with radiation
to make the cancer cells more sensitive to the radiation) or new
chemotherapy drugs.

Stage III Salivary Gland Cancer
Treatment depends on whether the cancer is low grade (slow growing) or high grade (fast growing).

If the cancer is low grade, treatment may be one of the following:

1. Surgery possibly followed by radiation therapy.
2. Chemotherapy (if surgery or radiation therapy are refused or if the cancer
does not respond to surgery or radiation therapy).
3. A clinical trial of specialized radiation therapy or new chemotherapy
drugs.

If the cancer is high grade, treatment may be one of the following:

1. Surgery.
2. Surgery followed by radiation therapy.
3. Radiation therapy.
4. A clinical trial of radiosensitization drugs (drugs given with radiation
to make the cancer cells more sensitive to the radiation) given with
radiation therapy or chemotherapy.

Stage IV Salivary Gland Cancer
Treatment may be one of the following:

1. Radiation therapy.
2. A clinical trial of chemotherapy with or without radiation therapy.

Recurrent Salivary Gland Cancer
Treatment depends on the type of salivary gland cancer the patient has, where the cancer came back, the treatment the patient had before, and the patient's general health. Radiation therapy may be given, or a patient may choose to take part in a clinical trial of new treatments.






The information on this page was obtained from the National Cancer Institute. The National Cancer Institute provides accurate, up-to-date information on many types of cancer, information on clinical trials, resources for people dealing with cancer, and information for researchers and health professionals.

The National Cancer Institute is in no way affiliated with the Mary Stolfa Cancer Foundation.

The information on this web site is provided for general information only. It is not intended as medical advice, and should not be relied upon as a substitute for consultations with qualified health professionals who are familiar with your individual medical needs. The MSCF disclaims all obligations and liabilities for damages arising from the use or attempted use of the information, including but not limited to direct, indirect, special, and consequential damages, attorneys' and experts' fees and court costs. Any use of the information will be at the risk of the user.



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