Salivary Gland Cancer: From Early Detection to Effective Treatment

The salivary glands are a group of organs in the mouth that produce and secrete saliva. The saliva produced helps in digestion and keeps the mouth moist. Cancer in the salivary gland is rare, accounting for less than 1% of all cancer diagnoses. A group of rare malignancies (uncommon cancer) develops in the salivary gland near the head and neck area, resulting in salivary gland cancer.  

These types of cancers are categorized based on location, histology, and molecular profile. The most common type of cancer is mucoepidermoid carcinoma, which accounts for 30-40% of all cases. Other types of salivary gland cancer include adenoid cystic carcinoma, acinic cell carcinoma, and polymorphous adenocarcinoma.  

Causes and Risk Factors  

The clear cause of salivary gland cancer is still unknown. However, several risk factors have been identified which can lead to the development of this cancer. 

1. Age

People aged 50 or above are at an increasing risk of developing this disease. 

2. Gender

Men are more likely to develop salivary gland cancer than women.  

3. Radiation exposure

Radiation treatment to the head and neck area for other medical purposes increases the risk of this disease, especially if the salivary glands aren’t protected during radiation.

4. Family history

This cancer can be hereditary, and those with a family history are at higher risk of developing the same.  

5. Workplace exposure

Certain occupational exposures, such as working with rubber or asbestos, may cause this type of cancer.  

Stages of Salivary Gland Cancer  

Like other types of cancer, salivary gland cancer is staged based on the extent of the disease at the time of diagnosis. It stages are as follows:  

1. Stage I

The tumor is 2 centimeters or smaller and localized to the salivary gland where it first appeared and has not spread to nearby lymph nodes or other body parts.  

The survival rates for salivary gland cancer are generally good, especially for those with early-stage disease.  

2. Stage II

The tumor is larger than 2 centimeters but not larger than 4 centimeters and is still localized to the salivary gland. It may not necessarily have spread to the lymph nodes.    

The specific treatment plan depends on the location and size of the tumor, as well as the patient's overall health. The prognosis for Stage II salivary gland cancer is generally good, especially if the cancer is caught early and treated.  

3. Stage III

The tumor is larger than 4 centimeters and has spread to the nearby soft tissues of the salivary gland. Cancer has metastasized to a single lymph node located on the same side of the head or neck as the tumor. The affected lymph node measures 3 centimeters or less in size and has not grown beyond the lymph node.  

The prognosis of Stage III salivary gland cancer can vary depending on the factors such as the type and grade of cancer, the age and overall health of the patient, and the effectiveness of treatment.   

4. Stage IV

The tumor has spread beyond the salivary gland to other body areas, such as the bones, lungs, or liver. Based on the size and location of the tumor, the number and location of lymph nodes affected, and the extent of metastasis, this stage is further divided into Stage IVA, IVB, and IVC.  

The prognosis for Stage IV salivary gland cancer is generally poor, especially if it has spread to distant organs. However, some people with advanced salivary gland cancer may still benefit from advanced cancer treatment and clinical trials of new therapies.  

Diagnosis  

To determine the stage, doctors at our cancer center in Florida may use a combination of diagnostic tests. The diagnosis is typically based on various tests and imaging scans to help determine the tumor's size, location, and extent.  

1. Physical examination

A healthcare provider will examine the head, neck, jaw, and throat for lumps or swelling.   

2. Imaging tests

CT scans, MRI scans, and PET scans may be used to visualize the tumor and assess its size, location, and involvement of nearby tissues or organs.  

3. Biopsy

To collect the sample of tissue, a biopsy may be performed to confirm if it is salivary gland cancer and determine its type and grade. Biopsy typically involves removing a small tissue sample from the tumor and examining it under a microscope.  

4. Staging

Once the diagnosis is confirmed, the tumor is staged based on the size, location, and extent of its spread. Staging typically involves using the TNM system -

Tumor: How large is a tumor, and where is it located?  

Node: Has the tumor spread to the lymph node? If yes, then where and how many?  

Metastasis: Has cancer spread to the other parts of the body? If yes, then where and how much?  

Once the stage of salivary gland cancer has been determined, the oncologist can develop a treatment plan tailored to the patient's specific needs.   

Treatment Options  

Salivary gland cancer treatments depend on the stage and location of the tumor, as well as the person's overall health and preferences. The main advanced cancer treatment options for salivary gland cancer include:

1. Surgery

It is often the primary treatment for salivary gland cancer. Surgery aims to remove as much of the tumor as possible while preserving the function of the salivary gland and nearby nerves and blood vessels. The type of surgery depends on the location and stage of the tumor. It may involve removing part or all of the salivary gland, surrounding lymph nodes, or other affected tissue. One advantage of surgery is that it can provide a definitive diagnosis and may be curative for some patients. However, surgery can be associated with risks such as infection, bleeding, and nerve damage.  

2. Radiation therapy

It uses high-energy radiation to kill cancer cells and shrink tumors. Radiation therapy can be used before or after surgery or as the primary treatment for inoperable tumors. This therapy can be delivered externally (external beam radiation) or internally (brachytherapy). One advantage of radiation therapy is that it can target cancer cells that may have spread beyond the primary tumor site. However, it can also damage healthy tissue, leading to side effects such as fatigue, skin irritation, and dry mouth.  

3. Chemotherapy

It involves using drugs to kill cancer cells. Chemotherapy can be combined with surgery or radiation therapy for advanced or metastatic salivary gland cancer. It is either given orally or intravenously. The advantage of chemotherapy is that it can treat cancer cells that may have spread to other body parts. However, it also causes side effects such as nausea, hair loss, and an increased risk of infection.   

Therapies like targeted therapy and immunotherapy may also be used in certain cases. Targeted therapy involves drugs targeting cancer cells, while immunotherapy stimulates the body's immune system to fight cancer. 

Living with Salivary Gland Cancer  

Coping with cancer and its treatment can be physically, emotionally and mentally challenging. Patients with this type of cancer may experience physical symptoms such as pain, fatigue, difficulty swallowing, and changes in speech or facial appearance. In addition to physical symptoms, they may experience emotional challenges such as anxiety, depression, fear, and uncertainty about the future.

Here are some suggestions for managing side effects and coping with the diagnosis:  

1. Seek support

It's important to have a support system, whether family, friends or a support group. Talking to people who have gone through similar experience can help cope with the emotional challenges of a cancer diagnosis.  

2. Stay informed

Know about the disease and its treatment options. Ask healthcare provider questions and do your research to learn more about salivary gland cancer and its treatment.  

3. Practice self-care

Take care of physical and emotional health. This includes getting enough rest, eating a healthy diet, and engaging in joy and relaxation activities.  

4. Manage side effects

Work with a healthcare provider at the cancer center in Florida to manage the side effects of treatment. Medications or other interventions may help with pain, fatigue, and difficulty swallowing.  

5. Consider counseling or therapy

This can provide a safe space to express feelings and develop coping strategies.  

6. Stay positive

It's important to stay positive and maintain hope. Focus on the things that can be controlled, and celebrate small victories along the way.  

7. Financial Support

It is a valuable resource for individuals and families facing cancer diagnoses. Financial support can come in many forms, such as government programs, insurance coverage, charitable organizations, and community resources. Seeking guidance from a financial advisor or social worker can help navigate options and find the support required to manage the financial burden of cancer.  

The Bottom Line 

According to the American Cancer Society, salivary gland cancer is rare, with an estimated 2,000 to 2,500 new cases diagnosed annually in the United States. Early detection is key to the successful treatment. Regular screening and self-examination can help detect the disease in its early stages. While there are no guaranteed methods to prevent this cancer, adopting a healthy lifestyle, and avoiding known risk factors, can help detect the disease early and improve outcomes. Consult the top oncologists in Brooksville, Florida, at ACTC –a renowned Cancer Center in Florida - to learn the benefits and risks of each treatment option and discuss which treatment may be helpful.