Salivary gland cancer

Facts

Salivary glands make and release saliva that lubricates your mouth and throat, starts the digestion of your food, and coats the lining of the upper airway to help protect you from infections. Tumors, either benign (not cancer) or malignant (cancer), can arise in any of these glands.

Benign Not cancer. Benign tumors may grow larger but do not spread to other parts of the body.

There are three pairs of major salivary glands:

Parotid glands Located in front of your ears on either side of your head, these are your largest salivary glands. About 80 percent of salivary gland tumors start in these glands. About 75 percent of these tumors are benign (usually a type called pleomorphic adenomas) and 25 percent are malignant.
Submandibular glands These are just under your mandible, or jaw bone, about halfway between your chin and your ear. About 10 to 15 percent of salivary gland tumors start here. About half of the tumors arising in these glands are benign and half are malignant.
Sublingual glands These are in your mouth under your tongue on either side. Tumors are not as common in these glands. The majority of tumors arising in these glands are malignant.
You also have over 1000 microscopic salivary glands around your head and neck. We call these the minor salivary glands. Tumors in these glands are not common, but when they occur about 25 percent are benign and 75 percent are malignant.

There are many different types of salivary gland tumors, based on the type of cell where the tumor starts:

Mucoepidermoid carcinoma
Adenoid cystic carcinoma
Acinic cell carcinoma
Adenocarcinoma (either low grade or high grade).

These are the most common examples of malignant tumors, but other types of cancers can occur as well. One way that doctors group malignant salivary gland tumors is by grade. The grade of a tumor is based on how normal the cancer cells look and how quickly they grow or spread.

Grade 1: Cells look very normal and grow slowly. Outcome tends to be good when doctors can perform a surgical resection (removing the tumor through surgery). Also called low grade or well differentiated.
Grade 2: Cell appearance and outcome falls between grade 1 and 3. Also called intermediate grade or moderately differentiated.
Grade 3: Cells look very abnormal and grow or spread quickly. Outcome tends to be poor. Also called high grade or poorly differentiated. Doctors often use radiation therapy in addition to surgery for grade 3 tumors.

Benign Not cancer. Benign tumors may grow larger but do not spread to other parts of the body. Grade In cancer, a grade is a description of a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. In cancer, a grade is a description of a tumor based on how abnormal the cancer cells and tissue look under a microscope and how quickly the cancer cells are likely to grow and spread. Low-grade cancer cells look more like normal cells and tend to grow and spread more slowly than high-grade cancer cells. Grading systems are different for each type of cancer. They are used to help plan treatment and determine prognosis. Also called histologic grade and tumor grade. Nonmalignant Not cancer. Nonmalignant tumors may grow larger but do not spread to other parts of the body. Also called benign. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Adenocarcinoma Cancer that forms in the glandular tissue that lines certain internal organs and makes and releases substances in the body, such as mucus, digestive juices or other fluids.

Cancer that forms in the glandular tissue that lines certain internal organs and makes and releases substances in the body, such as mucus, digestive juices or other fluids. Most cancers of the breast, pancreas, lung, prostate, colon, esophagus and stomach are adenocarcinomas.

Risk Factors

Doctors have not been able to link salivary gland tumors to many risk factors (factors that increase your chance of getting a tumor). In most cases, there is no evidence to tell us what caused the DNA changes in the salivary gland cells that led to a tumor. These factors may increase the risk in some cases:

Having radiation treatment to the head or neck for other reasons
Being exposed to certain radioactive substances, such as might happen in some industries
Working with nickel alloy dust or silica dust
Eating a diet low in vegetables and high in animal fat.

Staging

If your tumor is cancer, your doctor will try to determine the stage. The stage reflects how large the tumor is, whether it has spread and, if it has, how far. There is a specific staging system only for major salivary gland tumors. (Tumors arising in minor salivary glands are often staged in the same manner as for the more common epithelial, or squamous cell, tumors arising in the same location.)

Stage I: The tumor is no larger than 2 centimeters (cm) in diameter. It is only within the salivary gland. It is not invading nearby tissue, and it has not spread anywhere else.

Stage II: The tumor is between 2 cm and 4 cm. It is only within the salivary gland. It is not invading nearby tissue, and it has not spread anywhere else.

Stage III: This stage applies in either of these cases:

The tumor is larger than 4 cm and/or is invading nearby tissue and possibly one lymph node that is less than 3 cm in size and is located on the same side of the neck as the tumor, but it has not spread anywhere else in the body.
The tumor is less than 4 cm and has spread to one lymph node that is less than 3 cm in size and is located on the same side of the neck as the tumor, but it has not spread anywhere else in the body.

Stage IVA: This stage applies in either of these cases:

The tumor is 6 cm or larger in size. It may or may not have spread to nearby tissue, including invading the facial nerve, and to one lymph node that is less than 3 cm in size and is located on the same side of the neck as the tumor, but it has not spread anywhere else in the body.
The tumor is any size, and it has spread to nearby tissue, including invading the facial nerve, and to one or more lymph nodes that are less than 3 cm in size, and are located on either side of the neck.

Stage IVB: This stage applies in either of these cases:

The tumor is larger than 6 cm in size or has spread to the skull bones, has surrounded the carotid artery, and/or has invaded the facial nerve. It may have spread to multiple lymph nodes on either side of the neck.
The tumor is any size, may have spread to adjacent tissues, and has spread to at least one lymph node that is greater than 6 cm in size.

Stage IVC: The tumor is any size and has spread to distant sites in the body. It may also have spread to nearby tissue and lymph nodes.

Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body. Staging Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from where it first formed to other parts of the body. Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from where it first formed to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.

Symptoms

Symptoms that might occur if you have a salivary gland tumor include:

A lump or ongoing pain in your face, neck, or mouth
A difference in the size or shape of your face or neck from one side to the other
Numbness or weakness somewhere in your face.

Other conditions besides tumors may cause these symptoms, too. If you have any of these symptoms, see your doctor for an evaluation.

Symptom A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. A physical or mental problem that a person experiences that may indicate a disease or condition. Symptoms cannot be seen and do not show up on medical tests. Some examples of symptoms are headache, fatigue, nausea and pain.

Diagnosis

If your doctor thinks you might have a salivary gland tumor, the doctor will ask about your health history and give you a physical exam, with special attention to your salivary glands, mouth, and neck. The doctor may also check for numbness or weakness in your face.

Imaging studies can also help your doctor determine whether you have a tumor and whether it has spread. These include a Computed Tomography (CT) scan, Magnetic Resonance Imaging (MRI) scan, and Positron Emission Tomography (PET) scan.

If your doctor finds a tumor, the next step is to have a biopsy to remove tumor cells and check whether they are cancer, and if so, which type. There are two types of biopsies you may have:

Fine needle aspiration: Removing some cells and fluid from the tumor using a syringe.
Excisional biopsy: Making a small incision to remove a piece of the tumor.
In some cases, the doctor may go directly to the step of doing surgery to remove as much of the tumor as possible rather than removing only a small piece first for a biopsy.

Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Computed tomography A procedure that uses a computer linked to an X-ray machine to make a series of detailed pictures of areas inside the body. The pictures are used to create three-dimensional (3-D) views of tissues and organs. A procedure that uses a computer linked to an X-ray machine to make a series of detailed pictures of areas inside the body. The pictures are taken from different angles and are used to create three-dimensional (3-D) views of tissues and organs. A dye may be injected into a vein or swallowed to help the tissues and organs show up more clearly. This scan may be used to help diagnose disease, plan treatment or find out how well treatment is working. Imaging In medicine, a process that makes pictures of areas inside the body. Imaging uses methods such as X-rays (high-energy radiation), ultrasound (high-energy sound waves) and radio waves. Magnetic resonance imaging A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. A procedure in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. MRI makes better images of organs and soft tissue than other scanning techniques, such as computed tomography (CT) or X-ray. MRI is especially useful for imaging the brain, the spine, the soft tissue of joints and the inside of bones.

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