Salivary Gland Cancer

Salivary gland cancer starts in one of the salivary glands, which make the saliva that keeps your mouth moist and helps you chew and digest food. These glands include the large parotid, submandibular, and sublingual glands, plus many small (minor) salivary glands found throughout the mouth and throat.

Most salivary gland tumors are not cancer. But cancer can develop, and these cancers can behave very differently from one person to another. Some grow slowly, while others grow and spread more quickly.

Types & Stages

There are several types of salivary gland cancer. Knowing the type helps your care team understand how the cancer may behave and plan treatment.

• Mucoepidermoid carcinoma. One of the most common types. It can range from slow-growing to more aggressive.
   
• Adenoid cystic carcinoma. Often slow-growing, but it tends to spread along nerves and can come back years later.
   
• Acinic cell carcinoma. Usually slow-growing and often found at an earlier stage.
   
• Adenocarcinoma. A group of cancers that start in gland cells and can vary widely in behavior.
   
• Secretory carcinoma. Often low-grade and slow-growing. It is found equally in men and women.
   
• Salivary duct carcinoma. A less common, more aggressive type that is more likely to spread.

Doctors also describe a cancer's grade, meaning how the cells look under a microscope. Low-grade cancers tend to grow slowly, while high-grade cancers grow and spread more quickly.

To describe how far the cancer has spread, doctors look at:

• The size of the tumor
• Whether it has grown into nearby tissue
• Whether it has reached lymph nodes in the neck
• Whether it has spread to other parts of the body

Signs & Symptoms

Salivary gland cancer often starts as a lump that may grow over time. Other symptoms can appear depending on where the tumor is.

Visit a doctor if you are experiencing any of these symptoms:

• A lump in the jaw, mouth or neck
• Pain, numbness or weakness in the face
• Trouble moving the jaw
• Trouble swallowing
• Voice changes or hoarseness, in some cases

Symptoms can differ by tumor type. For example, mucoepidermoid and adenoid cystic carcinoma may cause pain or problems with the facial nerve, such as facial weakness.

Many of these symptoms can be caused by conditions that are not cancer. Still, if a symptom is new, lasting, or worries you, talk with a healthcare provider.

Diagnosis

Tests and procedures used to diagnose salivary gland cancer may include:

• Biopsy. A small sample of tissue is removed from the suspicious area and examined under a microscope by a pathologist. This is the main way to confirm cancer.
   
• Imaging tests. A CT scan, MRI, or jaw X-ray may be used to see the size and location of the tumor and whether it has spread.
   
• Cell type and grade. The pathologist identifies the type of cancer and its grade (how slowly or quickly it is likely to grow). This helps guide treatment.
   
• Additional testing. In select cases, genomic testing or other tumor marker testing may be used to learn more about the cancer.

Treatment

Treatment depends on the type, grade, and location of the cancer, whether it has spread, and your overall health. Surgery is often the main treatment when the cancer can be removed.

Surgery depends on which gland is affected:

• Parotid gland. Surgery may remove part or all of the gland. Because the facial nerve passes through this gland, your surgeon will take care to protect it when possible. If the cancer involves the nerve, more extensive surgery may be needed.
   
• Submandibular or sublingual gland. Surgery removes the affected gland and possibly some nearby tissue. Nerves near these glands affect movement, sensation, and taste, so your surgeon will plan carefully.
   
• Minor salivary glands. Surgery depends on the tumor's size and location, such as in the lips, tongue, palate, mouth or throat.
   
• Lymph node removal. Lymph nodes in the neck may be removed if the cancer is high grade, if nodes appear enlarged, or if spread is suspected.

Other treatments may also be recommended based on the tumor type, grade, stage, or whether it has spread:

• Radiation therapy. Uses high-energy beams to kill cancer cells, often after surgery to lower the chance the cancer comes back.
   
• Medical oncology treatments. Medicines may be used in select cases, especially for more advanced cancer.

Clinical trials may also be an option. These studies test new treatments or new ways to use current ones. Ask your care team whether a clinical trial may be right for you.

Causes & Risk Factors

Because salivary gland cancer is rare, its exact causes are not well understood. Some factors may raise the risk, including:

• Radiation exposure. Past radiation to the head and neck, or radiation exposure in the workplace, may increase risk.
   
• Being male. This cancer is more common in men than in women.
   
• Older age. Most people are in their fifties or sixties when diagnosed.
   
• Tobacco use. This includes smoking and smokeless tobacco.
   
• Alcohol use. Research suggests a possible link, though the evidence is not clear.
   
• Workplace exposures. Regular contact with certain substances may raise risk, such as some metals, silica dust, asbestos, rubber manufacturing, plumbing work and some types of woodworking.

Having a risk factor does not mean you will develop salivary gland cancer, and many people with the disease have no clear risk factors. Talk with your healthcare provider about your personal risk.

Screening

There is no routine screening test for salivary gland cancer for people at average risk.

Because this cancer is uncommon, doctors usually do not test for it unless a person has symptoms, such as a lump or facial changes. People at higher risk, such as those who have had radiation to the head and neck, may be watched more closely.

If you notice a lump or other symptoms that do not go away, talk with a healthcare provider about whether further evaluation is needed.

This information is for general education only and is not a substitute for medical advice. Please consult a qualified healthcare provider for diagnosis, treatment recommendations, and guidance based on your personal health history.