Salivary gland tumors are growths of cells that start in the salivary glands. Salivary gland tumors are rare.
The salivary glands make saliva. Saliva aids in digestion, keeps the mouth moist and supports healthy teeth. There are three pairs of major salivary glands under and behind the jaw. These are the parotid, sublingual and submandibular glands. Many other tiny salivary glands are in the lips, inside the cheeks, and throughout the mouth and throat.
Salivary gland tumors can happen in any salivary gland. Most salivary gland tumors occur in the parotid gland. Of these, most aren't cancer. For every five parotid gland tumors, on average, only one is found to be cancerous.
Treatment for salivary gland tumors is usually with surgery to remove the tumor. People with salivary gland cancers may need additional treatments.
Signs and symptoms of a salivary gland tumor may include:
Make an appointment with your doctor or other healthcare professional if you have any symptoms that worry you.
The cause of many salivary gland tumors isn't known. Healthcare professionals have identified some things that raise the risk of salivary gland tumors. These include smoking and radiation therapy for cancer. Not everyone with a salivary gland tumor has these risk factors, though. More research is needed to find out exactly what causes these tumors.
Salivary gland tumors happen when cells in a salivary gland develop changes in their DNA. A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions also tell the cells to die at a set time. In tumor cells, the changes give different instructions. The changes tell the tumor cells to make many more cells quickly. Tumor cells can keep living when healthy cells would die. This causes too many cells.
Sometimes the changes in the DNA turn the cells into cancer cells. Cancer cells can invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.
Many different types of salivary gland tumors exist. Salivary gland tumors are classified based on the type of cells involved in the tumors. Knowing the type of salivary gland tumor you have helps your healthcare team decide which treatment options are best for you.
Types of salivary gland tumors that aren't cancerous include:
Types of cancerous salivary gland tumors include:
Factors that may increase the risk of salivary gland tumors include:
Salivary gland tumor diagnosis often begins with a physical exam of the area by a healthcare professional. Imaging tests and a biopsy may be used to find the location of the tumor and determine what type of cells are involved.
A healthcare professional feels the jaw, neck and throat for lumps or swelling.
Imaging tests make pictures of the body. They can show the location and size of a salivary gland tumor. Tests might include MRI, CT and positron emission tomography, which is also called a PET scan.
A biopsy is a procedure to remove a sample of tissue for testing in a lab. To collect a sample of tissue, a fine-needle aspiration or a core needle biopsy may be used. During the biopsy, a thin needle is inserted into the salivary gland to draw out a sample of suspicious cells. The sample is sent to a lab for testing. Tests can show what types of cells are involved and whether the cells are cancerous.
If you're diagnosed with salivary gland cancer, you may have other tests to see if the cancer has spread. These tests help your healthcare team find out the extent of your cancer, also called the stage. Cancer staging tests often involve imaging tests. The tests might look for signs of cancer in your lymph nodes or in other parts of your body. Your healthcare team uses the cancer staging test results to help create your treatment plan.
Imaging tests may include CT, MRI and PET scan. Not every test is right for every person. Talk with your healthcare professional about which procedures will work for you.
The stages of salivary gland cancer range from 0 to 4. A stage 0 salivary gland cancer is small and only in the gland. As the cancer gets larger and grows deeper into the gland and surrounding areas, such as the facial nerve, the stages get higher. A stage 4 salivary gland cancer has grown beyond the gland or has spread to the lymph nodes in the neck or to distant parts of the body.
Treatment for salivary gland tumors usually involves surgery to remove the tumor. People with salivary gland cancers may need additional treatments. These additional treatments can include radiation therapy, chemotherapy, targeted therapy or immunotherapy.
Surgery for salivary gland tumors may include:
Reconstructive surgery. After the tumor is removed, your surgeon may recommend reconstructive surgery to repair the area. If bone, skin or nerves are removed during your surgery, these may need to be repaired or replaced using reconstructive surgery.
During reconstructive surgery, the surgeon works to make repairs that improve your ability to chew, swallow, speak, breathe and move your face. You may need transfers of skin, tissue, bone or nerves from other parts of your body to rebuild areas in your mouth, face, throat or jaws.
Salivary gland surgery can be difficult because several important nerves are located in and around the glands. For example, a nerve in the face that controls facial movement runs through the parotid gland.
Removing tumors that involve important nerves may require working around and underneath the facial nerves. Sometimes the facial nerve gets stretched during surgery. This can cause loss of movement in the face muscles. Muscle movement often gets better over time. Rarely, the facial nerve must be cut in order to get all of the tumor. Surgeons can repair the facial nerve using nerves from other areas of the body or with other techniques.
If you're diagnosed with salivary gland cancer, your healthcare team may recommend radiation therapy. Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons or other sources. For salivary gland cancer, radiation therapy is most often done with a procedure called external beam radiation. During this treatment, you lie on a table while a machine moves around you. The machine directs radiation to precise points on your body.
Radiation therapy can be used after surgery to kill any cancer cells that might remain. If surgery isn't possible because a tumor is very large or is located in a place that makes removal too risky, your healthcare professional may recommend radiation alone or in combination with chemotherapy.
Chemotherapy treats cancer with strong medicines. Chemotherapy isn't currently used as a standard treatment for salivary gland cancer, but researchers are studying its use.
Chemotherapy may be an option for people with advanced salivary gland cancer. It's sometimes combined with radiation therapy.
Targeted therapy for cancer is a treatment that uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die.
For salivary gland cancer, targeted therapy may be used when the cancer can't be removed with surgery. It also may be used for advanced cancers that spread to other parts of the body or cancer that comes back after treatment.
Some targeted therapies only work in people whose cancer cells have certain DNA changes. Your cancer cells may be tested in a lab to see if these medicines might help you.
Immunotherapy for cancer is a treatment with medicine that helps the body's immune system kill cancer cells. The immune system fights off diseases by attacking germs and other cells that shouldn't be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells.
For salivary gland cancer, immunotherapy may be used on cancer that can't be removed with surgery. It also may be used for advanced cancers that have spread to other parts of the body or cancer that has come back after treatment.
Palliative care is a special type of healthcare that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve pain and other symptoms. A healthcare team that may include doctors, nurses and other specially trained health professionals provides palliative care. The care team's goal is to improve quality of life for you and your family.
Palliative care specialists work with you, your family and your care team. They provide an extra layer of support while you have cancer treatment. You can have palliative care at the same time you're getting strong cancer treatments, such as surgery, chemotherapy or radiation therapy.
The use of palliative care with other proper treatments can help people with cancer feel better and live longer.
People with salivary gland tumors that are cancerous may need to have radiation therapy. One side effect of radiation therapy to the head and neck area is having a very dry mouth, called xerostomia. Having a dry mouth can cause discomfort. It can lead to frequent infections in your mouth, cavities and problems with your teeth. Dry mouth also can make eating, swallowing and speaking difficult.
You may find some relief from dry mouth and its complications if you:
Tell your healthcare professional if you have dry mouth. Treatments may help you cope with more-severe symptoms of dry mouth. You also may be referred to a dietitian who can help you find foods that are easier to eat if you're experiencing dry mouth.
Complementary or alternative medicine treatments can't cure salivary gland tumors. But complementary and alternative treatments can be combined with your healthcare team's care to help relieve fatigue, pain and other symptoms.
Options may include:
Ask your healthcare team whether these options are safe for you.
With time, you'll find what helps you cope with the worries that may come with a salivary gland tumor diagnosis. Until then, you may find it helps to:
Ask your healthcare team about your tumor, including the type, stage and treatment options. As you learn more about your tumor, you may become more confident in making treatment decisions.
Keeping your close relationships strong can help you cope during treatment. Friends and family can help you with the small tasks you may not have the energy for during treatment. And they can be there to listen when you need to talk.
Other people who've had salivary gland tumors can offer unique support and insight because they understand what you're experiencing. Connect with others through support groups in your community and online.
Get enough rest each night so that you wake feeling rested. Try to exercise when you feel up to it. Choose a healthy diet full of fruits and vegetables.
Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.
If your healthcare professional thinks that you might have a salivary gland tumor, you may be referred to a doctor who specializes in diseases that affect the ears, nose and throat. This doctor is called an ENT specialist or otolaryngologist.
Because appointments can be brief, it's a good idea to be prepared. Here's some information to help you get ready.
Your time with your healthcare team is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For salivary gland tumors, some basic questions to ask include:
Don't hesitate to ask other questions.
Be prepared to answer questions, such as:
