Salivary gland cancer affects the glands responsible for secreting saliva located in the mouth area. You will learn about the modern techniques available to treat salivary gland cancer in Turkey.
There are two types of tumors, malignant (cancerous) or benign (non-cancerous), and they both occur in equal numbers.
The chance of treatment depends on where the cancer is located in the salivary glands, whether the cancer is in the area where it began or has spread to other tissues, how the cancer cells look under a microscope, and the patient's general health.
What are the salivary glands?
They are the glands responsible for making and releasing saliva in the mouth to keep the mouth and throat moist and help in swallowing and digesting food.
These glands vary in size, with large and small salivary glands. There are three pairs of major salivary glands: the parotid, submandibular, and sublingual glands.
Parotid gland
The parotid glands are located in front of the ears and behind the jaw. Saliva is secreted into the mouth through a tube called the parotid duct. This tube opens from the inside on the cheek near the area of the upper molars.
Through the parotid gland, the nerve that controls the facial muscles is called the facial nerve, which is responsible for making you smile, frown, close your eyes and raise your eyebrows.
The parotid gland is the largest salivary gland and is where most salivary gland cancers occur.
The parotid glands also contain lymph nodes, which are nodes that are part of the immune system's defense against infections. Skin cancers can sometimes spread to these lymph nodes within the parotid glands, but most parotid tumors, fortunately, are not cancers and are called benign tumors.
Submandibular and sublingual glands
The submandibular glands are located in the area under the jawbone, one on each side. These glands release saliva into the mouth through a duct (tube) that opens into the floor of the mouth under the tongue.
We find that there are three important nerves beside these glands: the hypoglossal nerve, the lingual nerve, and the marginal branch of the lower jaw of the facial nerve. These nerves give movement, sensation and taste to the tongue and move the lower lip.
Submandibular gland tumors can be benign (not cancerous) or malignant (cancerous).
The sublingual glands are located under the tongue, one on each side. Saliva is released into the submandibular canal, located near the lingual nerves that give feeling and taste at the front of the tongue.
The sublingual glands are the smallest of the major salivary glands and rarely develop tumors, but when they do, their tumors tend to be malignant (cancer) when they do develop.
minor salivary glands
There are hundreds of small salivary glands scattered in the mouth and throat. They can be found inside the mouth just below the surface including the lips, cheeks, and top of the mouth (soft palate). Small salivary glands can also develop benign or malignant tumors.
What is salivary gland cancer?
Salivary gland cancer is a term used to describe malignant tumors of the salivary glands in or near the mouth. Salivary gland tumors may be benign (noncancerous) or malignant (cancerous), each occurring with equal frequency.
Salivary gland cancer can affect any of the salivary glands. Your prognosis (outlook) depends on the type of salivary gland cancer you have and the stage (how advanced the disease is).
Who is likely to get salivary gland cancer?
Anyone can develop salivary gland cancer, but men are more likely to develop salivary gland tumors. A person is also more likely to develop salivary gland cancer if they:
- Is 55 years of age or older
- smokes Or drink alcohol frequently
- receive Radiotherapy on the head or neck or exposed to radioactive materials
- He works in some occupations including plumbing, rubber product manufacturing, asbestos mining, and the leather industries
Symptoms and causes of salivary gland tumors
What causes salivary gland cancer?
The exact cause of most salivary gland cancers is unknown. Salivary gland tumors can occur in any salivary gland located in or near the mouth. The most common of them occur in the three major salivary glands, which are:
- Parotid glands (inside each cheek)
- Submandibular glands (at the bottom of the mouth)
- glands under the tongue (under the tongue)
Salivary gland cancer also occurs within the microscopic salivary glands. These glands are located within the roof or floor of the mouth, lining of the tongue and lips, and inside the cheeks, sinuses, nose, and voice box.
Salivary gland tumors may be benign or malignant (cancer). Benign tumors generally grow slowly and are not likely to spread to other tissues.
About 50 percent of salivary gland tumors are noncancerous. However, some salivary gland tumors are malignant and may spread to other areas of the body.
What are the symptoms of salivary gland cancer?
A small number of people with salivary gland cancer have no symptoms. In most cases, salivary gland cancer causes a painless mass in the salivary glands.
If your salivary gland tumor is malignant, you'll likely have other symptoms, including:
- Weakness or numbness in the face, neck, jaw, or mouth.
- Persistent pain in the face, neck, jaw, or mouth.
- Difficulty opening your mouth fully or moving your facial muscles.
- difficulty swallowing;
- bleeding from the mouth;
Diagnostics and tests
How is salivary gland cancer diagnosed?
Your doctor diagnoses salivary gland cancer through a physical exam and a review of your medical and personal history.
In some cases, doctors order additional diagnostic tests to confirm the presence of a tumor. These tests include:
- Computerized tomography using X-rays to provide images of masses within the salivary glands
- Magnetic resonance imaging (MRI), which uses magnets and radio waves to create images of internal body structures
- Positron emission tomography (PET) scan using small amounts of radioactive material to identify cancerous masses
- Fine needle biopsy to collect a small sample of tissue and fluid from a salivary gland tumor for further examination in the laboratory
Diagnosis of salivary gland cancer by MRI
When should I call my doctor?
If you have any of the symptoms of a salivary gland tumor listed above, especially if symptoms persist for more than two weeks, contact your doctor for a diagnostic evaluation.
What are the stages of salivary gland cancer?
Once salivary gland cancer is detected, further tests will be done to see if the cancer cells have spread to other parts of the body. This is called staging. The doctor needs to know the stage of the disease to plan treatment.
Salivary gland cancers are classified by "grade," which tells us how quickly the cancerous cells grow and spread based on how the cells look under the microscope. Low-grade cancers grow more slowly than high-grade cancers.
The following stages are used to treat salivary gland cancer:
Stage I salivary gland cancer
The cancer is 2 cm or less in diameter and has not spread beyond the salivary glands.
stage 2 salivary gland cancer
The cancer is larger than 2 cm but not more than 4 cm in diameter and has not spread beyond the salivary glands.
stage III salivary gland cancer
- Any of the following may be true: Cancer is more than 4 cm in diameter and has spread to the skin, soft tissue, bone, or nerves around the gland. Cancer may or may not have spread to a single lymph node.
- Cancer is less than 4 cm in size and has spread to one lymph node.
stage IV salivary gland cancer
The first fourth stage
Any of the following may be true:
- Cancer has spread to the skin, soft tissue, bone, or nerves around the salivary gland. It may be up to 6 centimeters in size. It may have spread to one or more lymph nodes but has not spread to other parts of the body.
- Cancer is any size and has spread to nearby tissues and has spread to a single lymph node on the same side of the neck as the cancer, to lymph nodes on both sides of the neck, or to any lymph node.
The second fourth stage
Any of the following may be true:
- Cancer has spread to the bones of the skull and/or the surrounding carotid artery, which is the main artery (right and left) of the neck that carries blood to the head and brain, and may have spread to one or more lymph nodes.
- Cancer is larger than 6 cm and may have spread to nearby tissues and has spread to at least one lymph node.
The third fourth stage
Cancer may be any size and it may have spread to nearby tissues and lymph nodes and has spread to other parts of the body.
Recurrence and recurrence of salivary gland cancer
Recurrence means the cancer has returned after it has been treated. It may come back in the salivary glands or in another part of the body.
salivary gland cancer treatment
Surgery is usually the best treatment option for polyps that can be safely removed. After surgery, your recovery focuses on preventing infection and managing pain. Your doctor may prescribe medications such as antibiotics and pain relievers to achieve these goals.
If the tumor is growing rapidly or has spread to other parts of the body, your doctor may recommend additional treatments. These include:
Surgery
Surgery is the primary treatment for malignant salivary gland tumors. The surgeon may remove lymph nodes (lymphadenectomy) in addition to removing the tumor if cancer is suspected to have spread there. After surgery, you'll likely receive radiation therapy to kill any remaining cancer cells so that the cancer does not return.
Radiotherapy
In radiation therapy, a machine is used to direct radiation towards a part of the body that has cancer cells in it to destroy them. Two types of radiation therapy used to treat salivary gland cancer are the photon and neutron beam.
You may also receive radiation as part of your palliative care. Palliative care provides symptom relief and improves your treatment experience and overall life.
Chemotherapy
Chemotherapy uses drugs to destroy cancer cells. You may receive chemotherapy if cancer has spread from the salivary glands to other tissues outside the head and neck.
Follow-up after treatment
Some of the tests performed to diagnose cancer may be repeated later to see how well treatment is working. Decisions about whether to continue, change or stop treatment are made based on the results of these tests.
Some tests will still be done from time to time after your treatment ends. The results of these tests show whether your condition has changed or if your cancer has recurred (come back). These tests are called follow-up tests or screenings.
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