Description

Salivary gland tumors are masses of cells that originate in the salivary glands. Tumors of salivary glands are rare.

The salivary glands produce saliva. The Saliva helps in digestion, keeps your mouth moist and supports healthy teeth. There are three pairs of major salivary glands under and behind your jaw. These are the parotid, sublingual, and submandibular glands. Many other tiny salivary glands are in your lips, inside your cheeks, and throughout your mouth and throat.

Salivary gland tumors can occur in any salivary gland. The majority of salivary gland tumors occur in the parotid gland. Of these, most are not cancer. For every five tumors of the parotid gland, on average, only one is found to be cancerous.

The treatment for tumors of the salivary gland is usually with surgery to remove the tumor. People with cancer of the salivary gland may need additional treatments.

Symptoms

The signs and symptoms of a salivary gland tumor may include:

  • A lump or swelling on or near your jaw or in the neck or the mouth.
  • Muscle weakness on one side of the face.
  • Numbness in the part of the face.
  • Ongoing pain near a salivary gland.
  • Difficulty opening the mouth widely.
  • Difficulty swallowing.

When to see a doctor

Make an appointment with your doctor or other health care professional if you have any symptoms that worry you.

Causes

The cause of many of the tumors of the salivary gland is not known. Health professionals have identified some things that increase the risk of salivary gland tumors. These include smoking, and radiation therapy for cancer. Not all people with a tumor of the salivary gland have these risk factors, however. More research is needed to find out exactly what is the cause of these tumors.

Salivary gland tumors occur when cells in a salivary gland develop changes in their DNA. A cell's DNA contains the instructions that tell the cell what to do. In healthy cells, the DNA contains the instructions to grow and multiply at a set rate. The instructions also say that the cells die at a set time. In tumor cells, the changes that are given different instructions. Changes to say to the tumor cell to make many more cells quickly. Tumor cells can continue living when healthy cells would die. This makes too many cells.

Sometimes changes in the DNA of rotation of the cells in the cancer cells. The cancerous cells can invade and destroy healthy body tissue. At the time, cancer cells can break off and spread to other parts of the body. When cancer spreads, it is called metastatic cancer.

Types of salivary gland tumors

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 health care team to decide which treatment options are best for you.

Types of salivary gland tumors that are not cancerous are:

  • The pleomorphic adenoma.
  • Adenoma, basal cell.
  • Adenoma Canalicular.
  • Oncocytoma.
  • Warthin tumor.

Types of cancerous, tumors of the salivary gland include:

  • Acinic cell carcinoma.
  • The Adenocarcinoma.
  • The adenoid cystic carcinoma.
  • Clear cell Carcinoma.
  • Malignant mixed tumours.
  • Mucoepidermoid carcinoma.
  • Carcinoma oncocytic.
  • Polymorphous low-grade adenocarcinoma.
  • Salivary duct carcinoma.
  • The squamous cell carcinoma.

Risk factors

Factors that may increase the risk of salivary gland tumors include:

  • Advanced age. Although salivary gland tumors can occur at any age, it most often occurs in older adults.
  • The exposure to radiation. Radiation treatments for cancer, such as the radiation that is used for the treatment of cancers of the head and neck, may increase the risk of salivary gland tumors.
  • The smoking of tobacco. Smoking tobacco is shown to increase the risk of salivary gland tumors.
  • Viral infections. People who have had viral infections, such as Epstein-Barr virus, human immunodeficiency virus and human papilloma virus, may have an increased risk of tumors of the salivary gland.
  • Workplace exposure to certain substances. The people who work with certain substances may have an increased risk of tumors of the salivary gland. Examples of industries that are associated with a higher risk are those that involve the manufacturing of rubber and nickel.

Diagnosis

Salivary gland Tumor diagnosis often begins with a physical examination of the area by a healthcare professional. The imaging tests and a biopsy can be used to find the location of the tumor and determine what type of cells are involved.

Physical examination

A health care professional feels the jaw, neck and throat for lumps or swelling.

Imaging tests

Imaging tests create pictures of the body. You can show the location and size of a tumor of the salivary gland. The tests may include magnetic resonance, computed tomography and positron emission tomography, also called a PET scan.

Biopsy

A biopsy is a procedure to remove a sample of tissue for testing in a lab. To collect a tissue sample, a fine-needle aspiration or core needle biopsy can be used. During the biopsy, a fine needle is inserted in the salivary gland to remove a sample of suspicious cells. The sample is sent to a laboratory for analysis. Tests can show what types of cells are involved, and whether the cells are cancerous.

Determination of the extent of the cancer of the salivary gland

If you are diagnosed with cancer of the salivary gland, you may have other tests to see if the cancer has spread. These tests can help your health care team figure out the extent of your cancer, also called stage. Cancer staging tests often involve testing image. Tests to detect signs of cancer in the lymph nodes or other parts of your body. Your healthcare team uses the stage of the cancer, the results of the test to help you to create your treatment plan.

Imaging tests may include CT, MRI and PET. Not each of the tests is appropriate for each person. Talk with your healthcare provider about the procedures that will work for you.

Stages of cancer of the salivary gland range from 0 to 4. A stage 0 of salivary gland cancer is small and only in the gland. As the cancer grows and grows more within the gland and the surrounding areas, such as the facial nerve, the stages get more. 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

Treatment for salivary gland tumors usually involves surgery to remove the tumor. People with cancer of the salivary gland may need additional treatments. These additional treatments may include radiation therapy, chemotherapy, targeted therapy, or immunotherapy.

Surgery

Surgery for salivary gland tumors may include:

  • The removal of part of the affected salivary gland. If the tumor is small and located in an easy-to-access spot, the surgeon can remove the tumor and a small portion of healthy tissue that surrounds it.
  • The removal of the entirety of the salivary gland. If you have a larger tumor, the surgeon may recommend removal of the entirety of the salivary gland. If the tumor extends into nearby structures, which can also be removed. Nearby structures may include the facial nerves, the ducts that connect the salivary glands and the facial bones and the skin.
  • Removal of the lymph nodes in the neck. If your salivary gland tumor is cancerous, it may be a risk that the cancer has spread to the lymph nodes. Your surgeon may recommend the removal of some lymph nodes in the neck and put them to the test for cancer.
  • The reconstructive surgery.After the removal of the tumor, the surgeon may recommend reconstructive surgery for the repair of the area. If the bone, skin or nerves are removed during surgery, these may need to be repaired or replaced by the use of the reconstructive surgery. During the reconstructive surgery, the surgeon works to make the repairs that improve your ability to chew, swallow, talk, breathe, and move your face. You may need to transfer the skin, tissues, bones, or nerves in other parts of your body to rebuild areas in the mouth, the face, throat or jaws.

The reconstructive surgery. After the removal of the tumor, the surgeon may recommend reconstructive surgery for the repair of the area. If the bone, skin or nerves are removed during surgery, these may need to be repaired or replaced by the use of the reconstructive surgery.

During the reconstructive surgery, the surgeon works to make the repairs that improve your ability to chew, swallow, talk, breathe, and move your face. You may need to transfer the skin, tissues, bones, or nerves in other parts of your body to rebuild areas in the mouth, the face, throat or jaws.

Salivary gland surgery can be difficult due to several important nerves are found in and around the glands. For example, a nerve in the face that controls facial movement runs through the parotid gland.

The removal of tumors that involve major nerves may require working around and underneath the facial nerves. Sometimes the facial nerve is stretched during the surgery. This can cause loss of movement in the muscles of the face. The movement of the muscles, often gets better with time. Rarely, the facial nerve must be cut in order to get all of the tumor. Surgeons can repair the facial nerve via the nerve of the other areas of the body or with other techniques.

Radiation therapy

If you are diagnosed with cancer of the salivary gland, your health care team may recommend radiation therapy. Radiation therapy treats cancer with powerful rays of energy. The energy can come from X-rays, protons or other sources. For cancer of the salivary gland, radiation therapy is most often done with a procedure called external-beam radiation. During this treatment, you will lie on a table while a machine moves around you. The machine directs radiation to precise points on your body.

Radiation therapy may be used after surgery to destroy any cancer cells that may remain. If surgery is not possible due to a tumor is very large or is located in a place that makes the removal too risky, your health care professional may recommend radiation therapy alone or in combination with chemotherapy.

Chemotherapy

Chemotherapy treats the cancer with strong medications. Chemotherapy is currently used as a standard treatment for cancer of the salivary gland, but researchers are studying its use.

Chemotherapy may be an option for people with advanced cancer of the salivary gland. Sometimes combined with radiation therapy.

Targeted therapy

Targeted therapy for cancer is a treatment that uses drugs that attack specific chemicals in cancer cells. By blocking these chemicals, specific treatments can cause cancer cells to die.

For cancer of the salivary gland, the targeted therapy may be used when the cancer cannot be removed with surgery. It can also be used for advanced cancers that spread to other parts of the body or of the cancer that comes back after treatment.

Some targeted therapies only work in the people that the cancer cells have been certain changes in the DNA. Cancer cells can be analyzed in a laboratory to see if these medications can help.

Immunotherapy

Immunotherapy for cancer is a treatment with a medication that helps the body's immune system destroys the cancer cells. The immune system fights diseases by attacking the germs and other cells that should not be in the body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the cells of the immune system find and kill cancer cells.

For cancer of the salivary gland, immunotherapy can be used in cancer that cannot be removed with surgery. It can also be used for advanced cancers that have spread to other parts of the body, or cancer that has returned after treatment.

Palliative care

Palliative care is a special type of health care that helps you feel better when you have a serious illness. If you have cancer, palliative care can help relieve the pain and other symptoms. A health care team that may include doctors, nurses and other specially trained health professionals providing palliative care. The care team's goal is to improve the 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 that you are getting strong cancer treatments, such as surgery, chemotherapy or radiation therapy.

The use of palliative care with other appropriate treatments can help people with cancer feel better and live longer.

Lifestyle and home remedies

Dealing with a dry mouth

People with salivary gland tumors that are cancerous may need radiation therapy. One of the side effects of radiation therapy to the head and neck is having a very dry mouth, called xerostomia. Having a dry mouth can cause discomfort. It can lead to frequent infections in the mouth, tooth decay, and problems with their teeth. Dry mouth can also make eating, swallowing and speaking difficult.

You can find a little bit of relief from the dryness of the mouth and its complications if you:

  • Avoid acidic or spicy foods and drinks. Choose foods and beverages that do not irritate the mouth. Avoid caffeine and alcoholic beverages.
  • Brushing your teeth several times each day. Use a soft-bristled toothbrush and gently brush your teeth several times each day. Tell your health care professional if your mouth becomes too sensitive to tolerate gentle brushing.
  • Choose the wet food. Avoid dry food. Moisten the dry food with sauce, meat sauce, broth, butter, or milk.
  • Keep your mouth moistened with water or sugar-free candy. Drink water throughout the day to keep your mouth moist. Also try chewing gum or sugarless hard candy to stimulate your mouth to produce saliva.
  • Rinse your mouth with warm salt water after meals. Make a mild solution of warm water and salt. Rinse your mouth with this solution after every meal.

Tell your health care professional if you have a dry mouth. Treatments can help you deal with the most severe symptoms of dry mouth. You may also be referred to a dietitian who can help you find the foods that are easier to eat if you have dry mouth.

Alternative medicine

Complementary or alternative medicine treatments can't cure tumors of the salivary gland. But complementary and alternative treatments can be combined with your health care team care to help relieve fatigue, pain and other symptoms.

The options may include:

  • Acupuncture.
  • Exercise.
  • Guided imagery.
  • Hypnosis.
  • The massage.
  • Relaxation techniques.

Ask your health care team if these options are safe for you.

Coping and support

With time, you will find what helps you to deal with the concerns that may come with a salivary gland tumor diagnosis. Until then, you can find help for:

Learn enough about the tumors of the salivary gland to make decisions about your care

Ask your health care team about your tumor, including the type, stage, and treatment options. As you learn more about your tumor, you can be more confident in making treatment choices.

Keep friends and family close

Keep your close relationships strong can help you cope during treatment. Friends and family can help with small tasks that do not have the energy during the treatment. And they can be there to listen when you need to talk.

Connect with others

Other people who have had tumors of the salivary gland can offer unique support and understanding, because they understand that what they are experiencing. Connect with others through support groups in your community and online.

Take care of yourself during treatment

Get enough rest each night so that you wake up feeling rested. Try to exercise when you feel up to it. Choose a healthy diet full of fruits and vegetables.

Preparing for your appointment

Make an appointment with a doctor or other health care professional if you have any symptoms that worry you.

If your healthcare provider thinks you might have a tumor of the salivary gland, you may be referred to a physician that specializes in diseases that affect the ears, nose, and throat. This doctor is called an OTOLARYNGOLOGIST or an ent.

Because appointments can be brief, it is a good idea to be prepared. Here's some information to help you prepare.

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything that you need to do in advance, such as restrict your diet.
  • Write down any symptoms you're experiencing, including any that do not seem to be related to the reason for which you scheduled the appointment.
  • Write down key personal information, including major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements you are taking and the dose.
  • Have a family member or friend. Sometimes it can be very difficult to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
  • Write questions to ask their health care team.

Your time with your health care team is limited, so preparing a list of questions can help you make the most of their time together. A list of questions from most important to least important in case time runs out. For tumors of the salivary gland, some basic questions to ask include:

  • Where is my tumor of the salivary gland located?
  • How big is my salivary gland tumor?
  • Is my salivary gland tumor cancerous?
  • If the tumor is cancerous, what type of salivary gland cancer do I have?
  • Has my cancer has spread beyond the salivary gland?
  • More evidence is needed?
  • What are my treatment options?
  • Can my salivary gland tumor be cured?
  • What are the possible side effects of each treatment option?
  • We tried to make it hard for me to eat or talk?
  • Will treatment affect my appearance?
  • You should see a specialist? What will that cost, and will my insurance cover it?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Be prepared to answer questions, such as:

  • When did your symptoms begin?
  • The symptoms been continuous or occasional?
  • How severe are the symptoms?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
The symptoms and treatment of tumors of the Salivary gland