Salivary gland cancer is an extremely rare form of head and neck cancer. It makes up less than 1% of all cancer diagnoses and only about 5% of all head and neck cancers combined. If you or someone close to you has been diagnosed with salivary gland cancer, we understand that you might have questions about the condition and treatment options. The OSUCCCC – James is home to the region’s only dedicated Head and Neck Oncology Clinic, where we see and treat these cancers every day. Our team of experts will develop a customized plan based on your specific needs, from diagnosis through treatment options and any support resources you may need.
What is salivary gland cancer?
Salivary gland cancer occurs when cancerous cells form a tumor in the salivary glands, which are located on the floor of the mouth and near the jawbone. The salivary glands produce saliva and help you digest and taste your food. They also protect the throat and mouth against infection.
Cancer can occur in either the major or minor salivary glands. Although there are two distinct types of salivary glands, they both play an important role in key functions of your mouth and throat.
The three major salivary glands include:
- Parotid glands: These are in front of the ears on both sides of the face. They’re also the largest of the major salivary glands. This is where most salivary gland cancers form.
- Submandibular glands: The submandibular glands are located under the jawbone. They’re the second-largest major salivary glands.
- Sublingual glands (found under the tongue): The sublingual glands are the smallest of the three major salivary glands, about the size of an almond.
In addition to the major salivary glands, minor salivary glands work with the major salivary glands to produce both saliva and mucous. There are about 1,000 minor salivary glands scattered throughout the mouth and throat. Unlike the major glands, which are large and easily distinguishable, the minor salivary glands are small and embedded in the protective lining of the throat.
As mentioned, cancer can start in either the major or minor salivary glands and can spread quickly. Therefore, early detection and treatment are key to ensure the best possible outcomes.
What causes salivary gland cancer?
There are no exact known causes of salivary gland cancer. It’s very rare.
Researchers are still understanding salivary gland cancer. Salivary gland cancer occurs when cells grow and replicate at an abnormal rate, resulting in a tumor (mass) in the tissue surrounding the glands. Our cells contain “instructions” called DNA to help them grow and replicate normally. As time passes, DNA can change (mutate), leading to “bad instructions” directing cells how to grow. This causes uncontrolled cell growth, resulting in salivary gland cancer.
It's important to note that most tumors that occur in the salivary glands are noncancerous (benign). Most of the tumors that develop in the parotid glands and about half of those that develop in the submandibular glands are benign. Tumors that develop in the sublingual glands are more likely to be cancerous.
Despite this, researchers are still studying why salivary gland cancer forms in some people and not others. While the exact cause is still unknown, there are some risk factors that can play a role in the development of salivary gland cancer.
Salivary gland cancer risk factors
A risk factor is anything that increases your chance of developing a condition. Not everyone with risk factors will develop the disease, but having certain risk factors may increase your chances of developing salivary gland cancer.
These factors may be environmental, behavioral or genetic. There are some risk factors you can influence and others you can’t.
Risk factors for salivary gland cancer include:
- Age: Those aged 55 and older are more likely to develop salivary gland cancer.
- Sex: Males assigned at birth are at an increased likelihood of developing salivary gland cancer when compared to females.
- Previous exposure to radiation: If you’ve had previous treatment with radiation therapy to the head or neck for other conditions, your chances of developing salivary gland cancer increase.
- Occupational exposure: Some jobs may expose you to certain chemicals, which can increase the likelihood that you could develop salivary gland cancer.
If you’re at risk for developing salivary gland cancer, you should talk to your doctor.
Salivary gland cancer symptoms
Salivary gland cancer shares similar symptoms with other conditions. If you’re experiencing any unusual symptoms, you should talk to your doctor.
When symptoms develop, they may include:
- A lump near the jaw, in the mouth or on the neck
- Difficulty swallowing
- Unable to open the mouth wide
- Muscle weakness or numbness in the face
- Fluid draining from the ear
- Facial pain that doesn’t go away
Having these symptoms doesn’t necessarily mean you have salivary gland cancer. But if you have one or a combination of these symptoms, you should talk to your doctor.
How is salivary gland cancer diagnosed?
If you’re having symptoms or are at risk of developing salivary gland cancer, your doctors may order a series of tests to confirm a diagnosis.
For those who have salivary gland cancer, an early diagnosis is a key contributor to successful treatment outcomes. Depending on your symptoms, the head and neck cancer experts at the OSUCCC – James will begin with a physical exam to check overall health and to look for signs of disease, as well as discuss health habits, past illnesses and treatments. This will include a comprehensive exam of the mouth, tongue, throat and neck.
After a thorough exam, your doctor may also recommend additional tests, including:
- Magnetic resonance imaging (MRI) scan
- Computed tomography (CT) scan
- Positron emission tomography (PET) scan
These tests may uncover an abnormal growth, mass or lesion, and if so, help OSUCCC – James specialists determine what the possible causes could be. They may order a series of biopsies to take a tissue sample from the affected area that will be assessed by a specially trained pathologist. These tests can also help your medical team tailor an individualized treatment plan specifically for your condition.
Salivary gland cancer staging
Once a diagnosis of salivary gland cancer has been made, there are different tests that can determine if the cancer has spread to different parts of the body. Salivary gland cancer is staged depending on the size of the tumor and where it has spread (if applicable). Minor salivary gland (small salivary glands lining parts of the mouth, nose and larynx) cancers are staged according to where they were first formed, such as in the oral cavity or sinuses. While there is no routine salivary gland cancer, staging is an important factor when determining treatment options.
- Stage 0 (carcinoma in situ)
In stage 0, abnormal cells are detected in the lining of the salivary ducts. These cells may become cancerous and spread into surrounding tissue. - Stage I
In stage I cancer has formed in the salivary gland only and is smaller than 2 centimeters. - Stage II
In stage II, the tumor is only in the salivary gland but is between 2 and 4 centimeters in length. - Stage III
In stage III salivary gland cancer, one of the following will occur:- The tumor is larger than 4 centimeters and has spread to soft tissue around the salivary gland; or
- The tumor is any size but has spread into soft tissue and into the lymph node on the same side as the tumor. The lymph node is smaller than 3 centimeters and cancer hasn’t grown outside the lymph node.
- Stage IV
Stage IV is divided into three substages — IVA, IVB and IVC. In each of these substages, salivary gland cancer will be categorized based on the growth of the tumor size, where the tumor has spread (such as to facial skin, jawbone, ear canal, facial nerve or places like the lung) and how advanced it is.
Salivary gland cancer treatment
As experts at one of the highest-volume cancer centers in the nation, the OSUCCC – James Head and Neck Cancer Program team is exceptionally and extensively experienced in treating all forms of head and neck cancers, including the most complex and rare tumors, like salivary gland cancer. These nationally and internationally recognized experts meet with you to discuss your specific cancer type. Our team wants to recommend the most effective course of treatment that minimizes side effects, preserves the highest level of function and results in the best optimal outcomes.
You may receive one treatment or a combination of treatments, including:
You and your doctors will decide which treatments are necessary for you. This decision will be based on different factors such as the stage and your preferences. Each of these treatments has its own advantages and potential side effects, which will be discussed with you in detail. The goal is to tailor your treatment plan to achieve the best possible outcome.
Surgery for salivary gland cancer
Though rare, salivary gland tumors may be aggressive, eroding facial nerves and invading delicate tissues and skin nearby. Working together, our specialists use advanced surgical tools and techniques that provide the utmost precision needed to remove the cancer and repair critical nerves, vessels and tissues in the head and neck. This unique approach means you’ll receive the most appropriate, targeted surgical interventions while spending less time in surgery and less time under anesthesia. This further reduces the risk of complications and improves treatment outcomes.
Salivary gland cancer is complex, and you may experience a variety of effects following treatment. For example, some may have trouble with speech or swallowing after treatment. Those who receive radiation therapy may experience dental side effects post-treatment. Every person is different, which is why our team will work with you to determine the best course of treatment.
Within our program, you’ll have access to a multidisciplinary team of specialists, including speech pathologists, dentists, and physical and occupational therapists — all dedicated to providing the highest level of care and support for you and your loved ones.
Salivary gland cancer clinical trials
Our team of experts at the OSUCCC – James leads groundbreaking studies to understand the latest research and developments when it comes to treating salivary gland cancer. We know that no two cancers are the same, and our clinical trial program continues to help us design innovative individualized treatment approaches for this disease.
At any given time, we have over 500 clinical trials occurring, with many of those dedicated to head and neck cancer treatments. We offer phase I, phase II and phase III trials, which means earlier access to groundbreaking potential salivary gland cancer treatments for you. Your doctors will determine whether you’re a candidate.
If you have been diagnosed with salivary gland cancer, or would like a second opinion, please call The James Line at 800-293-5066 or 614-293-5066 to make an appointment.