Salivary gland cancer

 

Definition

Salivary gland cancer is a rare form of cancer that begins in the salivary glands. Salivary gland cancer can start in any of the salivary glands in the mouth, neck or throat.

Salivary glands make saliva, which aids in digestion and keeps your mouth moist. You have three pairs of major salivary glands under and behind your jaw - parotid, sublingual and submandibular. Many other minor salivary glands are in your lips, inside your cheeks and throughout your mouth and throat.

Salivary gland cancer most commonly occurs in the parotid gland, which is in front of the ear.

Treatment for salivary gland cancer often involves surgery. Other treatments for cancer, salivary gland may include radiation therapy and chemotherapy.

Symptoms

Signs and symptoms of salivary gland cancer may include:

• A lump or thickening in or near your jaw or neck or mouth
• Numbness in part of your face
• Muscle weakness on one side of your face
• Persistent pain in the area of ​​salivary gland
• Difficulty swallowing
• Difficulty opening the mouth widely

When to see a doctor 

Make an appointment with your doctor if you have any signs or symptoms that worry you.

Having a lump or swelling in the area near your salivary gland is a common sign of a salivary gland tumor, but that does not mean you have cancer. Tumors of the salivary glands are more benign (benign).

Causes

It is not clear what causes salivary gland cancer. Doctors know salivary gland cancer occurs when some cells in a salivary gland develop mutations in their DNA. The mutations allow the cells to grow and divide rapidly. The mutated cells continue living when other cells would die. The accumulated cells form a tumor that can invade adjacent tissue. Cancer cells can break off and spread (metastasize) to distant areas of the body.

Types of salivary gland cancer 

There are many different types of salivary gland cancer. Doctors classify salivary gland cancer based on the type of cells involved in the tumor. The type of salivary gland cancer you have helps a doctor determine which treatment options are best for you.

Salivary gland cancer types include:

• Acinar cell carcinoma
• Adenocarcinoma
• Adenoid cystic carcinoma
• Clear cell carcinoma
• Mixed malignant tumor
• The mucoepidermoid carcinoma
• Oncocytic carcinoma
• Adenocarcinoma low grade polymorph
• Salivary duct carcinoma
• Squamous Cell Carcinoma

Risk factors

Salivary gland cancer. Types of salivary gland cancer.

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

• Older age. Although it can occur at any age, salivary gland cancer is most commonly diagnosed in older adults.
• The radiation exposure. Radiation, such as radiation used to treat cancers of the head and neck increases the risk of cancer of the salivary gland.
• Workplace exposure to certain chemicals. People who work with certain substances may have an increased risk of cancer of the salivary gland. Jobs associated with salivary gland cancer include those involved in the manufacture of rubber, asbestos mining and plumbing.

Preparing for your appointment

If you have any signs or symptoms that worry you, make an appointment with your family doctor or dentist.

If your doctor or dentist suspects that you may have a salivary gland tumor, it can be referred to a surgeon who specializes in head and neck operations (maxillofacial surgeon). Other specialists involved in treating salivary gland cancer may include doctors who treat cancer (oncologists) and doctors who specialize in throat problems (ENT) and head.

Because appointments can be brief, and because there is often a lot of ground to cover, it's a good idea to be well prepared. Here is some information to help you prepare and know what to expect from your doctor.

Preparing for your appointment. Workplace exposure to certain chemicals.

What can you do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there is anything you need to do in advance, such as restrict your diet.
• Write down any symptoms you're experiencing, including those that may seem unrelated to the reason for which you scheduled the meeting.
• Write down important personal information, including major stresses or recent life changes.
• Make a list of all medications, vitamins or supplements that you are taking.
• Consider taking a family member or friend along. Sometimes it can be hard to remember all the information provided during an interview. Someone who accompanies you may remember something that you missed or forgot.
• Write down questions to ask your doctor.

Your time with your doctor 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 cancer, some basic questions to ask include:

• I have salivary gland cancer?
• Where is my salivary gland cancer?
• How large is my salivary gland cancer?
• What type of salivary gland cancer do I have?
• Has my cancer spread beyond the salivary gland?
• I'll need more evidence?
• What are my treatment options?
• My salivary gland cancer can be cured?
• What are the possible side effects of each treatment option?
• Will treatment make it difficult for me to eat or speak?
• Will treatment affect my appearance?
• Should I see a specialist? What will be the cost and my insurance cover it?
• There are brochures or other printed material that I can take with me? What sites do you recommend?

In addition to the questions that you've prepared to ask your doctor, do not hesitate to ask other questions that occur to you during your appointment.

What to expect from your doctor 

Your doctor will probably ask you a series of questions. Being ready to answer them may allow later to cover other points you want to address. Your doctor may ask:

• When did you begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?

Testing and diagnosis

Salivary gland cancer diagnosis 

tests and procedures used to diagnose salivary gland cancer include:

• A physical examination. Your doctor will feel your jaw, neck and neck for lumps or swelling.
• Imaging tests. Imaging tests, such as magnetic resonance imaging (MRI), computed tomography (CT) and positron emission tomography (PET), can help the doctor determine the size and location of your salivary gland cancer.
• Collecting a tissue sample for testing. In some cases, physicians may recommend collecting a tissue sample (biopsy) for laboratory testing. During an aspiration biopsy, the doctor inserts a needle into the suspicious area and draws fluid or cells. Tumors of the salivary glands are analyzed in the laboratory after the surgery to confirm the diagnosis.

Determining the extent of cancer salivary gland 

After the cancer is diagnosed, the doctor will determine the extent (stage) of your cancer. Stage of their cancer determines treatment options and gives your doctor an idea of your prognosis. Cancer stages are identified by Roman numerals, with stage I indicating a small localized tumor and stage IV indicating an advanced cancer that has spread to the lymph nodes of the neck or to distant parts of the body.

Treatments and drugs

Treatment for salivary gland cancer depends on the type, size and stage of salivary gland cancer you have, and your health and your preferences. The treatment of salivary gland cancer usually involves surgery, with or without radiation therapy.

Surgery 

Surgery for salivary gland cancer may include:

• Removing a portion of the affected salivary gland. If the cancer is small and located in an easily accessible place, the surgeon can remove the tumor and a small amount of healthy tissue that surrounds it.
• Removing the entire salivary gland. If you have a larger tumor, the doctor may recommend removing the entire salivary gland. If the cancer spreading to nearby structures - such as facial nerves, the ducts that connect the salivary glands, facial bones and skin - these can also be removed.
• The removal of the lymph nodes of the neck. If there is evidence that the cancer has spread to lymph nodes in the neck, the surgeon can remove most of the lymph nodes in the neck (emptying). Neck dissection may involve removal of other muscles and nerves in his neck, too.
• Reconstructive surgery. If bone, skin or nerves are removed during surgery, these may need to be repaired or replaced by reconstructive surgery. During reconstructive surgery, a plastic surgeon works to make repairs that improve your ability to chew, swallow, speak or breathe after surgery.You may need skin grafts, tissue or nerves from other parts of your body to rebuild areas in your mouth, throat or jaw.

Salivary gland surgery can be difficult because several important nerves are located around the glands. For example, a nerve that controls the face facial movement through the parotid gland.Removing tumors that involve important nerves may require damaging the nerves, causing partial paralysis of his face. Surgeons take care to preserve these nerves whenever possible. In some cases, severed nerves can be repaired with nerves taken from other areas of your body.

Radiotherapy 

Radiation therapy uses high-powered energy beams such as X-rays, to kill cancer cells. During radiation therapy, you lie on a table while a machine moves around you, directing high-powered beams at specific points on your body. A more recent type of radiation therapy which utilizes neutrons calls particles may be more effective in treating certain cancers of the salivary gland. However, neutron radiation therapy is not widely available in Europe.

Radiation therapy may be used after surgery to kill any cancer cells that might remain. If surgery is not possible because a tumor is very large or is located in an area which makes too risky removal, radiation alone can be used to treat cancer of the salivary gland.

Chemotherapy 
Chemotherapy is a drug treatment using chemicals to kill cancer cells. Chemotherapy may be an option for people with advanced salivary gland cancer that has spread to distant areas of their bodies.Chemotherapy is not currently used as standard treatment for cancer, salivary gland, but investigators to study their use.

Lifestyle and home remedies

Coping with dry mouth 

People who undergo radiation therapy for head and neck area often experience dry mouth (xerostomia). Having a dry mouth can be uncomfortable. It can also lead to frequent infections in your mouth and difficulty eating, swallowing and speaking. You can find some relief from dry mouth and its complications if you:

• Brush your teeth several times a day. Use a soft bristle brush and gently brush your teeth several times a day. Tell your doctor if your mouth becomes too sensitive to tolerate gentle brushing.
• 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 each meal.
• Keep your mouth moistened with water or sugarless candy. Drink water throughout the day to keep the mouth moist. Also try sugarless gum or sugarless candies to stimulate your mouth to produce saliva.
• Choose moist foods. Avoid dry foods. Moisten dry food with sauce, gravy, broth, butter or milk.
• Avoid spicy or acidic foods and drinks. Choose foods and drinks that will not irritate your mouth. Avoid caffeine and alcohol.

Tell your doctor if you have dry mouth. Treatments can help deal with the most severe signs and symptoms of dry mouth. Your doctor may also refer you to a nutritionist who can help you find foods that are easier to eat if you are experiencing dry mouth.

Alternative medicine

No complementary treatments or alternative medicine can cure salivary gland cancer. But complementary treatments and alternative medicine can help you cope with salivary gland cancer and the side effects of cancer treatment.

Alternative treatments for fatigue 

Many people undergoing radiation therapy for cancer experience fatigue. Your doctor may treat the underlying causes of fatigue, but the feeling of being completely worn out may persist despite treatments. Complementary therapies can help you cope with fatigue. Ask your doctor about trying:

• Exercise. Try gentle exercise for 30 minutes most days of the week. Moderate exercise, such as brisk walking, during and after cancer treatment reduces fatigue. Talk to your doctor before you start exercising, to make sure it's safe for you.
• Acupuncture. Acupuncture involves inserting several thin needles into your skin at certain points on your body. Acupuncture is safe when it is done by a certified professional, but check with your doctor to make sure it's okay for you. Ask your doctor to recommend a professional in your community.
•  Massage therapy. During a massage, a massage therapist uses his hands to apply pressure on the skin and muscles. Some massage therapists are specially trained to work with people who have cancer. Ask your doctor for names of massage therapists in your community.
• Relaxation. Activities that help you feel relaxed may help you deal with it. Try listening to music or writing in a journal.