Salivary gland cancer

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Salivary Gland Cancer

Understanding Salivary Glands

Salivary glands produce saliva, which plays several essential roles in the body:

• Keeps the mouth moist

• Assists in digestion

• Prevents infections in the mouth and throat

Salivary glands are divided into two groups based on their size:

1. Minor Salivary Glands:

Found in small clusters in various parts, including the lips, tongue, throat, and sinuses.

2. Major Salivary Glands:

Three pairs of large glands:

Parotid glands: Located near the ears (largest salivary glands)

Submandibular glands: Found under the jaw

Sublingual glands: Located under the tongue

What is Salivary Gland Cancer?

Salivary gland cancer is a type of head and neck cancer where healthy salivary gland cells grow uncontrollably, forming a tumor. Tumors can be:

Benign (non-cancerous): Grows but does not spread to other areas.

Malignant (cancerous): Can invade surrounding tissues and spread to other parts of the body.

80% of tumors in parotid glands are benign, while most tumors in sublingual glands are malignant.

Statistics

• In India, about 7,850 new cases of salivary gland cancer are reported annually.

• It ranks 27th among all cancers and 24th in cancer-related deaths, with 5,127 deaths annually.

Survival Rate

• The 5-year survival rate in the United States is 76%.

• If the cancer is confined to the gland, the survival rate increases to 94%.

Risk Factors

Age: More common in people above 55 years.

Radiation exposure: Radiation treatments to the head and neck increase the risk.

Occupational exposure: Frequent exposure to chemicals (e.g., leather and pesticide industries).

Symptoms

Not all individuals with salivary gland cancer exhibit symptoms. However, possible signs include:

Lump in the face, neck, or mouth (usually painless)

Facial numbness or tingling

Weakness or paralysis on one side of the face

Swelling or pain in the face or neck

Asymmetry in facial features

Diagnosis

Biopsy: A tissue sample is removed and examined under a microscope.

• If guided by ultrasound, it is called ultrasound-guided needle biopsy.

Ultrasound

Endoscopy

CT Scan

MRI

PET-CT

Panoramic radiograph

Types of Salivary Gland Tumors

Benign Tumors:

Pleomorphic adenoma (benign mixed tumor)

Warthin’s tumor

Oncocytoma

Monomorphic adenoma

Sebaceous adenoma

Benign lymphoepithelial lesion

Malignant Tumors (Cancerous):

Mucoepidermoid carcinoma

Adenoid cystic carcinoma

Acinic cell carcinoma

Adenocarcinoma

Squamous cell carcinoma

Carcinoma ex pleomorphic adenoma

Undifferentiated carcinoma

Treatment Options

1. Surgery

Surgery is the primary treatment to remove the tumor and nearby tissues (margin). Types of surgery include:

Parotidectomy: Removal of part or all of the parotid gland. If the facial nerve is involved, reconstructive surgery may be required to restore nerve function.

Endoscopic surgery: Used for tumors in areas like the paranasal sinuses and larynx.

Neck dissection: Performed if cancer has spread to the lymph nodes in the neck.

Reconstructive surgery: Restores tissue or nerve function after tumor removal.

Side effects:

• Swelling in the face, mouth, or neck.

• Facial nerve damage may cause facial muscle weakness.

• Reconstructive surgery may be necessary if facial bones are removed.

2. Radiation Therapy

Uses high-energy radiation to destroy cancer cells.

External beam radiation therapy (EBRT): A machine delivers radiation externally.

IMRT (Intensity-Modulated Radiation Therapy): Targets the tumor with high-dose radiation while sparing healthy tissues.

Side effects:

Dry mouth, thickened saliva

Skin redness and irritation

Fatigue

Difficulty swallowing

Changes in taste and hearing

• If the mouth area is treated, a dental checkup is required beforehand to prevent complications.

3. Chemotherapy and Other Drug Treatments

Chemotherapy, targeted therapy, and immunotherapy are used for advanced-stage salivary gland cancers.

Chemotherapy: Uses drugs to kill cancer cells.

Targeted therapy: Focuses on specific genes or proteins in cancer cells.

Immunotherapy: Enhances the body’s immune response to cancer.

Follow-Up Care

After treatment, regular follow-ups are essential to:

• Monitor for recurrence

• Manage side effects

• Perform physical exams, blood tests, and imaging

Follow-up care ensures early detection of any issues and maintains the patient’s quality of life.

Salivary gland cancer, though rare, requires specialized treatment and long-term follow-up. Early detection and appropriate treatment can significantly improve outcomes.

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Further Reading

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