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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
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.
• 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.
• 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%.
• 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).
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
• 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
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
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.
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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