Salivary gland cancer
Encyclopedia
Salivary gland cancer is a cancer
that forms in tissues of a salivary gland
. The salivary glands are classified as major and minor. The major salivary glands consist of the parotid, submandibular
, and sublingual
glands. The minor glands include small mucus-secreting glands located throughout the palate
, nasal
and oral cavity. Salivary gland cancer is rare, with 2% of head and neck tumors
forming in the salivary glands, the majority in the parotid.
as primary or secondary, benign or malignant, and by tissue of origin. This system defines five broad categories of salivary gland neoplasms:
The most common symptom
of major salivary gland cancer is a painless lump in the affected gland, sometimes accompanied by paralysis
of the facial nerve
.
Treatment for stage I salivary gland cancer depends on whether the cancer is low-grade (slow growing) or high-grade (fast growing).
If the cancer is low-grade, treatment may include the following:
• Surgery with or without radiation therapy.
• Fast neutron radiation therapy.
If the cancer is high-grade, treatment may include the following:
• Surgery with or without radiation therapy.
• A clinical trial of chemotherapy.
• A clinical trial of a new local therapy.
Stage II Salivary Gland Cancer
Treatment for stage II salivary gland cancer depends on whether the cancer is low-grade (slow growing) or high-grade (fast growing).
If the cancer is low-grade, treatment may include the following:
• Surgery with or without radiation therapy.
• Radiation therapy.
• Chemotherapy.
If the cancer is high-grade, treatment may include the following:
• Surgery with or without radiation therapy.
• Fast neutron or photon-beam radiation therapy.
• A clinical trial of radiation therapy and/or radiosensitizers.
• A clinical trial of chemotherapy.
Stage III Salivary Gland Cancer
Treatment for stage III salivary gland cancer depends on whether the cancer is low-grade (slow growing) or high-grade (fast growing).
If the cancer is low-grade, treatment may include the following:
• Surgery with or without lymphadenectomy. Radiation therapy may also be given after surgery.
• Radiation therapy.
• Fast neutron radiation therapy to lymph nodes with cancer.
• Chemotherapy.
• A clinical trial of fast neutron radiation therapy to the tumor.
• A clinical trial of chemotherapy.
If the cancer is high-grade, treatment may include the following:
• Surgery with or without lymphadenectomy. Radiation therapy may also be given after surgery.
• Fast neutron radiation therapy.
• Radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
• A clinical trial of radiation therapy and/or radiosensitizers.
• A clinical trial of chemotherapy.
Stage IV Salivary Gland Cancer
Treatment of stage IV salivary gland cancer may include the following:
• Fast neutron or photon-beam radiation therapy.
• A clinical trial of chemotherapy with or without radiation therapy.
has been used successfully to treat salivary gland tumors, and has shown to be significantly more effective than photons in studies treating unresectable salivary gland tumors.
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...
that forms in tissues of a salivary gland
Salivary gland
The salivary glands in mammals are exocrine glands, glands with ducts, that produce saliva. They also secrete amylase, an enzyme that breaks down starch into maltose...
. The salivary glands are classified as major and minor. The major salivary glands consist of the parotid, submandibular
Submandibular gland
The paired submandibular glands are salivary glands located beneath the floor of the mouth. In humans, they account for 70% of the salivary volume and weigh about 15 grams. Unstimulated in humans, the percentage contribution to whole saliva; ~25% Parotid, Submandibular and Sublingual ~ 67% and...
, and sublingual
Sublingual gland
The sublingual glands are salivary glands in the mouth.They lie anterior to the submandibular gland under the tongue, beneath the mucous membrane of the floor of the mouth.They are drained by 8-20 excretory ducts called the ducts of Rivinus....
glands. The minor glands include small mucus-secreting glands located throughout the palate
Palate
The palate is the roof of the mouth in humans and other mammals. It separates the oral cavity from the nasal cavity. A similar structure is found in crocodilians, but, in most other tetrapods, the oral and nasal cavities are not truly separate. The palate is divided into two parts, the anterior...
, nasal
Nasal cavity
The nasal cavity is a large air filled space above and behind the nose in the middle of the face.- Function :The nasal cavity conditions the air to be received by the other areas of the respiratory tract...
and oral cavity. Salivary gland cancer is rare, with 2% of head and neck tumors
Head and neck cancer
Head and neck cancer refers to a group of biologically similar cancers that start in the upper aerodigestive tract, including the lip, oral cavity , nasal cavity , paranasal sinuses, pharynx, and larynx. 90% of head and neck cancers are squamous cell carcinomas , originating from the mucosal lining...
forming in the salivary glands, the majority in the parotid.
Classification
Salivary gland neoplasms are classified by the World Health OrganizationWorld Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
as primary or secondary, benign or malignant, and by tissue of origin. This system defines five broad categories of salivary gland neoplasms:
- malignant epithelial tumors (e.g. acinic cell carcinomaAcinic cell carcinomaAcinic cell carcinoma is a tumor most commonly found in the parotid gland. The disease presents as a slow growing mass, sometimes associated with pain or tenderness....
, mucoepidermoid carcinomaMucoepidermoid carcinomaMucoepidermoid carcinoma is the most common type of salivary gland malignancy in children. Mucoepidermoid carcinoma can also be found in other organs, as bronchi, lacrimal sac and thyroid.Mucicarmine staining is one stain used by pathologist for detection....
and adenoid cystic carcinomaAdenoid cystic carcinomaAdenoid cystic cancer is a rare type of cancer that can exist in many different body sites. It most often occurs in the areas of the head and neck, in particular the salivary glands; but has also been reported in the breast, lacrimal gland of the eye, lung, brain, bartholin gland, trachea, and...
, salivary duct carcinomaSalivary duct carcinomaSalivary duct carcinoma, abbreviated SDC, is a rare type of aggressive cancer that arises from the salivary gland ducts. It is predominantly seen in men and, generally, has a poor prognosis.-Symptoms:...
) - benign epithelial tumors (e.g. pleomorphic adenomaPleomorphic adenomaPleomorphic adenoma is a common benign salivary gland neoplasm characterised by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality. It is the most common type of salivary gland tumor and the most common tumor of the...
, myoepithelioma and Warthin tumour, sebaceous lymphadenomaSebaceous lymphadenoma-Diagnosis:Sebaceous lymphadenoma is a tissue diagnosis, e.g. salivary gland biopsy.It may be confused with a number of benign and malignant neoplasms, including Warthin tumour, mucoepidermoid carcinoma and sebaceous lymphadenocarcinoma....
) - soft tissue tumors (HemangiomaHemangiomaA hemangioma of infancy is a benign self-involuting tumor of endothelial cells, the cells that line blood vessels. It usually appears during the first weeks of life and sometimes resolves by age 10. In more severe case hemangioma may have permanency, if not treated by a physician...
) - hematolymphoid tumors (e.g. Hodgkin lymphoma)
- secondary tumors.
Signs and symptoms
Signs include fluid draining from the ear, pain, numbness, weakness, trouble swallowing, and a lump.The most common symptom
Symptom
A symptom is a departure from normal function or feeling which is noticed by a patient, indicating the presence of disease or abnormality...
of major salivary gland cancer is a painless lump in the affected gland, sometimes accompanied by paralysis
Paralysis
Paralysis is loss of muscle function for one or more muscles. Paralysis can be accompanied by a loss of feeling in the affected area if there is sensory damage as well as motor. A study conducted by the Christopher & Dana Reeve Foundation, suggests that about 1 in 50 people have been diagnosed...
of the facial nerve
Facial nerve
The facial nerve is the seventh of twelve paired cranial nerves. It emerges from the brainstem between the pons and the medulla, and controls the muscles of facial expression, and functions in the conveyance of taste sensations from the anterior two-thirds of the tongue and oral cavity...
.
Causes
. Risk factors include older age, radiation therapy treatment to head or neck, and being exposed to certain substances at workTreatment
Stage I Salivary Gland CancerTreatment for stage I salivary gland cancer depends on whether the cancer is low-grade (slow growing) or high-grade (fast growing).
If the cancer is low-grade, treatment may include the following:
• Surgery with or without radiation therapy.
• Fast neutron radiation therapy.
If the cancer is high-grade, treatment may include the following:
• Surgery with or without radiation therapy.
• A clinical trial of chemotherapy.
• A clinical trial of a new local therapy.
Stage II Salivary Gland Cancer
Treatment for stage II salivary gland cancer depends on whether the cancer is low-grade (slow growing) or high-grade (fast growing).
If the cancer is low-grade, treatment may include the following:
• Surgery with or without radiation therapy.
• Radiation therapy.
• Chemotherapy.
If the cancer is high-grade, treatment may include the following:
• Surgery with or without radiation therapy.
• Fast neutron or photon-beam radiation therapy.
• A clinical trial of radiation therapy and/or radiosensitizers.
• A clinical trial of chemotherapy.
Stage III Salivary Gland Cancer
Treatment for stage III salivary gland cancer depends on whether the cancer is low-grade (slow growing) or high-grade (fast growing).
If the cancer is low-grade, treatment may include the following:
• Surgery with or without lymphadenectomy. Radiation therapy may also be given after surgery.
• Radiation therapy.
• Fast neutron radiation therapy to lymph nodes with cancer.
• Chemotherapy.
• A clinical trial of fast neutron radiation therapy to the tumor.
• A clinical trial of chemotherapy.
If the cancer is high-grade, treatment may include the following:
• Surgery with or without lymphadenectomy. Radiation therapy may also be given after surgery.
• Fast neutron radiation therapy.
• Radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
• A clinical trial of radiation therapy and/or radiosensitizers.
• A clinical trial of chemotherapy.
Stage IV Salivary Gland Cancer
Treatment of stage IV salivary gland cancer may include the following:
• Fast neutron or photon-beam radiation therapy.
• A clinical trial of chemotherapy with or without radiation therapy.
Radiotherapy
Fast neutron therapyFast neutron therapy
Fast neutron therapy utilizes high energy neutrons typically greater than 20 MeV to treat cancer. Most fast neutron therapy beams are produced from proton beams impinging upon beryllium targets.-Advantages:...
has been used successfully to treat salivary gland tumors, and has shown to be significantly more effective than photons in studies treating unresectable salivary gland tumors.
External links
- Salivary gland cancer entry in the public domain NCI Dictionary of Cancer Terms
- The Patients Forum on Tumors Of The Parotid Gland
- Clinically reviewed salivary gland cancer for patients from Cancer Research UKCancer Research UKCancer Research UK is a cancer research and awareness charity in the United Kingdom, formed on 4 February 2002 by the merger of The Cancer Research Campaign and the Imperial Cancer Research Fund. Its aim is to reduce the number of deaths from cancer. As the world's largest independent cancer...
.