In this section: Salivary Gland Cancer

salivary gland CANCER 

What is 'Salivary Gland Cancer''? Most Salivary-Gland-Cancer-HANCA2020-docx_4Salivary Gland Cancers are found in the parotid glands. The parotid glands contain glands of the immune system (lymph nodes). If this is not the cancer type you're looking for, please explore the information about other types of Throat Cancers or other types of Head and Neck Cancers.

All the information in this section is available in a PDF.
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1. Treatment options for Salivary Gland Cancer

Following a diagnosis of Salivary Gland Cancer, your cancer care team will discuss treatment options that are suitable for you. This is also a good time to consider if you would like a second opinion.

The most suitable treatment of Salivary Gland Cancer depends on many things. These include:

  • type and grade of Salivary Gland Cancer

  • size and location of the cancer 

  • whether it has spread

  • personal factors  (e.g. age, general health and treatment history)

  • treatments available (and whether any clinical trials are available)

  • your preferences for treatment. 

Surgery is often the main treatment for Salivary Gland Cancer. This involves cutting the cancer out and, for some patients, taking out the lymph nodes.

A week or two after surgery, your pathologist will give a detailed report on the cancer. This will be used by your cancer care team to decide if you need more treatment to reduce the risk of the cancer coming back. This treatment may be radiation therapy alone or radiation combined with chemotherapy (chemoradiation) and, occasionally, it may be radiation therapy followed by chemotherapy.

Adding another treatment after surgery is called adjuvant therapy. Adjuvant therapy usually starts about 4–6 weeks after surgery so that you have time to recover from your surgery. Adjuvant therapy usually lasts for about 6 weeks.

  • Low-grade cancer is usually treated with surgery alone and, usually, the lymph nodes do not need to be removed.

  • High-grade cancer usually involves removing the lymph nodes during surgery and adjuvant radiation therapy after surgery. Sometimes chemotherapy is added, however, this will depend on the features of the cancer, your cancer care team and, sometimes, what clinical trials are available.

Salivary Gland Cancer can cause physical changes while its treatment can cause side effects. Some of these physical changes and side effects will go away soon after treatment, while others may be long-term or permanent.

How can I prepare for the surgery?

Your doctor will explain details of the surgery, general risks and side effects of surgery. Ask your doctor if you have questions. They may recommend:

  • stopping blood thinners (e.g. aspirin) before surgery to reduce the risk of bleeding

  • special stockings to reduce the risk of blood clots

  • early mobilisation (i.e not staying in bed) to reduce the risk of blood clots and chest infection

  • antibiotics to lower the risk of wound infection.

Before starting treatment, it is important that you consider stopping smoking to reduce the risk of infection and help you fully recovery after your treatment.

2. Surgery for Salivary Gland Cancer

There are a number of different types of operations that can be used to remove Salivary Gland Cancer. The type of surgery used will depend on the size and the location of the cancer.

The different operations that can be used for Salivary Gland Cancers are:


This is removal of one or both of the parotid glands (pair of major salivary glands located in front of each ear) and the surrounding tissue. 

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This is removal of the submandibular glands (located beneath the floor of your mouth) and some of the surrounding tissue and/or bone.

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This is removal of the sublingual glands (located in the mouth) and some of the surrounding tissue.

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This is removal of facial nerve, which controls facial expression. It is performed when a cancer in the parotid glands has spread to surrounding facial nerve.

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This is the removal of some or all of the bone in the temple and behind the ear. It is used when a cancer in the parotid glands spreads into the nearby bone.

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This involves taking out the lymph nodes from the neck. It is used when cancer of the salivary glands has spread to the lymph nodes in the neck or there is a risk of cancer in the lymph nodes of the neck.

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This may be considered if you have a large area of tissue removed. This may involve taking tissue from another part of the body, this is called a free flap repair. This operation is carried out by a surgeon who specialises in reconstructive surgery, your head and neck surgeon or another surgeon.

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A tracheostomy is used to create an opening in the trachea (windpipe) after major head and neck surgery. A tube is inserted into the opening to help you breathe until normal breathing is possible.

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  • A gastrostomy tube (called a PEG tube) goes through the skin and the muscles of your abdomian wall into the stomach, with part of the tube staying outside the stomach for as long as the tube is needed.  Gastrostomy is recommended if feeding is needed for a medium to longer time (months or years).
  • A nasogastric tube goes through the nose down into the stomach. Nasogastric feeding is used for short time (days or weeks).
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Tooth extractions may be recommended to remove any broken or infected teeth before radiation therapy. This is important because removal of unhealthy teeth after radiation therapy can cause problems with the jaw bone.

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Side effects of surgery

Treatment for salivary gland cancer may lead to a number of side effects. Possible side effects depend on the surgical approach that best suits your individual cancer. It depends on whether you need to have lymph nodes removed from the neck. You may not experience all of the side effects. Speak with your doctor if you have any questions or concerns about treatment side effects.

3. Radiation Therapy for Salivary Gland Cancer

The most common approach of radiation therapy for Salivary Gland Cancer is called external beam radiation. This type of radiation therapy applies radiation from outside the body.

Radiation therapy can be used in the following ways: 


This is when radiation therapy is used on its own without surgery to cure Salivary Gland Cancer. It is used in Salivary Gland Cancer when surgery is not a treatment option.


This is when radiation therapy is given after surgery, to kill cancer cells that may not have been taken out during surgery. It can be used either on its own or at the same time as chemotherapy (chemoradiation), to make it more effective. The decision to give radiation therapy, either alone or with chemotherapy, is based on the pathology results after surgery. The aim of adjuvant radiation therapy is to reduce the risk of Salivary Gland Cancer coming back. Not everyone will require adjuvant radiation therapy.


In cases where a cure is not possible, radiation therapy is used to relieve symptoms of advanced Salivary Gland Cancer. Symptoms that may require palliative radiation therapy include pain, bleeding, breathing and trouble swallowing.

How do I prepare for radiation therapy? 

You will meet with many members of the cancer care team, who will help you learn how to look after yourself through radiation therapy, recovery and long term follow-up. They will also talk to you about side effects and how to manage them. It may be helpful to write down questions as they come up, so you can ask anyone in your cancer care team when you see them.


Radiation therapy mask-making and simulation 

  • Radiation therapy is a precise treatment. In order to make sure, that the cancer is covered by the treatment, you will need to be very still during the treatment, usually for about five minutes. A radiation therapy mask that is made to fit perfectly to your shape, will be put on you during each treatment to help the machine target where the cancer is.
  • You will have a planning CT scan (and sometimes other scans) with the mask on. Your radiation oncologist and radiation therapists will use these scans with all your other clinical information to develop a radiation therapy plan just for you (a personalised plan). Your plan will be checked by the radiation therapy and radiation oncology physics team before it is ready to be used for your treatment. This whole process can take approximately 2-3 weeks.

Teeth and mouth care

You might need to have some of your teeth taken out, this will depend on the area being treated and the dose of radiation therapy. It is important to take out any broken or infected teeth before radiation therapy. Taking out unhealthy teeth after radiation therapy can cause problems with the jaw bone. Further information about removing teeth and what to expect during and after the operation is available here



Diet, nutrition and the role of your dietitian

Your cancer and its treatment can make it hard to eat and drink. Your doctor will recommend you see a dietitian to maximise your nutrition during treatment as well as while you are recovering. Sometime feeding tubes may be recommended depending on the area being treated and the dose of radiation therapy.
There are two common types of feeding tubes: 

  • Gastrostomy tube (sometimes called a PEG tube): this type of tube is inserted through your abdominal wall into your stomach, with part of the tube staying outside the stomach.  A syringe can be attached to the tube to give you food this way if needed. The tube is inserted using a camera through the mouth into the stomach (gastroscopy) or using a CT scanner to guide insertion directly through the skin. If a PEG tube is needed, your doctor will organise this before starting your radiation therapy

  • Nasogastric tube: this type of tube goes through the nose down into the stomach and is usually used for short periods (days or weeks). A nasogastric tube can be inserted at any time (before, during or after treatment).


Speech, voice and swallowing

Your cancer and its treatment can make swallowing and speech difficult. Your doctor will recommend you see a speech pathologist, who can help you with ways to manage swallowing and communication difficulties, during and after treatment.



There are many other aspects of supportive care that are available, ask your doctor if you have any specific needs.

Side effects

The side-effects of radiation therapy start around two weeks into treatment and progress through treatment to peak in the last week or just after treatment ends. The side effects start to improve 2-3 weeks after the end of treatment.

Side effects associated with radiation therapy depend on:
  • the dose of radiation therapy

  • the area being treated

  • whether or not chemotherapy is added to the radiation.

Each individual responds to radiation therapy differently. Some people may experience a few side effects while others may not experience any at all. The following are some common side effects of radiation therapy.

Common side effects of radiation therapy include:
  • tiredness

  • skin irritation in the treated area e.g. redness, dryness and itching, weeping skin, scaling or sometimes skin breakdown (sores)

  • dry mouth or throat due to lack of saliva (called xerostomia)

  • ulcers in the mouth or throat that make it painful or difficult to chew or swallow

  • sticky or thick saliva

  • altered taste, which is usally a loss of taste or sometimes an unpleasant taste in the mouth

  • weight loss

  • blocked ears from inflammation within the ear canals.

Most side effects are short lived and may go away within 4–6 weeks of finishing radiation therapy. Some side effects may last for months after you finish radiation therapy and some may be permanent.

Once your radiation therapy ends, you will have regular follow-up appointments so your cancer care team can check your recovery and monitor any side effects that you may have. Your doctor may recommend some specific supportive care options to help during your recovery, such as help with changes in diet, teeth and mouth care and speech or swallowing.

To learn more about Radiation Therapy and to watch
a video of an Immobilisation Maks being made click here


4. Chemotherapy for Salivary Gland Cancer

Chemotherapy works by destroying or damaging cancer cells. For Salivary Gland Cancer, it is usually given into a vein through a needle with a cannula (tube) attached.

There are a number of ways that chemotherapy may be used to treat  Salivary Gland Cancer including: 


This is when chemotherapy is given after surgery and is usually combined with radiation therapy (chemoradiation). It is usually given once a week during radiation therapy. Adding chemotherapy makes the radiation more effective at destroying cancer cells, but also leads to increased side effects for most patients


This is when radiation therapy is given before surgery or radiation therapy. It is used to shrink large cancers so they are easier to remove during surgery or target with radiation therapy. Neoadjuvant chemotherapy is rarely used for Salivary Gland Cancer.


This is given when the cancer is incurable, because the cancer is too big or has spread too far to be removed by surgery. Even if a cancer is incurable, some patients feel better from palliative chemotherapy as it slows the growth of the cancer, and can relieve or prevent symptoms.

Before you start treatment, your medical oncologist will choose one or more chemotherapy medications that will be best to treat the type of cancer you have. 

The chemotherapy medications your doctor chooses may depend on:

  • whether the treatment is curative or palliative

  • when it is used

  • your medical history.

Side effects

The side effects of chemotherapy depend on the medication used and its dose. The most common medications used are called cisplatin, carboplatin and fluorouracil (5-FU).

Each individual responds to chemotherapy differently. Some people may experience a few side effects while others may not experience any at all.
The following are common side effects of chemotherapy: 
  • ulcers on the lining of the mouth and throat

  • a feeling of wanting to vomit (nausea) and vomiting

  • loss of feeling in the fingers and toes

  • ringing in the ears (tinnitus), or hearing loss

  • rash

  • change in taste

  • hair loss or thinning

  • higher risk of infection (if the chemotherapy reduces the number of white cells in the blood) 

  • low levels of red blood cells, sometimes requiring a blood transfusion.

Most of these side effects are short lived and go away once you finish chemotherapy. Some side effects like hearing loss, may be permanent.

Once your treatments end, you will have regular follow-up appointments so that your doctor can check your recovery, make sure the cancer has not returned and monitor and treat any side effects that you may have. Your doctor may recommend that you receive some specific supportive care to help during your recovery. 
All the information in this section is available in a PDF.
Download it here.

1. Introduction to Salivary Gland Cancer

  • What is Salivary Gland Cancer?
  • What are the salivary glands
  • What do the salivary glands do?
  • What causes Salivary Gland Cancer?

2. Symptoms, signs and tests of Salivary Gland Cancer

  • Signs and Symptoms of Salivary Gland Cancer
  • Tests for Salivary Gland Cancer

3. Treatment for Salivary Gland Cancer

  • Treatment options for Salivary Gland Cancer
  • Surgery 
  • Radiation Therapy
  • Chemotherapy
  1. Head and Neck Cancer Australia Resources 
  2. External Links to other Head and Neck Cancer Resources