In this section: Salivary Gland Cancer

salivary gland CANCER 
TREATMENT


What is 'Salivary Gland Cancer''? Most Salivary 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.


 
PRINT
All the information in this section is available in a PDF.
Download it here.
IN THIS SECTION

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.

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:

PAROTIDECTOMY

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. 

download pdf

SUBMANDIBULAR GLAND SURGERY

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

download pdf

SUBLINGUAL GLAND SURGERY

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

download pdf  

FACIAL NERVE SACRIFICE (RADICAL PAROTIDECTOMY)

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.

download pdf

LATERAL TEMPORAL BONE SURGERY

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.

 download pdf

NECK DISSECTION

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.

download pdf

RECONSTRUCTIVE SURGERY - SOFT TISSUE FREE FLAP

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.

download pdf

TRACHEOSTOMY

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.

download pdf

FEEDING TUBES

  • 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).
 download pdf 

DENTAL EXTRACTION

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.

download pdf


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: 

Definitive

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.

Adjuvant

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.

Palliative

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.

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: 

Adjuvant

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

Neo-adjuvant

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.

Palliative

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.

IN THIS SECTION

1. Introduction to Salivary Gland Cancer
2. Symptoms, signs and tests of Salivary Gland Cancer
3. Treatment for Salivary Gland Cancer

FURTHER INFORMATION
  1. Head and Neck Cancer Australia Resources 
  2. External Links to other Head and Neck Cancer Resources