Salivary gland cancer is a rare cancer that occurs in the salivary glands. These glands are responsible for producing saliva or spit.
Your salivary glands are located in several places around the face, neck, jaw, and mouth. Cancerous tumors can develop in any of these spots. Noncancerous (benign) tumors are also possible in these same areas.
Read more to learn about salivary gland cancer, including common symptoms and how it’s diagnosed and treated.
Salivary glands are a series of glands and ducts, or tubes, that carry saliva to your mouth, neck, and sinuses. They keep the lining of your mouth and sinuses lubricated and moist. Saliva is a clear fluid filled with enzymes that break down food. It also holds antibodies and other substances that protect the mouth and throat from infection.
Salivary gland cancer occurs when irregular cells form in the tissues of the salivary glands or the ducts connected to the glands.
The salivary gland system is made up of two main types: major salivary glands and minor salivary glands.
The major salivary glands are further divided into three types:
- Parotid glands. These are the largest salivary glands. They’re located just in front of the ears. Nearly
80 percentof salivary gland tumors are found in these glands. The majority of tumors found here are benign. Approximately 20 to 25 percentare malignant (cancerous).
- Sublingual glands. These are the smallest of the major salivary glands. They’re found on the floor of the mouth and beside the tongue. Tumors in these glands are rare, although the risk of a tumor in this gland being malignant is
- Submandibular glands. These glands are located below the jaw. They deliver saliva under the tongue. Roughly
10 to 20 percentof salivary gland tumors begin here, and about 90 percentare malignant.
There are also hundreds of minor salivary glands lining the lips, roof of the mouth, and tongue. They’re also located inside the cheeks, nose, and sinuses.
Tumors in these microscopic salivary glands are uncommon. However, when they do occur, they’re more likely to be cancerous. The palate, or roof of the mouth, is the most common location for tumors.
Symptoms of a salivary gland tumor could appear wherever you have a salivary gland. However, most of the symptoms are similar no matter which type of salivary gland is impacted.
The most common symptoms of salivary gland cancer include:
- a lump or swollen area in your mouth, jaw, cheek, or neck
- ulcerated mass inside the mouth
- constant pain in your mouth, jaw, check, neck, or ear
- a noticeable size difference on the sides of your face or neck
- difficulty opening your mouth widely
- numbness in your mouth or jaw
- muscle weakness on one side of your face
- difficulty swallowing (late-stage symptom)
It’s unclear why salivary gland cancers develop. However, researchers discovered some risk factors that increase a person’s risk for developing this rare cancer.
- Age: Older adults are more likely to develop salivary gland cancer. The average age of diagnosis is 64.
- Gender: Salivary gland cancers are more common in men.
- Radiation exposure: If you’ve received medical radiation treatment to the head or neck, your risk for salivary gland cancer is higher. Likewise, people with workplace exposure to radiation or radioactive substances have a higher risk.
- Certain occupations: A
2018 studyfound that certain occupations were associated with an increased risk for salivary gland cancer. These include: waiters, housecleaners, electrical equipment assemblers, plumbers, welders, sheet-metal workers, building painters, and material handling equipment operators.
- Poor nutrition: A
2009 studyfound that poor nutrition may also be a risk factor for malignant salivary gland tumors.
If you have a family history of salivary gland cancer, your risk for it may be higher. However, most people who develop salivary gland cancer don’t have a family history of this cancer.
It’s worth noting that some benign salivary gland tumors may become malignant over time. While the risk is low, it’s important to be aware of.
A doctor may use several tests to help make a diagnosis if they suspect you have salivary gland cancer.
The first test is likely to be a medical history review and physical. Your healthcare professional will likely conduct a full physical. They’ll carefully examine your mouth, face, jaw, and ears, and will look for additional symptoms.
After this exam, your doctor may request additional tests, including:
- Imaging tests. X-rays and ultrasounds of your mouth and jaws can help your doctor see any tumors or other irregularities. Computed tomography (CT or CAT) scans and magnetic resonance imaging (MRI) can provide more in-depth looks at tissue and bones. A positron emission tomography (PET) scan can help your doctor see disease in your body.
- Nasopharyngolaryngoscopy. This nonsurgical procedure allows your doctor to see the inside of your mouth, throat, and larynx. During this procedure, they’ll insert a thin, lighted tube with a lens or small camera into your mouth and throat. This allows them to look for signs of tumors or other issues.
- Biopsy. This test helps your doctor check the cells of a growth or tumor for signs of cancer under a microscope. To complete the biopsy, your doctor or another healthcare professional will remove fluid or tissue from the area. This sample is then sent to a lab for testing and analysis.
Salivary gland cancer can be divided into five stages. These include:
- Stage 0: In this stage, the cancer is “in situ.” This means it’s stayed in the same place and has not spread to nearby tissues. This stage of cancer is typically highly treatable.
- Stage 1: Stage 1 tumors are small (2 centimeters or less) and have not grown to nearby tissue or lymph nodes.
- Stage 2: Stage 2 tumors are larger than 2 cm but less than 4 cm, and have not spread to other structures or lymph nodes.
- Stage 3: If the tumor is greater than 4 cm and/or has spread to surrounding soft tissues or lymph nodes, it’s considered stage 3.
- Stage 4: This advanced stage cancer has metastasized, or spread, to other organs or areas of the body.
Grades are also assigned in addition to stages
Doctors and healthcare professionals typically give salivary gland cancer a “grade” in addition to a stage. These grades extend from 1 to 3, or low to high.
Grades are based on the tumor type and how abnormal the cancer’s cells look under a microscope. A biopsy helps your doctor decide on a grade. A grade tells your doctor and other providers two things: how advanced the cancer is, and how quickly it’s likely to spread.
- Grade 1: This low-grade cancer is well-defined from nearby cells. It looks nearly normal under a microscope. It also tends to grow slowly and has a better prognosis than the other grades.
- Grade 2: This intermediate cancer grade indicates the cancer is moderately advanced. It has an appearance between grades 1 and 3.
- Grade 3: A cancer at this grade is very difficult to recognize from normal cells. This indicates the cancer could grow and spread quickly. The prognosis for salivary gland cancer grade 3 is not as good as lower grades.
Salivary gland cancer makes up only six percent of head and neck cancers. Therefore, it’s important to seek out a team of doctors with an expertise in treating head and neck cancer, or salivary gland cancer specifically.
Treatment is determined by the grade of the cancer and whether it’s spread (metastasized) beyond the salivary glands.
Fast-growing, high-grade cancers may be treated more aggressively with both surgery and radiation or chemotherapy. Lower-grade cancers may not be treated as aggressively because of how slowly they grow.
The combination of treatments could include:
- Surgery. This is often the primary treatment for salivary gland cancer. A surgeon can remove the cancer and any surrounding glands, tissues, or lymph nodes.
- Radiation therapy. This treatment uses high-energy X-rays or particles to narrowly target and destroy cancer cells. This may either be the primary treatment, or it may be used with another treatment option.
- Chemotherapy. These anti-cancer drugs, which seek out and kill cancer cells in the body, are not often used to treat salivary gland cancers; surgery and radiation therapy are more common.
It’s important to discuss all treatment options with your doctors to determine what’s best for you.
It’s important to discuss your recovery and prognosis with your doctor. They can help you understand the impact of treatments. They can also help you decide a course of treatment when it comes to quality of life and expectations.
Your doctor will likely discuss survival rates with you. Survival rates depend on the type, grade, and stage of the particular type of salivary gland cancer you have. Your personal health history will also impact your prognosis.
Salivary gland cancer is a rare type of cancer that develops in the glands and ducts that supply saliva to your mouth and throat.
It’s not clear what causes this type of cancer, but people with exposure to radiation therapy — as well as older adults, men, and people working in certain occupations — are more likely to develop it.
If salivary gland cancer is found early and treated, prognosis is good.
If you notice any changes in your mouth, jaw, or throat — such as a lump, swelling, or pain — see a doctor for a physical. An early diagnosis can make a significant difference in outcome.