⦁ Salivary Gland pathology
Tests and procedures used to diagnose salivary gland tumors include:
Physical exam. Your doctor will feel your jaw, neck and throat for lumps or swelling.
Imaging tests. Imaging tests, such as magnetic resonance imaging (MRI), computerized tomography (CT), positron emission tomography (PET), ultrasound or X-ray, may help your doctor determine the size and location of your salivary gland tumor.
Collecting of a sample of tissue for testing (biopsy). To collect a sample of tissue, your doctor may recommend a fine-needle aspiration or a core needle biopsy. During the biopsy, the doctor inserts a thin needle into the salivary gland to draw out a sample of suspicious cells. Doctors in a lab analyze the sample to determine what types of cells are involved and whether the cells are cancerous.
Determining the extent of salivary gland cancer
If you’re diagnosed with salivary gland cancer, your doctor will determine the extent (stage) of your cancer. Your cancer’s stage determines your treatment options and gives your doctor an idea of your prognosis.
Cancer stages are identified by Roman numerals, with stage I indicating a small, localized tumor and stage IV indicating an advanced cancer that has spread to the lymph nodes in the neck or to distant parts of the body.
Treatment for salivary gland tumors is usually with surgery to remove the tumor. People with salivary gland cancers may need additional treatments, such as with radiation therapy and chemotherapy.
Surgery for salivary gland tumors may include:
Removing a portion of the affected salivary gland. If your tumor is small and located in an easy-to-access spot, your surgeon may remove the tumor and a small portion of healthy tissue that surrounds it.
Removing the entire salivary gland. If you have a larger tumor, your doctor may recommend removing the entire salivary gland. If your tumor extends into nearby structures — such as the facial nerves, the ducts that connect your salivary glands, facial bones and skin — these also may be removed.
Removing lymph nodes in your neck. Your surgeon may recommend removing some lymph nodes from your neck if your salivary gland tumor is cancerous and there’s a risk that the cancer has spread to the lymph nodes. The surgeon removes the lymph nodes that are most likely to contain cancerous cells.
Reconstructive surgery. After surgery to remove the tumor, your doctor may recommend reconstructive surgery to repair the area. If bone, skin or nerves are removed during your surgery, these may need to be repaired or replaced with reconstructive surgery.
During reconstructive surgery, the surgeon works to make repairs that improve your ability to chew, swallow, speak, breathe and move your face. You may need transfers of skin, tissue, bone or nerves from other parts of your body to rebuild areas in your mouth, face, throat or jaws.
Salivary gland surgery can be difficult because several important nerves are located in and around the glands. For example, a nerve in the face that controls facial movement runs through the parotid gland.
Removing tumors that involve important nerves may require stretching or cutting the nerves. This can cause partial or complete paralysis of your face (facial droop) that can be temporary or, in some situations, permanent. Surgeons take care to preserve these nerves whenever possible. Sometimes severed nerves can be repaired with nerves taken from other areas of your body or with processed nerve grafts from donors.
If you’re diagnosed with salivary gland cancer, your doctor may recommend radiation therapy. Radiation therapy uses high-powered energy beams, such as X-rays and protons, to kill cancer cells. During radiation therapy, you lie on a table while a machine moves around you, directing high-powered beams at specific points on your body.
A newer type of radiation therapy that uses particles called neutrons may be more effective in treating certain salivary gland cancers. More study is needed to understand the benefits and risks of this treatment. Neutron radiation therapy isn’t widely available in the United States.
Radiation therapy can be used after surgery to kill any cancer cells that might remain. If surgery isn’t possible because a tumor is very large or is located in a place that makes removal too risky, your doctor may recommend radiation alone or in combination with chemotherapy.
Chemotherapy is a drug treatment that uses medications to kill cancer cells. Chemotherapy isn’t currently used as a standard treatment for salivary gland cancer, but researchers are studying its use.
Chemotherapy may be an option for people with advanced salivary gland cancer. It’s sometimes used in combination with radiation therapy.
Supportive (palliative) care
Palliative care is specialized medical care that focuses on providing relief from pain and other symptoms of a serious illness. Palliative care specialists work with you, your family and your other doctors to provide an extra layer of support that complements your ongoing care. Palliative care can be used while undergoing other aggressive treatments, such as surgery, chemotherapy or radiation therapy.
When palliative care is used along with all of the other appropriate treatments, people with cancer may feel better and live longer.
Palliative care is provided by a team of doctors, nurses and other specially trained professionals. Palliative care teams aim to improve the quality of life for people with cancer and their families. This form of care is offered alongside curative or other treatments you may be receiving.