Cancer can start anywhere in your body, even the parts you never really think about. Take the salivary glands, for instance. They make the saliva -- spit -- that keeps your mouth and throat moist. This fluid contains enzymes that help to break down your food. It also plays a big role in helping to prevent infections in your mouth and throat.
You have hundreds of salivary glands in and around your mouth. Some are so small you can only see them with the help of a microscope. Because there are so many salivary glands, and so many types of cells in those glands, there are also hundreds of types of salivary gland cancer. Most of them are extremely rare, and more than half of salivary gland tumors turn out to be benign (not cancer).
What Is Salivary Gland Cancer?
It’s what happens when abnormal cells in these glands grow out of control. Normal salivary glands are made of many different types of cells. Tumors can grow in any of them.
There are two main types of salivary glands -- major and minor. You can see the major ones with the naked eye. The minor ones (and there are hundreds of them) are only visible with a microscope.
There are three sets of major salivary glands on each side of the face. Most salivary gland cancers start here. The major gland sets are:
- Parotid glands. These are the largest salivary glands. About 70% of salivary gland tumors start here. Most of the time, they’re benign.
- Submandibular glands. These are located below the jaw. About 15% of salivary gland tumors start here. Nearly all of them turn out to be malignant (cancer).
- Sublingual glands. These are located under the tongue. It’s rare for a tumor to start here.
Most often, cancers of the minor salivary glands start in the roof of the mouth.
Risk Factors and Causes
Doctors don’t know for sure what causes salivary gland cancer.
It usually doesn’t run in families. You’re more likely to get it as you age. Your chances also go up if you’ve had radiation therapy on your head or neck. Men get it more often than women do. Salivary gland cancer also shows up in people who’ve worked in plumbing, rubber manufacturing, and asbestos mining.
Doctors usually find salivary gland cancer when a patient shows up with the following symptoms:
- Lumps in the mouth or side of the face
- Pain in the mouth, cheek, jaw, ear, or neck
- Difficulty swallowing or opening mouth widely
- Fluid draining from the ear
- Facial numbness
Sometimes, a dentist first notices these symptoms. If you have them, it doesn’t mean that you have a tumor. Even if you do, remember that most salivary gland tumors are benign. Your doctor will do a physical exam, order an MRI or CT scan, and get a tissue sample for a biopsy to make sure.
If it does turn out that you have a cancerous tumor, your doctor will stage it based on its size and location.
- Stage I tumors are very small (less than 2 centimeters across), and they don’t spread to other parts of the body.
- Stage II cancers are a little bigger (between 2 and 4 cm) but still in the original gland.
- Stage III cancers have moved out of the gland, possibly to the lymph nodes in the same side of the neck.
- Stage IV cancers have spread to the lymph nodes and maybe other parts of the body.
Doctors also give salivary gland tumors a grade of 1 to 3 that measures how fast the cancer cells seem to be growing:
- Grade 1 (low-grade) cancers have the best chance of being cured. They grow slowly and don’t look much different than normal cells.
- Grade 2 cancers grow moderately fast
- Grade 3 cancers grow quickly
Your options will depend on the size, stage, grade, type, and location of your cancer. Your doctor will also take into account your age and general health.
Surgery is the most common treatment for salivary gland cancer, especially early-stage and slower-growing cases. It may involve taking out part of a salivary gland or the entire gland, removing lymph nodes, and maybe reconstructive work on your face and neck.
Radiation and chemotherapy aren’t the first line of defense for salivary gland cancer, except in advanced cases. You might have radiation after surgery to destroy any possible remaining cancer cells.