Salivary Gland Cancer- all that you want to know

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• Salivary gland cancer is a rare disease in which malignant (cancer) cells form in the tissues of the salivary glands.
• Being exposed to certain types of radiation may increase the risk of salivary cancer.
• Signs of salivary gland cancer include a lump or trouble swallowing.
• Tests that examine the head, neck, and the inside of the mouth are used to detect (find) and diagnose salivary gland cancer.
•  
  The salivary glands make saliva and release it into the mouth. Saliva has enzymes that help digest food and antibodies that help protect against infections of the mouth and throat. There are 3 pairs of major salivary glands:
  
  

  • Parotid glands: These are the largest salivary glands and are found in front of and just below each ear. Most major salivary gland tumours begin in this gland.
  • Sublingual glands: These glands are found under the tongue in the floor of the mouth.
  • Submandibular glands: These glands are found below the jawbone.
    There are also hundreds of small (minor) salivary glands lining parts of the mouth, nose, and larynx that can be seen only with a microscope. Most small salivary gland tumors begin in the palate/ roof of the mouth.
    More than half of all salivary gland tumors are benign , i.e. not cancerous and do not spread to other tissues.
      This is a type of head and neck cancer.

    Signs of salivary gland cancer include a lump or trouble swallowing.

    Salivary gland cancer may not cause any symptoms. It may be found during a regular dental check-up or physical exam. Signs and symptoms may be caused by salivary gland cancer or by other conditions. Check with your doctor if you have any of the following:

    
    

    • A lump (usually painless) in the area of the ear, cheek, jaw, lip, or inside the mouth.
    •   Fluid draining from the ear.
    • Trouble swallowing or opening the mouth widely.
    • Numbness or weakness in the face.
    • Pain in the face that does not go away. 
    •  
      
      The following procedures may be used to detect salivary gland-
      • Physical exam and history: An exam of the body to check general signs of health. The head, neck, mouth, and throat will be checked for signs of disease, such as lumps or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
      • Magnetic Resonance Imaging/ MRI: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
      • CAT scan: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
      • Positron Emission Tomography/ PET scan: A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose  is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
      •   Biopsy- removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer.
        • FNA/ Fine Needle Aspiration : The removal of tissue or fluid using a thin needle. An FNA is the most common type of biopsy used for salivary gland cancer.
        •  Surgery: If cancer cannot be diagnosed from the sample of tissue removed during an FNA biopsy or an incisional biopsy, the mass may be removed and checked for signs of cancer.
      Because salivary gland cancer can be hard to diagnose, patients should ask to have the tissue samples checked by a pathologist who has experience in diagnosing salivary gland cancer.

      After salivary gland cancer has been diagnosed, tests are done to find out if cancer cells have spread within the salivary gland or to other parts of the body.

      The process used to find out if cancer has spread within the salivary glands or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following procedures may be used in the staging process:

      • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. This procedure is also called nuclear magnetic resonance imaging (NMRI).
      • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.

      There are three ways that cancer spreads in the body.

      Cancer can spread through tissue, the lymph system, and the blood:

      • Tissue. The cancer spreads from where it began by growing into nearby areas.
      • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
      • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

      Cancer may spread from where it began to other parts of the body.

      When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.

      • Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
      • Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.

      The metastatic tumor is the same type of cancer as the primary tumor. For example, if salivary gland cancer spreads to the lung, the cancer cells in the lung are actually salivary gland cancer cells. The disease is metastatic salivary gland cancer, not lung cancer.

      The following stages are used for major salivary gland cancers:

      
      

      Stage I

      In stage I, the tumor is in the salivary gland only and is 2 centimeters or smaller.

      Stage II

      In stage II, the tumor is in the salivary gland only and is larger than 2 centimeters but not larger than 4 centimeters.

      Stage III

      In stage III, one of the following is true:

      • The tumor is not larger than 4 centimeters and has spread to a single lymph node on the same side as the tumor and the lymph node is 3 centimeters or smaller.
      • The tumor is larger than 4 centimeters and/or has spread to soft tissue around the affected gland. Cancer may have spread to a single lymph node on the same side as the tumor and the lymph node is 3 centimeters or smaller.

      Stage IV

      Stage IV is divided into stages IVA, IVB, and IVC as follows:

      • Stage IVA:
        • The tumor may be any size and may have spread to soft tissue around the affected gland. Cancer has spread to a single lymph node on the same side as the tumor and the lymph node is larger than 3 centimeters but not larger than 6 centimeters, or has spread to more than one lymph node on either or both sides of the body and the lymph nodes are not larger than 6 centimeters; or
        • Cancer has spread to the skin, jawbone, ear canal, and/or facial nerve, and may have spread to one or more lymph nodes on either or both sides of the body. The lymph nodes are not larger than 6 centimeters.
      • Stage IVB:
        • The tumor may be any size and may have spread to soft tissue around the affected gland. Cancer has spread to a lymph node larger than 6 centimeters; or
        • Cancer has spread to the base of the skull and/or the carotid artery, and may have spread to one or more lymph nodes of any size on either or both sides of the body.
      • Stage IVC:
        • The tumor may be any size and may have spread to soft tissue around the affected gland, to the skin, jawbone, ear canal, facial nerve, base of the skull, or carotid artery, or to one or more lymph nodes on either or both sides of the body. Cancer has spread to distant parts of the body.

      Salivary gland cancers are also grouped by grade. The grade of a tumor tells how fast the cancer cells are growing, based on how the cells look under a microscope. Low-grade cancers grow more slowly than high-grade cancers.

      Minor salivary gland cancers are staged according to where they were first found in the body.

      
      

      The info is from the National Cancer Institute site.