Salivary Gland Cancer
Humans have three large paired salivary glands. They are located on both sides of the head (see picture):
- Parotid glands, located in front of the ear
- Submandibular glands, lie beneath the lower jawbone
- Sublingual glands, located in the floor of the mouth
In addition, there are a large number of small salivary glands in the mucous membrane of the mouth and throat. Most salivary gland tumors are benign. However, malignant salivary gland tumors (salivary gland cancer) are also much rarer. Some of them grow slowly and rarely form offshoots (metastases).
Others, however, have aggressive growth and a high tendency to spread throughout the body. Some types of salivary gland cancer can develop from benign tumors of the salivary glands.
Signs
Salivary gland cancer usually manifests itself as a nodular change in the affected gland. These nodules are often painless. Depending on their location, they can hinder swallowing.
If the parotid gland is affected, paralysis of the facial nerve that runs through this gland can also occur. Other signs may include lumps on the neck (lymph node offshoots or lymph node metastases) or unexplained weight loss.
Causes and Distribution in the Population
The causes of salivary gland cancer are largely unknown. Overall, salivary gland cancer is a rare disease. In Switzerland, fewer than 100 people develop salivary gland cancer every year. Almost all of them occur in adulthood.
Examination
If there are nodular changes in the salivary glands, a detailed investigation must be carried out. The goal is to detect or rule out salivary gland cancer as quickly as possible.
In addition to the clinical examination, the ultrasound examination is very suitable for this purpose. A sample can be taken from the affected tissue using a fine needle. This is then examined microscopically.
Additional imaging techniques such as magnetic resonance imaging (MRI) and computed tomography (CT) provide important information about the extent. If we cannot make a diagnosis after this, we will have to examine a larger tissue sample. To do this, part of the salivary gland often has to be removed along with the entire tumor.
Treatment
Treatment for salivary gland cancer is intended to cure the disease permanently. This usually requires an operation. If left untreated, the tumor spreads in the neck and spreads into the body, which sooner or later leads to death.
Basically, the cancer and the affected salivary gland must be removed as completely as possible and with a safe distance. If the parotid gland is affected, we use a facial nerve monitoring device during the procedure. Depending on the type of cancer, the neighboring lymph nodes in the neck may also need to be removed.
After the operation, additional radiation (radiotherapy) is often necessary. If the cancer has already spread in the body when it is discovered, drug therapy (chemotherapy) is the primary option.
Care and Aftercare
Care, rehabilitation and aftercare are essential elements in the treatment of salivary gland cancer in the head and neck area. In aftercare:
- we can detect a possible recurrence of the tumor at an early stage,
- we identify sequelae, such as swallowing or speaking disorders, and treat them,
- we advise you on physical, mental and social problems.
For these checks, patients come either to the polyclinic of the University Clinic for Ear, Nose and Throat Diseases, Head and Neck Surgery, or to the polyclinic of the University Clinic for Cranial and Maxillofacial Surgery. After radiation, checks are also carried out in the University Clinic for Radiation Oncology, Inselspital, Bern University Hospital.
Who to Contact?
Do the signs and symptoms mentioned above persist for more than three weeks? An examination is advisable either:
- at the family doctor,
- with an ear, nose and throat specialist,
- or directly in the polyclinic of the University Hospital for Ear, Nose and Throat Diseases, Head and Neck Surgery, Inselspital, University Hospital Bern