Dr. M.J. Bazos, MD. Patient Handout

About Your Diagnosis

Salivary glands produce saliva to keep the mouth moist and to lubricate the food as it is chewed. Salivary gland tumors may be benign or malignant (cancerous). The salivary glands are classified into major and minor glands. The major salivary glands are the parotid gland in front of your ear and under the skin of your cheek; the submandibular glands under your jaw bone; and the sublingual salivary glands under you tongue. There are more than 500 minor salivary glands, and most are in the roof of the mouth. Salivary gland tumors are rare. They are not contagious, and the cause is not. The only sure way to diagnose salivary gland tumors is to remove the tumor completely with a surgical procedure and examine the tissue with a microscope. Salivary gland tumors can be cured if detected and removed before the cancer has spread.

Living With Your Diagnosis
A lump or mass is the usual first sign that a tumor is present. Salivary gland cancers tend to spread locally by invading surrounding tissue. For parotid tumors, local spread may involve the facial nerve, which crosses through the parotid gland. This can lead to facial paralysis with facial droop and inability to close the eye on the affected side. Other salivary cancers spread into the muscles at the floor of the mouth, base of the skull, and to local lymph glands. This causes facial pain, ear pain, headache, and swollen lymph glands. In advanced cases, the cancer can spread to the blood stream and metastasize to the lungs and bones.

Computed tomography (CT) or magnetic resonance imaging (MRI) and a physical examination give a good idea whether the cancer is malignant. Nevertheless, the treatment of all major and minor salivary gland tumors is removal of the entire gland and surrounding involved structures. In the case of the parotid gland, the involved lobe is removed, but care is taken not to cut the facial nerve. If the cancer has spread to the local lymph nodes, these nodes are removed. Complications of surgical treatment include cutting important nerves, such as the facial nerve and the nerve that goes to the tongue. Radiation therapy can be used to manage advanced inoperable tumors or tumors that return. Complications are dry, red, itchy skin; loss of ability to produce saliva, which causes dry mouth, sore throat, and difficulty swallowing; loss of facial hair growth; and loss of the sense of taste.

The DOs
• Seek an experienced surgeon who specializes in tumors of the head and neck.
• Understand the importance of nutrition after treatment. Because of pain, loss of saliva, and loss of taste, you can lose a substantial amount of weight. It is important to take nutritional supplements and to drink lots of fluids to stay hydrated.
• Remember to keep all appointments during and after treatment to monitor any side effects or recurrence of the cancer.
• Remember the earlier the cancer is detected, the better is the prognosis. The 10-year survival rate is 90% for salivary gland tumors less than 2 centimeters (0.8 inches) in diameter and localized to the gland without any spread. It is 25% when the tumor is larger than 2 centimeters (0.8 inches) and has spread to a lymph node.

The DON’Ts
• Do not ignore any lumps in your mouth, cheek or neck.
• Do not ignore any swollen lymph glands.
• Do not forget that 80% of tumors of the parotid gland are benign, whereas 80% of tumors of the minor salivary glands are malignant.

When to Call Your Doctor
• If you notice a lump anywhere in your head or neck.
• If you suddenly notice facial droop with the inability to close your eye on the same side. This can be paralysis of the facial nerve.
• If you have facial or ear pain.
• If you need emotional support.