Salivary gland cancer

Treatment will depend on the type of salivary gland tumour.

Benign salivary tumours

There are different types of benign salivary gland tumours. Most benign tumours start in the parotid glands. The most common is a pleomorphic adenoma which is usually slow-growing.

Benign salivary gland tumours are removed using surgery. Even though they are benign, some benign salivary gland tumours may also need radiotherapy treatment if it is not possible to remove all of the tumour. This prevents possible complications caused by any remaining tumour cells.

Cancerous salivary tumours

These include:

• Muco-epidermoid cancer – these usually develop in the parotid gland but they can also develop in the submandibular glands. They can also develop in the minor salivary glands. They can be slow-growing, but some may grow more quickly.
• Adenoid-cystic cancer – these are one of the most common types of minor salivary gland cancer. They usually grow very slowly, but they may sometimes come back after treatment.
• Acinic cell carcinoma – develops in the acinar cells which produce saliva.
• Adenocarcinoma – rare cancers of the salivary gland. They develop in the lining cells of the body, in the major or minor salivary glands.
• Malignant mixed cancers – similar to a benign tumour of the salivary gland (pleomorphic adenoma).

Rarer types of salivary gland cancer include a squamous cell carcinoma.

The exact causes of salivary gland cancers are not known. But there are risk factors that can increase the chances of developing it.

Your risk of developing salivary gland cancer may be higher if you have had:

• radiotherapy for Hodgkin lymphoma
• radiotherapy to the head and neck area as a child.

The risk of getting salivary gland cancer increases as you get older.

As with other cancers, salivary gland cancer is not infectious and cannot be passed onto other people.

We have general information about the causes and risk factors of head and neck cancer.

The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging. The grade of the cancer gives an idea how quickly it may develop.

Knowing the stage and grade of the cancer helps the doctors plan the best treatment for you.

The staging systems most often used for salivary gland cancer are the TNM and number staging systems. The number staging system is less commonly used.

TNM staging system

TNM stands for tumour, node and metastases.

Tumour (T)

T describes the size of the tumour and whether it has grown into nearby tissues. It is numbered between 0 and 4 depending on the size and extent of the tumour.

• T0 means that there are no signs of a tumour, but there may be abnormal cells that are pre-cancerous.
• T1 tumours are smaller than 2cm and have not spread outside the salivary gland.
• T2 tumours are between 2 and 4cm and have not spread outside the salivary gland.
• T3 tumours are larger than 4cm and have spread outside the salivary gland.
• T4 tumours have spread into nearby skin, nerves or bones, or other areas of the head or skull.

Nodes (N)

N describes whether the cancer has spread to the neck lymph nodes.

Metastases (M)

M describes whether the cancer has spread to another part of the body. This is called metastatic cancer.

We have more information about the staging systems used for head and neck cancer.

Grading of salivary gland cancer

The grade describes how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread.

We have more information about grading for head and neck cancer.

After treatment, you will have regular follow-up appointments with your specialist doctor. These may continue for several years. You may also have regular follow-up appointments with your multidisciplinary team (MDT), including,a speech and language therapist (SLT), dietitian, restorative dentist and dental hygienist and sometimes a physiotherapist.

If you have any problems or notice new symptoms between appointments, let your doctor or nurse know as soon as possible.

Some treatment side effects may take a long time to improve after treatment finishes, or they may become permanent. These are called long-term effects. Other side effects can develop months or even years after treatment has finished. These are known as late effects. We have more information about long-term and long-term and late effects of head and neck cancer treatment.

Head and neck cancer and its treatment can sometimes have an effect on your sex life.

If you are worried about this, talk to your doctor or nurse. You can read about things that may help in our information on cancer and sex.

Some cancer treatments can also affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

We have more information about:

• fertility in women after treatment
• fertility in men after treatment.
• LGBTQ+ people and cancer treatment

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes during and after treatment. For example, if you smoke or drink alcohol, it is best to avoid smoking or reduce the amount of alcohol.

Eating well and keeping active can improve your health and well-being. It can also help your body recover. Your dietitian can help with any difficulties you might have with eating after treatment.

We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:

• Call the Macmillan Support Line on 0808 808 00 00.
• Chat to our specialists online.
• Visit our head and neck cancer forum to talk with people who have been affected by head and neck cancer, share your experience, and ask an expert your questions.

Further support and information is available through The Swallows. The Swallows is a national head and neck cancer support charity. It offers support to people affected by head and neck cancer, their carers, friends and relatives.

Support is also available from Salivary Gland Cancer UK. This charity supports people with rare salivary gland cancers, such as adenoid cystic carcinoma, ACC, and unknown carcinoma.