Treatment overview
Your treatment will depend on the position, stage and grade of the cancer and your general health. The main treatment for salivary gland cancer is usually surgery. Radiotherapy is often given after surgery to reduce the risk of the cancer coming back. It may also be given if the surgeon was not able to remove all the cancer or if the cancer comes back after treatment. Sometimes radiotherapy can be given as the main treatment if surgery is not possible.
Radiotherapy or chemotherapy can also be used to control the symptoms of salivary gland cancer that has spread.
Surgery
Surgery is used to remove all or as much of the cancer as possible. The type of surgery you have depends on the size and position of the tumour. If the cancer is small and has not spread, the surgeon may only remove the salivary gland. But sometimes they will also need to remove nearby tissue or bone if it is affected by the cancer.
The thought of having any type of surgery to your head and face can be frightening. Your surgeon will explain what to expect and answer any questions before your operation. Your surgery is planned carefully by a team of specialist surgeons. They will try to avoid changes to your appearance or to areas of your mouth or face that help you talk, swallow or eat.
If your surgery involves removing any of these areas, the surgeon may rebuild them with tissue, skin or bone taken from somewhere else in your body. If part of the roof of your mouth is removed, the surgeon will fit a special piece of plastic (called an obturator) into the missing area. This covers any gaps in the roof of the mouth to help you speak and eat.
The surgeon usually removes some of your neck lymph nodes during surgery, even if they do not show signs of cancer. This is to reduce the risk of the cancer coming back.
After surgery
How long you stay in hospital depends on the operation you have. Some people will have a small operation at a hospital day surgery and go home the same day. But if your surgery is more complicated, you might stay in hospital for up to three weeks. You may be looked after in a high-dependency unit or intensive care for a while after the operation. Your doctor or nurse can explain more about this.
As you recover, you may see a dietitian and speech and language therapist (SALT) if you need help to cope with any changes to your speech or swallowing. If you have an obturator, you will see a restorative dentist regularly. They will make sure it fits well as your mouth heals.
Side effects of surgery
These will depend on the type of operation you have. Your speech, swallowing or your sense of taste and smell might be affected. Some operations may leave scars or a change in your appearance.
It is important to prepare for this kind of surgery. You can discuss your operation fully with your surgeon so that you know what to expect and how it will affect you. You may also find some of these organisations helpful:
- Changing Faces supports people who have conditions or injuries which affect their appearance. It offers a skin camouflage service for people living with scarring or a skin condition that affects their confidence.
Telephone: 0300 012 0275 (Mon–Fri, 10am–4pm)
email: info@changingfaces.org.uk
- Let’s Face It is a support network for people with facial disfigurements.
Telephone: 01843 491291
email: chrisletsfaceit@aol.com
- Saving Faces has an expert patient helpline that puts people in touch with someone who has had the same condition or similar surgery.
Telephone: 07792 357972 (Mon–Fri, 9am–5pm)
email: helpline@savingfaces.co.uk
Radiotherapy
Radiotherapy uses high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells.
You have treatment in small doses (called fractions) over five to seven weeks from a radiotherapy machine similar to an x-ray machine. It is usually given as a daily dose from Monday to Friday, with a break at weekends. Radiotherapy does not make you radioactive. The treatment itself only takes a few minutes and is not painful.
When you have radiotherapy, it is important to keep still so that the treatment is given to exactly the right area. To make sure you keep your head still, you may need to wear a see- through plastic mask during your treatment. The mask should not be uncomfortable and does not affect your breathing. If you are worried about the mask, let your radiotherapy team know so they can help.
Radiotherapy may also be used to control symptoms, such as pain, if the cancer has spread to other areas of the body. For this, you might only need a few days of treatment or just a single dose.
Side effects of radiotherapy
You may develop side effects during radiotherapy. These usually get better gradually over a few weeks or months after treatment finishes. The main side effects are tiredness (fatigue) and difficulty swallowing.
Your radiotherapy team will tell you more about what to expect. Tell them about any side effects you have. There are often things that can be done to help.
Most side effects get better after treatment ends, but many people have a dry mouth after their treatment is over. Your doctor or nurse can tell you what can help. Radiotherapy to the head and neck can cause other long-term effects. These are not as common, but can happen months or even years after your treatment.
Our general information on head and neck cancers has more details about radiotherapy, coping with side effects and the long-term effects.
Chemotherapy
Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It is sometimes given to treat the symptoms of salivary gland cancer that has spread.
Side effects of chemotherapy
The side effects depend on the drug or combination of drugs you are given. Your doctor or nurse will explain any treatment you are offered and what to expect. Tell them about any side effects you have during treatment. They can often prescribe drugs to help.
Chemotherapy can reduce the number of white cells in your blood. This will make you more likely to get an infection. Your doctor or nurse will give you advice about what to do if this happens.
Chemotherapy can also cause side effects such as:
We have more information about coping with the side effects of chemotherapy and about different chemotherapy drugs.
Follow-up
You will have regular appointments with your cancer specialist after your treatment. But if you have any new symptoms or problems in between your appointments, you can see your GP or contact your specialist doctor or nurse.
Clinical trials
Cancer research trials are carried out to try to find new and better treatments for cancer. Trials that are done on patients are known as clinical trials.
Research into treatments for salivary gland cancer is ongoing and advances are being made. But because this type of cancer is rare, there may not always be a trial in progress. If there is, you may be asked to take part. Your doctor must discuss the treatment with you so that you have a full understanding of the trial and what it means to take part. You may decide not to take part or to withdraw from a trial at any stage. You will still receive the best standard treatment available.