Ways To Treat Salivary Gland Cancer
Salivary gland cancer occurs when abnormal cells in the salivary glands grow out of control. Malignant tumors can form in any of the salivary glands, which are located in the mouth, neck, and throat, and their function is to produce saliva. Saliva is what we usually refer to as spit, and it serves a number of purposes. There are hundreds of salivary glands, but the major salivary glands include the parotid, sublingual, and submandibular, with the majority of tumors occurring in the parotid glands. Signs and symptoms of salivary gland cancer include facial numbness, difficulty swallowing, and lumps where salivary glands are located. The causes of salivary gland tumors are still unclear, though risk factors include radiation exposure and advanced age.
While chemotherapy isn’t a standard treatment for salivary gland cancer, it can be used to treat certain types, locations, or stages of tumors. Chemotherapy treats cancer with chemical agents to stop the growth of cancer cells. This is accomplished by stopping the cells from dividing or by destroying them. The treatment is administered according to the type and stage of the tumor being treated. Systemic chemotherapy is delivered into the bloodstream by injection into a muscle or vein, or it can be taken orally. This type of chemotherapy can treat cancer cells in every part of the body. Regional chemotherapy is placed directly into certain areas of the body to treat those specific areas. This kind of chemotherapy can be used for organs, a body cavity, or placed directly into the cerebrospinal fluid.
Chemotherapy can be used when a tumor is very large or if its location renders it too risky for removal by surgical means. The combination of chemotherapy and radiation therapy may be a treatment option for advanced stages of salivary gland cancer.
Radiotherapy, also known as radiation therapy, treats salivary gland cancer with high-powered energy beams capable of killing cancer cells or at least stopping their growth. The process is done with a machine that points the beams at certain points on the body. There are two types of radiotherapy. The kind used depends on the type and stage of the salivary gland cancer. Internal radiotherapy is administered through wires, catheters, and other tools containing a radioactive substance. The instrument is placed directly into or close to the cancer.
External radiation uses a machine to deliver radiation from many different angles. Special types of external radiation therapy include fast neutron radiation therapy and photo-beam radiation therapy. Fast neutron radiation therapy uses neutrons to kill cancer cells, and higher-energy radiation is utilized for fewer treatments. Photon-beam radiation therapy uses a machine called a linear accelerator to reach deep tumors. This type is administered through high-energy x-rays and can also be delivered as hyperfractionated radiation therapy to allow for smaller doses given more than once daily. External radiation therapy can also be used palliatively.
A parotidectomy is a surgical procedure performed to remove the parotid gland, which is the largest of the salivary glands and most common location of salivary gland cancer. There are three main techniques used for this type of surgery. A superficial or lateral method removes the parts of the gland near the surface or beside the facial nerve. A partial superficial method removes the part of the gland surrounding the tumor along with some facial nerves.
The formal superficial technique removes nerves around the temple, face, and neck. A total parotidectomy removes all of the deep parts of the parotid gland. A less invasive version called the transcervical approach avoids the facial nerve by using a small incision in the neck. The most radical technique is performed when the tumor is encroaching on the facial nerve. This procedure excises both the parotid gland and the facial nerve.
A neck dissection involves a thorough examination of the neck for tumors and surgical removal of potentially cancerous lymph nodes. This procedure is performed if there’s evidence the salivary gland cancer has spread to the lymph nodes in the neck. The spread of cancer to this area reduces survival. The cancer can spread to this region from many of the areas where the salivary glands are located. A neck dissection may cause side effects because of injury to the nerves in the area, including numbness of the ear, weakness of the lower lip, and weakness when lifting an arm over the head. The weakness of the arm and lip may improve after a few months, but will last a lifetime if a nerve is removed as part of the procedure.
Surgery is usually the first treatment for most salivary gland cancer patients, especially if it's slow-growing or in the early stages. The surgery is performed to remove the cancerous growth and some healthy tissue surrounding it. This treatment is done to remove as much of the tumor as possible, but it's very risky because of the locations of the salivary glands. There are many important nerves located in and around the salivary glands. In addition, the tumor may be close to the brain, eyes, or mouth.
In endoscopic surgery, a common type used to treat salivary gland cancer, the surgeon uses a thin, flexible tube equipped with lighting to explore the inside of the body. The tube, which is called an endoscope, is inserted through the mouth and threaded all the way down to the small bowel. Endoscopic surgery is less destructive to healthy tissues than regular surgery, and it can be used to remove tumors around the nose or in the larynx. Radiation therapy can be used after surgery to kill remaining cells.