Salivary Gland Cancer

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This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Salivary Gland Cancer?

Salivary gland cancer is a rare malignancy arising in the salivary glands, which produce saliva to aid digestion and maintain oral health. There are three major pairs: parotid (80% of tumors, near the ear), submandibular (under the jaw), and sublingual (under the tongue), plus hundreds of minor glands. Types include mucoepidermoid carcinoma (most common, 35%), adenoid cystic carcinoma (slow-growing but invasive), and adenocarcinoma. In 2025, it accounts for about 1% of head and neck cancers, with approximately 1,500-2,000 new US cases annually, more common in men aged 60-70, often presenting as slow-growing masses but with potential for nerve invasion and metastasis.

Symptoms

Symptoms typically include a painless lump or swelling in the jaw, cheek, mouth, or neck (parotid most common), facial numbness or weakness (due to facial nerve involvement), difficulty swallowing or opening the mouth, persistent ear pain, and dry mouth if gland function is impaired. Advanced cases may cause facial paralysis, skin ulceration, weight loss, or symptoms from metastases (e.g., lung shortness of breath, bone pain). Symptoms develop gradually over months to years, often mistaken for benign cysts or infections.

Causes

The exact causes are unclear, but risk factors include prior radiation exposure (e.g., head/neck therapy, increasing risk 15-20 fold), occupational exposure to woodworking dust or nickel alloys, viral infections (e.g., EBV or HPV in rare cases), smoking, heavy alcohol use, and genetic mutations (e.g., TP53, PIK3CA). Age over 50, male gender, and family history (rare syndromes like Sjogren’s) elevate risk. In 2025, genomic studies highlight how chronic inflammation and cellular mutations lead to uncontrolled growth in glandular tissues.

Diagnosis

Diagnosis begins with a physical exam assessing lump size, mobility, and nerve function, followed by imaging: ultrasound for initial evaluation, MRI/CT for tumor extent and nerve involvement, and PET scans for metastasis detection. Fine-needle aspiration biopsy (FNAB) provides cytological confirmation, with core biopsy for inconclusive cases. Molecular testing identifies mutations like NTRK fusions for targeted therapy. In 2025, AI-assisted imaging and liquid biopsies improve diagnostic accuracy, reducing unnecessary surgeries.

Treatment

Treatment depends on tumor type, location, and stage. Surgery is primary (parotidectomy with facial nerve preservation if possible, or neck dissection for lymph node involvement), achieving cure in 70-90% of low-grade cases. Radiation therapy (postoperative or primary for unresectable) uses IMRT to spare healthy tissue. Chemotherapy (cisplatin-based) is reserved for advanced or metastatic disease, with limited efficacy. Targeted therapies like larotrectinib for NTRK fusions show 75% response rates. In 2025, immunotherapy (pembrolizumab for high PD-L1) and proton therapy enhance outcomes in recurrent cases.

Future Outlook

In 2025, 5-year survival is 70-90% for low-stage/low-grade tumors but 30-50% for advanced/high-grade, with recurrence in 20-40% due to perineural spread. Advances in targeted therapies and immunotherapy extend survival by 12-18 months in metastatic cases. Research focuses on NTRK/HER2 inhibitors, CAR-T cells, and AI for surgical planning, potentially raising overall survival to 80% by 2030, with reduced facial nerve damage through nerve-sparing techniques.

Sources

The information for salivary gland cancer is sourced from Cleveland Clinic’s “Salivary Gland Cancer: Symptoms, Causes & Treatment” for symptoms and treatment; Mayo Clinic’s “Salivary gland cancer – Symptoms and causes” for causes; American Cancer Society’s “Salivary Gland Cancer” for understanding; NCI’s “Salivary Gland Cancer Treatment (PDQ®)” for diagnosis and treatment; and PMC’s “Salivary Gland Cancer: Update on Current and Emerging Therapies” for 2025 updates.