Treatment options by stage of salivary gland cancer

The treatment options for salivary gland cancer depend largely on the stage (extent) of the cancer, as well as the grade of the cancer (how likely it is to grow and spread quickly) and other factors.

Stage I

If you have stage I salivary gland cancer, your doctors will probably recommend surgery to remove the cancer and part or all of the salivary gland.

Adjuvant radiation therapy may be recommended after surgery if you have an intermediate- or high-grade cancer or an adenoid cystic carcinoma, if the cancer could not be completely removed, or if the edges of the removed specimen contain cancer cells (indicating that some cancer may have been left behind).

Stage II

Stage II salivary gland cancers are larger but are still confined within the salivary gland. They are also treated mainly with surgery, but it may be more extensive (covering a wider area) than for stage I cancers. The surgeon may also remove lymph nodes in your neck on the same side to see if they contain cancer.

Radiation therapy may be given after surgery if your cancer is intermediate or high grade, if the cancer could not be completely removed, or if the edges of the removed specimen contain cancer cells. There is a greater chance that some cancer may have been left behind with stage II cancers.

Stage III

These cancers are even larger and/or have started to grow outside of the salivary gland. Doctors generally recommend more extensive surgery (removing the gland containing the tumor, nearby tissues, and all lymph nodes in your neck on the same side) for these cancers if it is possible, combined with radiation therapy. Chemotherapy (chemo) may be added as well, but this is still being studied.

Radiation therapy (with or without chemo) may be used as the main treatment if surgery is not a good option (for example, if surgical removal of the cancer would cause serious problems with your eating, speech, or appearance).

Stage IV

Because of the size and extent of spread of stage IV salivary gland cancer, cure is usually not possible, particularly if the cancer has spread to distant organs. Radiation therapy to the head and neck is often used as the main treatment in this situation to try to shrink the tumor(s) and relieve pain, bleeding, or other symptoms from the cancer. This may be combined with chemo. If you have metastases, chemo may shrink or slow the growth of the cancer for a time and may help relieve your symptoms.

These cancers can be hard to treat effectively, so taking part in a clinical trial of newer treatments may be a good option.