This information represents the views of the doctors and nurses serving on the American Cancer Society's Cancer Information Database Editorial Board. These views are based on their interpretation of studies published in medical journals, as well as their own professional experience.

The treatment information in this document is not official policy of the Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor.

Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask him or her questions about your treatment options.

There is a lot for you to think about when choosing the best way to treat or manage your cancer. Often there is more than one treatment to choose from. Take time to think about all of the choices. Two factors to consider are the type of cancer and the stage (extent) of the cancer. But your age, your overall health, and the ways the treatment may affect your speech, chewing, and swallowing are also important. It's often a good idea to get a second opinion, if possible from a doctor who often treats this type of cancer.

The 3 main types of treatments for these cancers are surgery, radiation, and, less often, chemotherapy. Sometimes 2 or more of these methods are used together.

Surgery

If you have salivary gland cancer, one of the first things your doctor will do is to find out if the cancer can be removed by surgery. Surgery is the main form of treatment in these cases. Most often, the surgeon will remove the cancer and some of the nearby tissue. If the cancer is a high grade (more likely to grow quickly) or if it has spread to the lymph nodes, the doctor may suggest removing the nodes, too. This is called a neck dissection. Before surgery, ask your doctor exactly what will be done during the operation, whether there are other options, and what side effects you can expect. Make sure that your surgeon has experience with this kind of operation. The type of surgery depends on which salivary gland is affected.

Parotid gland

Salivary gland tumors often start in the parotid gland. The facial nerve, which controls movement of the face, passes through this gland. This makes the surgery tricky. If your cancer has spread into deeper tissues, the surgeon will remove the entire gland and might also remove your facial nerve. You should ask your doctor about operations to repair the nerve and ways to treat side effects caused by removing the nerve.

Submandibular or sublingual gland

If your cancer is in the submandibular or sublingual glands, the surgeon will remove the entire gland and maybe some of the nearby tissue or bone. Some important nerves pass through or near these glands. These nerves control tongue movement, as well as feeling and taste. The surgeon may need to remove some of these nerves.

Minor salivary gland

If your cancer is in the minor salivary glands, the surgeon usually removes some tissue around the cancer along with the cancer. The exact details depend on the size and place of the cancer.

Side effects of surgery

With any of these operations, the surgeon may need to cut through your skin or your mouth. You might have problems with healing, infections, or bleeding after surgery. If your facial nerve is damaged during surgery, you may lose control of your facial muscles on the side the surgery was done and your mouth may droop. Damage to other nerves may cause speech or swallowing problems.

There can be side effects from each of the different kinds of surgery, especially if facial nerves or other nerves are damaged or need to be removed. Talk to your doctor about what to expect after your surgery and what you can do to help reduce any side effects.

Neck dissection

If your cancer is high grade (likely to grow and spread quickly), the surgeon might remove lymph nodes in the neck--this is called neck dissection. As a result, muscle, nerve, and other tissue may also be removed. This could cause things like ear numbness, weakness in raising your arm above your head, and weakness of the lower lip. These problems could get better with time. A physical therapist can teach you exercises that can help.

Radiation therapy

Radiation therapy is treatment with high energy x-rays to kill cancer cells and shrink tumors. External beam radiation is most often used to treat salivary gland cancers. It is much like getting a regular x-ray, but it lasts longer. Usually treatment will be given 5 days a week for 6 or 7 weeks. A new approach is to give radiation twice a day over a shorter length of time. Radiation treatment is not painful.

Radiation is sometimes used as the main treatment for salivary gland cancer, especially for patients whose health doesn't permit surgery, or for people whose cancers are too large to be removed by surgery. Radiation can also be used after surgery to kill cancer cells that could not be seen during the operation.

Radiation can be used to ease symptoms such as pain, bleeding, and trouble swallowing caused by the spread of cancer.

Side effects of radiation treatment

There can be side effects from radiation. These could include skin changes (like sunburn), sore throat, hoarseness, trouble swallowing, loss of taste, bone pain, bone damage, and tiredness. Often radiation is only needed on one side of the head. If so, it may be possible to avoid long-lasting side effects such as dry mouth and thyroid gland injury, which can happen if both sides of the head must be treated.

If you are going to have radiation treatment, you will need a dental exam before it begins. It may be necessary to remove some or all of your teeth. This depends on the area to be treated and the condition of your teeth. It can be done by either the head and neck surgeon or an oral surgeon.

It's a good idea to discuss the possible side effects of radiation treatment with your doctor before starting treatment. Talk to your doctor about what can be done to try to limit side effects. If you do have side effects, there are ways to relieve many of them, so it is important to discuss your symptoms with your doctor.

Chemotherapy (Chemo)

Chemotherapy (often called "chemo") refers to the use of drugs to kill cancer cells. Usually the drugs are given into a vein or by mouth. Once the drugs enter the bloodstream, they spread throughout the body.

Chemo is not often used to treat salivary gland cancers. Sometimes it is used for people whose cancer has spread to distant organs or whose cancer could not be controlled by surgery and radiation therapy. While the drugs may shrink the tumor for these patients, they do not cure this type of cancer.

Chemo can cause side effects, which usually go away after treatment. These include tiredness, nausea, mouth sores, and hair loss. It can also cause you to bleed or bruise easily, and be at a higher risk of infection. Side effects depend on the type of drugs given, the amount taken, and how long treatment lasts. Anyone who has problems with side effects should talk with their doctor or nurse, as there are often ways to help.

Last Medical Review: 02/26/2009
Last Revised: 02/26/2009