Treatment for salivary gland cancer depends on its location, severity, and stage. Treatment most often consists of surgery and radiation therapy.
Surgery is the primary treatment for salivary gland cancer, if the tumor can be removed entirely, and has not grown deeply into nearby structures. The doctor will remove all or part of the salivary gland, and may remove some nearby tissue and lymph nodes as well.
A parotidectomy is a procedure in which the doctor removes all or part of the parotid gland. This procedure is tedious and difficult because the facial nerves pass directly through the parotid glands. These nerves control facial movement on each side of the face. Fortunately, many parotid gland tumors start on the outer part of the gland, which can often be removed without affecting the facial nerve. For tumors that are more extensive, the entire parotid gland may need to be removed. In these cases, it is important to ask the doctor about facial nerve preservation. The doctor may be able to remove the gland while preserving the function of the facial nerve.
Submandibular/Sublingual gland surgery
For tumors in the submandibular and sublingual glands, surgery to remove the gland is the primary treatment. Low-grade tumors and benign tumors can often be treated by completely removing the gland. More severe tumors may require that the tumor bed and nearby soft tissues also be removed. The surgeon will pay close attention to the facial nerves in these areas, and will preserve them if possible.
The doctor may also recommend any of the following treatments:
Radiation therapy uses waves of high energy rays produced by a machine to destroy cancer cells. Radiation therapy is often given after surgery for salivary gland cancer, in order to kill any remaining cancer cells and prevent a local or regional recurrence. Radiation therapy may also be used as the primary treatment for tumors that can’t be removed with surgery, or as a palliative treatment in patients with advanced cancer in order to relieve symptoms. Chemotherapy may be combined with radiation therapy in some cases. Patients with head and neck cancer should meet with an oncologic dentist before this treatment, as radiation can cause tooth decay and other side effects when administered to the head and neck region.
Proton beam radiation therapy
Proton therapy is an advanced type of radiation therapy that uses “protons” rather than X-ray “photons” to deliver radiation to the tumor. In conventional radiotherapy, the photon beams can deposit radiation and damage healthy cells as they pass through the body. Proton therapy deposits most of the radiation directly at the tumor site, resulting in less damage to healthy tissue and fewer side-effects.
Chemotherapy is the use of drugs to target rapidly growing cells in an effort to destroy cancer cells. Chemotherapy is rarely used to treat salivary gland cancer, but may be combined with radiation in some cases. Chemotherapy may also be given to patients whose cancer has metastasized in order to shrink the tumor and relieve symptoms.
Clinical trials allow patients to try a new treatment before it is available to the general public. In some cases, this may be a new drug that has not been used in humans before, or it may be a drug or drug combination that is not currently used for that specific type of cancer. Early phase clinical trials are often used to test side effects of a drug or drug combination, while later phase clinical trials are used to see how effective a new treatment might be for a certain type of cancer. Clinical trials allow doctors and researchers to improve the treatment of cancers with possibly more effective therapies. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation.