What Are the Signs of Salivary Gland Cancer?

Lumps, swelling, numbness or weakness in the jaw or mouth may indicate that you have cancer in your salivary glands. See a doctor for diagnosis if you have these symptoms, as they may be caused by other conditions, too.

Salivary gland cancer occurs when cells in the salivary glands grow out of control. There are several different salivary glands found inside and near the mouth and a number of types of cancerous and benign (non-cancerous) tumors can form in these glands.

There are 3 sets of major salivary glands on each side of the face:

• Parotid glands
  • Largest salivary glands, located just in front of the ears
  • About 70% of salivary gland tumors develop here
  • While most tumors are benign, the parotid glands are still where most malignant (cancerous) salivary gland tumors start
• Submandibular glands 
  • Smaller salivary glands, located below the jaw
  • Secrete saliva under the tongue
  • About 10% to 20% of tumors form in these glands, and about half are cancerous
• Sublingual glands
  • Smallest salivary glands, located under the floor of the mouth and below either side of the tongue
  • Tumors in these glands are rare

Signs and symptoms of salivary gland cancer can include: 

• Lump or swelling in the mouth, cheek, jaw, or neck
• Persistent pain in the mouth, cheek, jaw, ear, or neck 
• A difference between the size and/or shape of the left and right sides of the face or neck
• Numbness in part of the face
• Muscle weakness on one side of the face
• Difficulty opening the mouth widely
• Fluid draining from an ear
• Problems swallowing

Salivary gland cancer is caused by genetic changes, but the reason for these changes is unknown. 

Risk factors for developing salivary gland cancer include: 

• Older age
  • Risk increases as people age
• Male gender
  • More common in men than in women
• Radiation exposure to the head and neck area for other medical reasons 
• Workplace exposure to certain radioactive substances 
• Family history
• Other possible risk factors 
  • Certain workplace exposures
    • Certain metals (nickel alloy dust) or minerals (silica dust)
    • Work in asbestos mining, plumbing, rubber products manufacturing, and some types of woodworking 
    • Salivary gland cancer is rare so these associations are still being studied
  • Tobacco and alcohol use
    • These factors can increase the risk of other cancers but the link between smoking and alcohol use and salivary gland cancer is not yet proven
  • Diet
    • Diets low in vegetables and high in animal fats may increase the risk of salivary gland cancer, but more research is needed 
  • Cell phone use
    • There may be an increased risk of parotid gland tumors among heavy cell phone users but research is still needed

Salivary gland cancer is diagnosed with a physical examination and patient history, along with tests such as: 

• Imaging tests
  • Computed tomography (CT or CAT) scan
  • Magnetic resonance imaging (MRI) scan
  • Positron emission tomography (PET) scan
• Biopsy
  • Fine needle aspiration (FNA) biopsy
  • Incisional biopsy
• Surgical removal of the tumor: provides both enough of a sample for a diagnosis and treats the tumor at the same time 

Treatment for salivary gland cancer may include one or more of the following: 

• Surgery 
  • Parotid gland surgery
    • Removal of the outside part of the gland, called the superficial lobe (superficial parotidectomy)
    • Removal of the entire gland (total parotidectomy)
      • May also involve removal of a facial nerve
  • Submandibular or sublingual gland surgery
    • Removal of the entire gland and sometimes some of the surrounding tissue or bone, and sometimes some nerves
  • Minor salivary gland surgery
    • For salivary gland cancers that occur in the lips, tongue, palate, mouth, throat, voice box (larynx), nose, and sinuses
    • Tumor is removed along with surrounding tissue
• Radiation therapy 
  • External beam radiation therapy
    • Accelerated hyperfractionated radiation therapy
    • Three-dimensional conformal radiation therapy (3D-CRT)
    • Intensity modulated radiation therapy (IMRT)
    • Fast neutron beam radiation
• Chemotherapy 
  • Cisplatin
  • Carboplatin
  • Doxorubicin (Adriamycin)
  • 5-fluorouracil (5-FU)
  • Cyclophosphamide (Cytoxan)
  • Paclitaxel (Taxol)
  • Docetaxel (Taxotere)
  • Vinorelbine (Navelbine)
  • Methotrexate

Life expectancy for salivary gland cancer is often expressed in 5-year survival rates, that is, how many people will be alive 5 years after diagnosis. 

Salivary gland cancer 5-year survival rates:

• Localized (no sign the cancer has spread outside the salivary glands): 94% 
• Regional (cancer has spread outside the salivary glands to nearby structures or lymph nodes): 65% 
• Distant (cancer has spread to distant parts of the body such as the lungs): 35%