RGCIRC, Niti Bagh
SALIVARY GLAND CANCER
Signs and Symptoms of Salivary Gland Tumours
- Numerous minor salivary glands are located on the hard and soft palate region
- Parotid gland is located in front of the ears
- Submandibular gland located below the lower jaw
- Sublingual glands are located below the tongue
- The salivary glands produce saliva, the fluid that keeps mucosal surfaces in the mouth and throat moist. There are many salivary glands e.g. parotid, submandibular, sublingual, and the minor salivary glands.
Most common symptoms:
- Swelling (with or without pain) in the neck below the jaw or in front of ears
- Weakness of one half of face
- Swelling in oral cavity, hard or soft palate area
Types of Salivary Gland Tumour
- There are 3 major salivary glands and many minor salivary glands.
- Major glands are- parotid,submandibular,sublingual
- Minor glands could be in –palate, tongue, buccal mucosa,larynx
Causes and Risk Factor of Salivary Gland Tumour
- Viruses-EBV,CMV,POLYOMA VIRUS
- Ionizing radiation
- Occupational hazards-asbestos,Nickel, rubber,wood industry
- Smoking in case of Warthin’s tumors
- Endogenous hormones
Screening and Diagnosis of Salivary Gland Tumours
How do we diagnose?
To find the cause of symptoms, a surgical oncologist evaluates a person’s medical history, performs a physical examination, and orders diagnostic tests. The examination and tests conducted may vary depending on the symptoms. Examination of a sample of tissue under the microscope is always necessary to confirm a diagnosis of cancer.
- A biopsy or FNAC is the only sure way to tell whether a person has cancer.
- Laboratory tests examine samples of blood, urine, or cells from the nodes.
- Ultrasound of parotid, neck is first modality.
- CT scan /Magnetic resonance imaging in selected cases.
- PET scan in selected advanced cancers of salivary gland.
If the diagnosis of cancer is confirmed, the surgical oncologist will want to know the stage (or extent) of the disease. Staging is a careful attempt to find out whether cancer has spread and if so, to which parts of the body. Knowing the stage of the disease helps the surgical oncologist plan treatment.
Treatment of Salivary Gland Tumours
Guidelines. (NCCN – National Comprehensive Cancer Network)
Surgeries Offered
- Superficial Parotidectomy
- Total conservative parotidectomy
- Radical and extended radical parotidectomy
- Facial nerve repair
- Submandibular gland resection
- Facial Reanimation
- Maxillectomy in palate tumors
DO’s after Surgery
- Normal diet.
- You can brush your teeth.
- Walking and moving around is a must.
- Shoulder exercises as and when advised.
- Care of the wound as advised .
- Care of the drain and output charting as advised.
- All medicines as prescribed in the discharge note along with medicines for chronic diseases like diabetes, hypertension, thyroid-related, and asthma should be continued as earlier.
- In the case of free flap reconstruction patient should sleep in a straight position or as advised.
- Care of the eyes if the closure is incomplete with lubricating eye drops every 4 hourly and ointment application plus taping at bedtime.
DON'Ts after Surgery
- Avoid hot fomentations.
- Avoid addictions.
- Avoid direct exposure to sunlight if operated for the parotid gland to avoid damage to eyes. Use dark glasses.
Tumor Board/ Multispecialty Clinic Evaluation
Each and every Head & Neck cancer patient is evaluated by a special team of Surgical Oncologists (Head & Neck unit), Medical Oncologists, Radiation Oncologists, Onco-pathologists and Imaging Specialists. Depending on the age, general condition, type of pathology, and stage of the disease, a custom-made treatment plan is charted out for each and every patient as per International Treatment
When to reach the Treating Team?
- As per appointment.
- If the swelling around the neck wound or facial wound increases suddenly or within few hours.
- Fresh bleeding from neck or facial wound. Minimal watery discharge during cleaning from neck wound is acceptable.
- If there’s difficulty in breathing or swallowing, fever.