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Salivary Gland Cancer - Introduction

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Salivary Gland Cancer. Use the menu to see other pages. Think of that menu as a roadmap for this complete guide.

About the salivary glands

The salivary glands contain tissues that produce saliva. Saliva is important to the body because it:

  • Helps keep the mouth moist

  • Contains enzymes that begin breaking down food

  • Helps prevent infections of the mouth and throat

There are clusters of salivary glands in several places in the head and neck. Doctors often refer to 3 pairs of salivary glands as the major salivary glands.

  • Parotid glands. These are the largest salivary glands. They are located on both sides of the face, in front of the ears.

  • Submandibular glands. These are found under the jawbone.

  • Sublingual glands. These are found in the bottom of the mouth, under the tongue.

There are also smaller clusters of salivary glands, called minor salivary glands. These include salivary glands in:

  • The area of the upper jaw along the inside of the teeth and the soft palate

  • Parts of the tissue that line the upper digestive tract, known as the mucosa

  • The windpipe

About salivary gland cancer

Salivary gland cancer is 1 of the 5 main types of cancer in the head and neck region, a grouping called head and neck cancer. Cancer begins when healthy cells change and grow out of control, forming a mass of tissue called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

Both benign and cancerous tumors can begin in any of the major or minor salivary glands. Most of the tumors (80%) that develop in the parotid gland, and about half of the tumors in the submandibular gland, are benign. Sublingual gland tumors are frequently cancerous. Most cancerous tumors of this type begin in the parotid gland or in the submandibular glands.

There are many subtypes of salivary gland tumors. The classification of subtype depends on the type of cell where the tumor started and an evaluation of tumor cells under a microscope (see Subtypes).

This section covers primary salivary gland cancer, which is cancer that begins in the salivary glands. Sometimes another type of cancer, usually melanoma or other types of skin cancers, can spread to the salivary glands or to the nearby lymph nodes located inside and surrounding the parotid gland and next to the submandibular gland. Lymph nodes are small, bean-shaped organs that fight infection. For more information about cancer that started in another part of the body and then spread to the salivary glands, please see the Cancer.Net guide for that type of cancer.

The next section in this guide is Statistics. It helps explain how many people are diagnosed with salivary gland cancer and general survival rates. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Statistics

Approved by the Cancer.Net Editorial Board, 03/2023

ON THIS PAGE: You will find information about the estimated number of people who will be diagnosed with salivary gland cancer each year. You will also read general information on surviving the disease. Remember, survival rates depend on several factors, and no 2 people with cancer are the same. Use the menu to see other pages.

Every person is different, with different factors influencing their risk of being diagnosed with this cancer and the chance of recovery after a diagnosis. It is important to talk with your doctor about any questions you have around the general statistics provided below and what they may mean for you individually. The original sources for these statistics are provided at the bottom of this page.

How many people are diagnosed with salivary gland cancer?

Worldwide, an estimated 53,583 people were diagnosed with salivary gland cancer in 2020. However, salivary gland cancer is uncommon in the United States, with about 2,000 to 2,500 new cases diagnosed each year. This type of cancer represents between 6% and 8% of all head and neck cancers in the United States. The average age of diagnosis is 55.

In 2020, an estimated 22,778 people died from salivary gland cancer worldwide.

What is the survival rate for salivary gland cancer?

There are different types of statistics that can help doctors evaluate a person’s chance of recovery from salivary gland cancer. These are called survival statistics. A specific type of survival statistic is called the relative survival rate. It is often used to predict how having cancer may affect life expectancy. Relative survival rate looks at how likely people with salivary gland cancer are to survive for a certain amount of time after their initial diagnosis or start of treatment compared to the expected survival of similar people without this cancer.

Example: Here is an example to help explain what a relative survival rate means. Please note this is only an example and not specific to this type of cancer. Let’s assume that the 5-year relative survival rate for a specific type of cancer is 90%. “Percent” means how many out of 100. Imagine there are 1,000 people without cancer, and based on their age and other characteristics, you expect 900 of the 1,000 to be alive in 5 years. Also imagine there are another 1,000 people similar in age and other characteristics as the first 1,000, but they all have the specific type of cancer that has a 5-year survival rate of 90%. This means it is expected that 810 of the people with the specific cancer (90% of 900) will be alive in 5 years.

It is important to remember that statistics on the survival rates for people with salivary gland cancer are only an estimate. They cannot tell an individual person if cancer will or will not shorten their life. Instead, these statistics describe trends in groups of people previously diagnosed with the same disease, including specific stages of the disease.

The 5-year relative survival rate for salivary gland cancer in the United States is 76%.

The survival rates for salivary gland cancer vary based on several factors. These include the stage and grade of cancer, a person’s age and general health, and how well the treatment plan works.

If cancer is located only in the salivary gland, the 5-year relative survival rate is 94%. If the cancer has spread outside the salivary gland to nearby structures or lymph nodes, the 5-year relative survival rate is 70%. If it is found after the cancer has spread to distant parts of the body, the 5-year relative survival rate is 43%.

Experts measure relative survival rate statistics for salivary gland salivary gland cancer every 5 years. This means the estimate may not reflect the results of advancements in how salivary gland cancer is diagnosed or treated from the last 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.

Statistics adapted from the websites of the American Cancer Society and the International Agency for Research on Cancer. (All sources accessed March 2023.)

The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by salivary gland cancer. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Medical Illustrations

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will find a drawing that shows the location of the major salivary glands. Use the menu to see other pages.

This illustration shows three major pairs of salivary glands. The parotid glands are the largest salivary glands, and are located on both sides of the face, in front of the ears. The submandibular glands are found under the jawbone at the top of the neck. The smallest salivary glands are the sublingual glands, found in the bottom of the mouth, under the tongue. Copyright 2003 American Society of Clinical Oncology. Robert Morreale/Visual Explanations, LLC.

For medical illustrations showing the different stages of salivary gland cancer, see the Stages and Grades section.

The next section in this guide is Risk Factors. It explains the factors that may increase the chance of developing salivary gland cancer. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Risk Factors

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will find out more about the factors that increase the chance of developing salivary gland cancer. Use the menu to see other pages.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The cause(s) of most salivary gland cancers are unknown, but the following factors may raise a person’s risk of developing salivary gland cancer:

  • Age. About 2 out of every 3 salivary gland cancers are found in people 55 and older, with an average age of 64.

  • Radiation exposure. Radiation therapy to the head or neck for another medical reason may increase the risk of developing salivary gland cancer.

  • Radioactive substance exposure. In some reports, exposure to certain radioactive substances has been linked to an increased risk of salivary gland cancer. Other reports suggest that there has not been enough evidence to support this. Talk with your doctor for more information.

  • Environmental/occupational exposure. Exposure to sawdust and chemicals used in the leather industry, pesticides, and some industrial solvents may increase the risk of a type of salivary gland cancer that occurs in the nose and sinuses.

Researchers continue to look into what factors cause this type of cancer. Other possible risk factors that doctors are investigating, but have not proven, include exposure to certain metals (nickel alloy dust) or minerals (silica dust), a diet low in vegetables and high in animal fats, and exposure to hair dye or hairspray. Talk with your doctor for more information about your personal risk of cancer and how you may be able to lower your risk.

The next section in this guide is Screening. It explains how tests may find cancer before signs or symptoms appear. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Screening

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will find out more about screening for salivary gland cancer. You will also learn the risks and benefits of screening. Use the menu to see other pages.

Screening is used to look for cancer before you have any symptoms or signs. Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer. The overall goals of cancer screening are to:

  • Lower the number of people who die from the disease, or eliminate deaths from cancer altogether

  • Lower the number of people who develop the disease

Learn more about the basics of cancer screening.

Screening information for salivary gland cancer

There are currently no specific screening tools that are used for salivary gland cancer for the general public. It is important to receive regular health and dental exams. If anything unusual is found during these general checkups, your doctor or dentist will recommend a more extensive examination. This may include using 1 or more of the diagnostic procedures mentioned in the Diagnosis section.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems salivary gland cancer can cause. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Symptoms and Signs

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. Use the menu to see other pages.

People with salivary gland cancer may experience the following symptoms or signs. Sometimes, people with salivary gland cancer do not have any of these changes. Or, the cause of a symptom may be a different medical condition that is not cancer.

  • A lump on the face, neck, or mouth that is usually painless

  • Numbness in the face

  • Inability to move some facial muscles, especially if the muscle on 1 side of the face stops moving and the affected area slowly expands. This is known as progressive facial muscle paralysis.

  • Pain or swelling in the face, chin, jawbone area, or neck

  • A difference between the size and/or shape of the left and right sides of the face or neck

If you are concerned about any changes you experience, please talk with your doctor and/or dentist right away, especially if they don’t go away or get worse. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help figure out the cause of the problem, called a diagnosis. When detected early, head and neck cancers have a much better chance of being cured.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may be called palliative care or supportive care. It is often started soon after diagnosis and continued throughout treatment. Be sure to talk with your health care team about the symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis, and it explains what tests may be needed to learn more about the cause of the symptoms. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Diagnosis

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors can use to find out what’s wrong and identify the cause of the problem. Use the menu to see other pages.

Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if the cancer has spread. Imaging tests show pictures of the inside of the body. Doctors may also do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know if an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

For a salivary gland tumor, a needle biopsy (see below) is the preferred test for making a diagnosis. A surgical (incisional) biopsy should be avoided in almost every case, except in rare exceptions. Imaging tests may be used to find out whether the cancer has spread.

This section describes options for diagnosing salivary gland cancer. Not all tests listed below will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and general health

  • The results of earlier medical tests

Tests and procedures (updated 04/2021)

To diagnose salivary gland cancer, the doctor will ask about your medical history and potential risk factors. Then they will do a careful physical examination. A thorough examination of the skin is particularly important if you have ever had a skin tumor. If there is facial nerve paralysis, specific tests will be necessary, and an examination of the oral cavity (mouth), hypopharynx (lower throat), and larynx (voice box) will also be done.

There are no specific blood or urine tests that can detect a salivary gland tumor because there are no known tumor markers for salivary gland cancer at this time. Tumor markers are substances found in higher-than-normal amounts in the blood, urine, or body tissues of people with certain kinds of cancer.

In addition to a physical examination, the following tests may be used to diagnose salivary gland cancer or be done as part of treatment planning:

  • Ultrasound. An ultrasound uses sound waves to create a picture of the internal organs.

  • Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. A pathologist then analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease. The pathologist will also look at the tissue and may perform lab tests on the sample to learn more about it. The results will be part of the pathology report.

  • Ultrasound-guided needle biopsy. During this type of biopsy, the doctor uses the images produced by an ultrasound to guide a needle into the tumor. The doctor may perform a fine needle aspiration biopsy or a core needle biopsy depending on the location of the tumor. A fine needle aspiration biopsy uses a thin, hollow needle attached to a syringe to collect a small amount of tissue from the tumor to examine and test. A core needle biopsy is similar to a fine needle aspiration biopsy, but it uses a larger needle to remove a larger amount of tissue.

  • Endoscopy. An endoscopy allows the doctor to see inside the body with a thin, lighted, flexible tube called an endoscope. The person may be sedated while the tube is inserted through the mouth, down the esophagus, and into the stomach and small bowel. The examination has different names depending on the area of the body that is examined, such as laryngoscopy (larynx), pharyngoscopy (pharynx), or a nasopharyngoscopy (nasopharynx). Sedation is giving medication to become more relaxed, calm, or sleepy.

  • Computed tomography (CT or CAT) scan. A CT scan creates a 3-dimensional picture of the inside of the body using x-rays taken from different angles. A computer combines these pictures into a detailed, cross-sectional image that shows any abnormalities or tumors. A CT scan can be used to measure the tumor’s size or to see if a tumor involves nearby bone. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a person's vein or given as a liquid to swallow.

  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body, especially images of soft tissue, such as the tonsils and base of the tongue, as well as images of the neck and base of the skull. MRI can be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a person's vein or given as a pill or liquid to swallow.

  • Positron emission tomography (PET) or PET-CT scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure just as a PET scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into a person's body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body

  • Panoramic radiograph. Also called a Panorex, this is a rotating, or panoramic, x-ray of the upper and lower jawbones to find cancer or evaluate teeth before cancer treatment. This x-ray is not generally used to evaluate salivary gland tumors because it mostly evaluates only bone and teeth structures.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor figure out the tumor’s subtype.

This information is based on the ISOO/MASCC/ASCO guideline, “Management of Salivary Gland Malignancy.” Please note that this link takes you to another ASCO website.

The next section in this guide is Subtypes. It lists the types of salivary gland tumors that may be diagnosed. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Subtypes

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will find a list of common subtypes of salivary gland tumors. Use the menu to see other pages.

There are many types of salivary gland tumors. Doctors classify the subtype of salivary gland tumor by looking at tumor cells under a microscope, called a histologic evaluation. Your doctor can provide more information about your specific diagnosis.

Benign tumor subtypes

  • Pleomorphic adenoma (benign mixed tumor)

  • Papillary cystadenoma lymphomatosum (Warthin’s tumor)

  • Oncocytoma

  • Monomorphic adenoma, including basal cell adenoma, glycogen-rich adenoma, and clear cell adenoma, among others

  • Sebaceous adenoma

  • Sebaceous lymphadenoma

  • Papillary ductal adenoma

  • Benign lymphoepithelial lesion

Cancerous tumor subtypes

  • Carcinoma ex pleomorphic adenoma

  • Mucoepidermoid carcinoma

  • Hybrid basal cell carcinoma–adenoid cystic carcinoma

  • Adenoid cystic carcinoma

  • Acinic cell carcinoma

  • Adenocarcinoma

  • Polymorphous low-grade adenocarcinoma

  • Oncocytic carcinoma (malignant oncocytoma)

  • Clear cell carcinoma

  • Epithelial-myoepithelial carcinoma of intercalated ducts

  • Squamous cell carcinoma

  • Undifferentiated carcinoma

  • Metastatic carcinoma

Source: Tumors of the Head and Neck, Clinical and Pathological Considerations, 2nd Edition, John G. Batsakis, MD, Copyright 1979, published by Lippincott Williams & Wilkins.

The next section in this guide is Stages and Grades. It explains the system doctors use to describe the extent of salivary gland cancer. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Stages and Grades

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread, as well as what the cancer cells look like under a microscope. This is called the stage and grade. Use the menu to see other pages.

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to find out the cancer’s stage, so staging may not be complete until the doctor performs a biopsy. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a person's prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

TNM staging system

One tool that doctors use to describe the stage is the TNM system. Doctors use the results from diagnostic tests and scans to answer these questions:

  • Tumor (T): How large is the primary tumor? Where is it located?

  • Node (N): Has the tumor spread to the lymph nodes? If so, where and how many?

  • Metastasis (M): Has the cancer spread to other parts of the body? If so, where and how much?

The results are combined to determine the stage of cancer for each person. There are 5 stages: stage 0 (zero) and stages I through IV (1 through 4). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

Staging can be clinical or pathological. "Clinical staging" is based on the results of tests done before surgery, which may include physical examinations and imaging tests. "Pathological staging" is based on what is found during surgery. In general, pathological staging provides the most information to determine a patient’s prognosis.

Here are more details on each part of the TNM system for salivary gland cancer:

Tumor (T)

Using the TNM system, the "T" plus a letter or number (0 to 4) is used to describe the size and location of the tumor. Tumor size is measured in centimeters (cm). A centimeter is roughly equal to the width of a standard pen or pencil.

Stage may also be divided into smaller groups that help describe the tumor in even more detail. Specific tumor stage information is listed below.

TX: Indicates the primary tumor cannot be evaluated.

T0 (T plus zero): No evidence of a tumor was found.

T1: Describes a small, noninvasive (has not spread) tumor that is 2 cm at its greatest dimension.

T2: Describes a larger, noninvasive tumor between 2 cm to 4 cm.

T3: Describes a tumor that is larger than 4 cm but not larger than 6 cm and has spread beyond the salivary glands but does not affect the seventh nerve, the facial nerve that controls expression, such as smiles or frowns.

T4a: The tumor has invaded the skin, jawbone, ear canal, and/or facial nerve.

T4b: The tumor has invaded the skull base and/or the nearby bones and/or encases the arteries.

Node (N)

The “N” in the TNM staging system is for lymph nodes. Lymph nodes near the head and neck are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes. There are many nodes located in the head and neck area, and careful evaluation of lymph nodes is an important part of staging cancer of the major salivary glands.

NX: The regional lymph nodes cannot be evaluated.

N0: There is no evidence of cancer in the regional lymph nodes.

N1: Cancer has spread to a single lymph node on the same side as the primary tumor, and the cancer found in the lymph node is 3 cm or smaller.

N2: Describes any of these conditions:

  • N2a: The cancer has spread to a single lymph node on the same side as the primary tumor and is larger than 3 cm but smaller than 6 cm.

  • N2b: The cancer has spread to more than 1 lymph node on the same side as the primary tumor, and none measures larger than 6 cm.

  • N2c: The cancer has spread to more than 1 lymph node on either side of the body, and none measures larger than 6 cm.

N3: The cancer found in the lymph nodes is larger than 6 cm.

Metastasis (M)

The "M" in the TNM system describes cancer that has spread to other parts of the body, called distant metastasis.

MX: Indicates distant metastasis cannot be evaluated.

M0: Indicates the cancer has not spread to other parts of the body.

M1: Describes cancer that has spread to other parts of the body.

Cancer stage grouping

Doctors assign the stage of the cancer by combining the T, N, and M classifications.

Stage I: Noninvasive tumors (T1, T2) with no spread to lymph nodes (N0) and no distant metastasis (M0).

Stage II: An invasive tumor (T3) with no spread to lymph nodes (N0) or distant metastasis (M0).

Stage III: Smaller tumors (T1, T2) that have spread to regional lymph nodes (N1) but have no sign of metastasis (M0).

Stage IVA: Any invasive tumor (T4a) with either no lymph node involvement (N0) or spread to only a single same-sided lymph node (N1), but no metastasis (M0). It is also used for a T3 tumor with 1-sided lymph nodal involvement (N1) but no metastasis (M0), or any tumor (any T) with extensive lymph nodal involvement (N2).

Stage IVB: Any cancer (any T), with more extensive spread to lymph nodes (N2, N3), but no metastasis (M0).

Stage IVC: Any cancer with distant metastasis (any T, any N, and M1).

Recurrent: Recurrent cancer is cancer that has come back after treatment. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

Used with permission of the American College of Surgeons, Chicago, Illinois. The original and primary source for this information is the AJCC Cancer Staging Manual, Eighth Edition (2017) published by Springer International Publishing.

Grade (G)

Doctors also describe this type of cancer by its grade (G). The grade describes how much cancer cells look like healthy cells when viewed under a microscope.

The doctor compares the cancerous tissue with healthy tissue. Healthy tissue usually contains many different types of cells grouped together. If the cancer looks similar to healthy tissue and has different cell groupings, it is called “differentiated” or a “low-grade tumor.” If the cancerous tissue looks very different from healthy tissue, it is called “poorly differentiated” or a “high-grade tumor.” The cancer’s grade may help the doctor predict how quickly the cancer will spread. In general, the lower the tumor’s grade, the better the prognosis.

Information about the cancer’s stage and grade will help the doctor recommend a specific treatment plan. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Types of Treatment

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will learn about the different types of treatments doctors use for people with salivary gland cancer. Use the menu to see other pages.

This section explains the types of treatments that are the standard of care for salivary gland cancer. “Standard of care” means the best treatments known. When making treatment plan decisions, you are encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn whether the new treatment is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Clinical trials are an option to consider for treatment and care for all stages of cancer. Your doctor can help you consider all your treatment options. Learn more about clinical trials in the About Clinical Trials and Latest Research sections of this guide.

Treatment overview

Many salivary gland cancers can often be cured, especially if found early. Although curing the cancer is the primary goal of treatment, preserving the function of the nearby nerves, organs, and tissues is also very important. When doctors plan treatment, they consider how treatment might affect a person’s quality of life, including how a person feels, looks, talks, eats, and breathes.

In cancer care, different types of doctors often work together to create a person's overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. An evaluation should be done by individual head-and-neck specialists before any treatment begins. The team may include these specialists:

  • Medical oncologist: a doctor who specializes in treating cancer with medication

  • Radiation oncologist: a doctor who specializes in giving radiation therapy to treat cancer

  • Surgical oncologist: a doctor who specializes in treating cancer using surgery

  • Maxillofacial prosthodontist: a specialist who performs restorative surgery in the head and neck areas

  • Otolaryngologist: a doctor who specializes in the ear, nose, and throat

  • Oncologic dentist or oral oncologist: dentists experienced in caring for people with head and neck cancer

  • Physical therapist: a health professional who addresses functional challenges that may develop as a result of cancer and cancer treatment

  • Speech pathologist: a specialist who helps people use muscles in the mouth and throat

  • Mental health providers: health professionals who diagnose and treat mental health problems, such as a psychiatrist or a psychologist

Cancer care teams also include a variety of other health care professionals, such as physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Descriptions of common types of treatments used for salivary gland cancer are listed below. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care.

Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. These types of talks are called “shared decision making.” Shared decision making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision making is particularly important for salivary gland cancer because there are different treatment options. Learn more about making treatment decisions.

This information is based on the ISOO/MASCC/ASCO guideline, “Management of Salivary Gland Malignancy.” Please note that this link takes you to another ASCO website.

Surgery (updated 04/2021)

Surgery is recommended for nearly everyone diagnosed with salivary gland cancer and is usually the first treatment. During surgery, a doctor performs an operation to remove the cancerous tumor and some surrounding healthy tissue, called a margin. A surgical oncologist is a doctor who specializes in treating cancer using surgery.

The goal of surgery is to remove as much of the tumor as possible and leave negative margins. This means no trace of cancer was found in the healthy tissue that was removed. The type and extent of surgery depends on the location and extent of the cancer. 

Types of surgery used to treat salivary gland cancer include:

  • Parotidectomy. Part or all of the parotid gland may be removed during a procedure called a parotidectomy. You have 1 parotid gland on each side of your mouth, located in your cheek and in front of your ear. These are the largest salivary glands in your body. This surgery often involves dissecting the facial nerve. If cancer has spread to the facial nerve, frequently a nerve graft or other reconstructive procedures are necessary for the person to regain use of some facial muscles. Any tissue that is removed can often be restored through reconstructive surgery (see below) and tissue transplantation.

  • Endoscopic surgery. Occasionally, it is possible to remove the tumor by endoscopic surgery (see Endoscopy, under Diagnosis), which is less destructive to healthy tissues than regular surgery. This is used particularly when a salivary gland tumor begins in the paranasal area (around the nose) or in the larynx. However, this is rare. More often, a tumor may be found unexpectedly during endoscopic surgery for what is believed to be chronic sinusitis (inflammation).

  • Neck dissection. A neck dissection is when the surgeon examines all of the critical structures in the neck and removes lymph nodes from the neck. This may be performed if the doctor suspects that the cancer has spread, or if there is a high enough chance of it spreading. A neck dissection may cause numbness of the ear, weakness when raising the arm above the head, and weakness of the lower lip. These side effects are caused by injury to nerves in the area. Depending on the type of neck dissection, weakness of the lower lip and arm may go away in a few months. Weakness will be permanent if a nerve is removed as part of the dissection.

  • Reconstructive surgery. Reconstructive (plastic) surgery may be used to replace tissue and nerves that were removed during surgery to eliminate the cancer.

Surgery can have significant risks because the cancer may be close to the eyes, mouth, brain, and important nerves and blood vessels. Surgical side effects can include swelling of the face, mouth, and throat, which makes it difficult to breathe and swallow. Frequently, a person may receive a temporary tracheostomy, a hole in the windpipe, to make breathing easier during their recovery.

Facial nerves may also be affected, either temporarily or permanently, by cancer or its treatment. Whenever possible, the surgeon will try to preserve function of the facial nerves. Changes to a person’s appearance because of surgery may need to be addressed using reconstructive plastic surgery. If the maxilla (upper jaw) is removed, a prosthodontist will play a large role in the rehabilitation process. A prosthodontist is a dentist who specializes in replacing teeth and parts of the jaw. Learn more about cancer rehabilitation.

Surgery is typically followed by additional treatment, most often radiation therapy. Sometimes, more than 1 operation may be needed to remove the cancer and to help restore the appearance and function of the affected tissues. If the cancer comes back after surgery, then additional surgery or other treatment may be recommended. Occasionally, it is not possible to remove salivary gland cancer using surgery. This type of tumor is called inoperable. In these cases, doctors will recommend other treatment options (see below).

Before surgery, talk with your health care team about the possible side effects from the specific surgery you will have. Learn more about the basics of cancer surgery.

Radiation therapy (updated 04/2021)

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. A radiation therapy regimen, or schedule, usually consists of a specific number of treatments given over a set period of time.

For a salivary gland tumor, radiation therapy is most often used in combination with surgery. Whether radiation therapy is given after surgery depends on the size, grade, extent, and location of the cancer and whether there are some cancer cells in the margin around the tumor removed by surgery. If radiation therapy is recommended, it should be started within 8 weeks of the surgery. Radiation therapy may also be given along with chemotherapy (see below). If a person cannot have surgery or decides not to have surgery, radiation therapy may be used as the main treatment.

There are 2 main types of radiation therapy used for salivary gland cancer:

  • External-beam radiation therapy. This is the most common type of radiation treatment and is given from a machine outside the body. External-beam radiation therapy may be used when a tumor has grown into the soft tissue, has spread to the lymph nodes, surrounds a nerve, or when surgery is not possible. Doctors also recommend this type of radiation therapy for poorly differentiated tumors. (See the Stages and Grades section for more information.)

    A specific method of external radiation therapy, known as intensity modulated radiation therapy (IMRT), allows more effective doses of radiation therapy to be delivered while reducing damage to nearby healthy cells.

    Other types of external-beam radiation therapy used for salivary gland tumors are proton, neutron, and carbon ion therapy. These types of radiation therapy use particles other than x-rays.

  • Internal radiation therapy. When radiation therapy is given using implants, it is called internal radiation therapy or brachytherapy. Internal radiation therapy involves surgically implanting tiny pellets or rods containing radioactive materials in or near the tumor.

Before beginning radiation treatment for salivary gland cancer, a person should receive a thorough examination from an oncologic dentist or oral oncologist. These doctors are experienced in treating people with head and neck cancer. Radiation therapy can cause tooth decay. Often, tooth decay can be prevented with proper treatment from a dentist before beginning treatment. Learn more about dental and oral health.

Other side effects from radiation therapy to the head and neck may include redness or skin irritation in the treated area, dry mouth (xerostomia) or thickened saliva from damage to salivary glands, bone pain, nausea, fatigue, mouth sores, and/or sore throat. People may also experience pain or difficulty swallowing; loss of appetite, often due to a change in sense of taste; hearing loss, due to the buildup of fluid in the middle ear; and buildup of earwax that dries out because of the radiation therapy’s effect on the ear canal.

Radiation therapy may also cause a condition called hypothyroidism in which the thyroid gland (located in the neck) slows down and causes the person to feel tired and sluggish. People who receive radiation therapy to the neck area should have their thyroid checked regularly. Talk with your health care team about what side effects of your treatment plan are possible and how they can be prevented or managed.

Learn more about the basics of radiation therapy.

Therapies using medication (updated 12/2022)

The treatment plan may include medications to destroy cancer cells. Medication may be given through the bloodstream to reach cancer cells throughout the body. When a drug is given this way, it is called systemic therapy. Medication may also be given locally, which is when the medication is applied directly to the cancer or kept in a single part of the body. 

This treatment is generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication. Research continues about the benefits of systemic therapy to treat salivary gland cancer, and this type of treatment is being evaluated in clinical trials.

For salivary gland cancer, therapies using medication are most often used to treat later-stage cancer or to relieve symptoms. Some drugs are available in clinical trials that may treat cancer at an earlier stage or that may be combined with radiation therapy to determine its effectiveness.

When medication is recommended, the main type is chemotherapy. Chemotherapy is the use of drugs to destroy cancer cells, usually by keeping the cancer cells from growing, dividing, and making more cells.

A medication called targeted therapy may be an option through clinical trials for people with certain subtypes of salivary gland cancer if the tumor has specific genetic changes or molecular alterations,  including HER2, NTRK, or androgen receptors.

If the tumor has high tumor mutational burden (TMB) or expresses a protein called PD-L1, then treatment using pembrolizumab (Keytruda) may be recommended. Pembrolizumab is a type of medication called immunotherapy. Immunotherapy uses the body's natural defenses to fight cancer by improving your immune system's ability to attack cancer cells.

Medication gets into the bloodstream to reach cancer cells throughout the body. Common ways to give cancer medications include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally). If you are given oral medications, be sure to ask your health care team how to safely store and handle them.

A regimen, or schedule, usually consists of a specific number of cycles given over a set period of time. A person may receive 1 drug at a time or a combination of different drugs given at the same time.

Each drug or combination of drugs can cause specific side effects, and it is important to talk with your doctor about which side effects to expect and whether any may be permanent. The side effects of systemic therapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, diarrhea, and open sores in the mouth. Talk with your health care team about how they can help manage or relieve treatment side effects.

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications, causing unwanted side effects or reduced effectiveness. Learn more about your prescriptions by using searchable drug databases.

This information is based in part on the ASCO guideline, “Immunotherapy and Biomarker Testing in Recurrent and Metastatic Head and Neck Cancers.” Please note that this link takes you to a different ASCO website.

Physical, emotional, and social effects of cancer

Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Managing all of these effects is called palliative care or supportive care. It is an important part of your care that is included along with treatments intended to slow, stop, or eliminate the cancer.

Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical needs. Any person, regardless of age or type and stage of cancer, may receive this type of care. And it often works best when it is started right after a cancer diagnosis. People who receive palliative care along with treatment for the cancer often have less severe symptoms, better quality of life, and report that they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of the cancer, such as chemotherapy, surgery, or radiation therapy.

Before treatment begins, talk with your child’s doctor about the goals of each treatment in the treatment plan. You should also talk about the possible side effects of the specific treatment plan and palliative care options.

During treatment, your health care team may ask you to answer questions about your/your child’s symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future.

Learn more about the importance of tracking side effects in another part of this guide. Learn more about palliative care in a separate section of this website.

Metastatic salivary gland cancer (updated 04/2021)

If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. 

Not all salivary gland cancers behave in the same way, and for some very slow-growing cancers, your doctor may recommend observation. Clinical trials might also be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

Your treatment plan may include 1 or more of the treatments listed above, depending on the subtype of the salivary gland cancer, the extent of the disease, and your symptoms. Typically, the main treatment is standard chemotherapy or targeted therapy, especially if a specific tumor marker such as HER2 or NTRK is found in your tumor (see above). Some of treatment options may be available by taking part in a clinical trial. Your doctor may also recommend further testing to determine the specific characteristics of your cancer. If certain tumor alterations are found, targeted therapy or another type of systemic therapy called immunotherapy (see Latest Research) may be options. Palliative care will also be important to help relieve symptoms and side effects.

For most people, a diagnosis of metastatic cancer is very stressful and difficult. You and your family are encouraged to talk about how you feel with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other people with cancer, including through a support group.

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about the treatment options. Often the treatment plan will include the treatments described above, such as surgery, radiation therapy, or chemotherapy, but they may be used in a different combination or given at a different pace. Your doctor may suggest clinical trials that are studying new ways to treat this type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with recurrent cancer often experience emotions such as disbelief or fear. You are encouraged to talk with the health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.

If treatment does not work

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and for many people, advanced cancer may be difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.

People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - About Clinical Trials

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. Use the menu to see other pages.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for people with salivary gland cancer. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. Every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested in clinical trials.

Clinical trials are used for all types and stages of salivary gland cancer. Many focus on new treatments to learn if a new treatment is safe, effective, and possibly better than the existing treatments. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment.

People who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there are some risks with a clinical trial, including possible side effects and the chance that the new treatment may not work. People are encouraged to talk with their health care team about the pros and cons of joining a specific study.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects.

Deciding to join a clinical trial

People decide to participate in clinical trials for many reasons. For some people, a clinical trial is the best treatment option available. Because standard treatments are not perfect, people are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other people volunteer for clinical trials because they know that these studies are a way to contribute to the progress in treating salivary gland cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future people with salivary gland cancer.

Insurance coverage and the costs of clinical trials differ by location and by study. In some programs, some of the person's expenses from participating in the clinical trial are reimbursed. In others, they are not. It is important to talk with the research team and your insurance company first to learn if and how your treatment in a clinical trial will be covered. Learn more about health insurance coverage of clinical trials.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” When used, placebos are usually combined with standard treatment in most cancer clinical trials. Study participants will always be told when a placebo is used in a study. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, people must participate in a process known as informed consent. During informed consent, the doctor should:

  • Describe all of the treatment options so that the person understands how the new treatment differs from the standard treatment.

  • List all of the risks of the new treatment, which may or may not be different than the risks of standard treatment.

  • Explain what will be required of each person in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

Clinical trials also have certain rules called “eligibility criteria” that help structure the research and keep people safe. You and the research team will carefully review these criteria together.

People who participate in a clinical trial may stop participating at any time for personal or medical reasons. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that people participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if they choose to leave the clinical trial before it ends.

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for salivary gland cancer, learn more in the Latest Research section.

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

PRE-ACT, Preparatory Education About Clinical Trials

In addition, you can find a free video-based educational program about cancer clinical trials in another section of this website.

The next section in this guide is Latest Research. It explains areas of scientific research for salivary gland cancer. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Latest Research

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will read about the scientific research being done to learn more about this type of cancer and how to treat it. Use the menu to see other pages.

Doctors are working to learn more about salivary gland cancer, ways to prevent it, how to best treat it, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for people through clinical trials. Always talk with your doctor about the best diagnostic and treatment options for you.

  • Combining treatments. There is ongoing research looking at the benefit of different treatment approaches, especially the use of concomitant treatment, which combines more than one treatment.

  • Immunotherapy. Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the cancer. It uses materials either made by the body or in a laboratory to improve, target, or restore immune system function. Learn more about immunotherapy.

  • Virus research. Researchers are studying the role of a common virus called cytomegalovirus in the development of salivary gland cancer and how that link could be used to find new treatments.

  • Tumor genetics. Early laboratory research indicates that genetic changes in a salivary gland tumor, particularly those related to the tumor suppressor genes APC and PTEN, may be new targets for treatments. More needs to be understood about the tumor genetics of salivary gland cancer. As scientists make advances in the basic fundamental knowledge of genetics and how these cancers develop, new treatment options based on these findings will develop. Learn more about targeted therapy.

  • Radiosensitizers. Researchers are investigating the use of radiosensitizers in the treatment of salivary gland cancer. Radiosensitizers are drugs that make tumor cells more sensitive to radiation therapy, which then makes radiation therapy more effective.

  • Palliative care/supportive care. Clinical trials are underway to find better ways to reduce or treat the side effects of cancer therapy to improve quality of life for patients.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding salivary gland cancer, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Treatment. It offers some guidance in how to cope with the physical, emotional, social, and financial changes that cancer and its treatment can bring. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Coping with Treatment

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will learn more about coping with the physical, emotional, social, and financial effects of cancer and its treatment. Use the menu to see other pages.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people do not experience the same side effects even when they are given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.

As you prepare to start cancer treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. Doctors call this part of cancer treatment “palliative care” or "supportive care." It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for salivary gland cancer are listed in the in the Types of Treatment section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Talk with your health care team regularly about how you are feeling. It is important to let them know about any new side effects or changes in existing side effects. If they know how you are feeling, they can find ways to relieve or manage your side effects to help you feel more comfortable and potentially keep any side effects from worsening.

You may find it helpful to keep track of your side effects so it is easier to explain any changes with your health care team. Learn more about why tracking side effects is helpful.

Sometimes, physical side effects can last after treatment ends. Doctors call these long-term side effects. They call side effects that occur months or years after treatment late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Coping with emotional and social effects

You can have emotional and social effects after a cancer diagnosis. This may include dealing with difficult emotions, such as sadness, anxiety, or anger, or managing your stress level. Sometimes, people find it difficult to express how they feel to their loved ones. Some have found that talking to an oncology social worker, counselor, or member of the clergy can help them develop more effective ways of coping and talking about cancer.

You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Coping with the costs of cancer care

Cancer treatment can be expensive. It is often a big source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost of medical care stops them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. People with cancer and their families are encouraged to talk about financial concerns with a member of their health care team. Learn more about managing financial considerations, in a separate part of this website.

Caring for a loved one with cancer

Family members and friends often play an important role in taking care of a person with salivary gland cancer. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the person with cancer, even if they live far away.

Caregivers may have a range of responsibilities on a daily or as-needed basis, including:

  • Providing support and encouragement

  • Talking with the health care team

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to and from appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

Learn more about caregiving.

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they likely to happen?

  • What can we do to prevent or relieve them?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you do not think the side effects are serious. This discussion should include physical, emotional, social, and financial effects of cancer.

Also, ask how much care you may need at home and with daily tasks during and after treatment. This can help you make a caregiving plan. Create a caregiving plan with this 1-page fact sheet that includes an action plan to help make caregiving a team effort. This free fact sheet is available as a PDF, so it is easy to print.

Looking for More on How to Track Side Effects?

Cancer.Net offers several resources to help you keep track of your symptoms and side effects. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Fact Sheets: Read 1-page fact sheets on anxiety and depression, constipation, diarrhea, and rash that provide a tracking sheet to record the timing and severity of the side effect. These free fact sheets are available as a PDF, so they are easy to print, fill out, and give to your health care team.

The next section in this guide is Follow-up Care. It explains the importance of checkups after cancer treatment is finished. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Follow-Up Care

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will read about your medical care after cancer treatment is completed, and why this follow-up care is important. Use the menu to see other pages.

Care for people diagnosed with salivary gland cancer does not end when active treatment has finished. Your health care team will continue to check that the cancer has not come back, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. Diagnostic examinations, including CT scans, MRIs, and/or PET-CT scans, may be done to watch for potential recurrences or to monitor how well treatment is working starting 3 months after you finish treatment.

Follow-up imaging should be done every 6 to 12 months for the first 2 years after treatment. Most recurrences happen within the first 2 or 3 years after salivary gland cancer is diagnosed, so follow-up visits will be more frequent during that time. Between 3 and 5 years after treatment, your doctor will determine what follow-up imaging may be needed based on your symptoms and physical examinations. After 5 years post-treatment, you should continue seeing your doctor each year for a follow-up visit and certain people, including those diagnosed with higher risk disease, will get yearly chest CT scans.

Cancer rehabilitation may be recommended, and this could mean any of a wide range of services, such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent and productive as possible. Learn more about cancer rehabilitation.

Learn more about the importance of follow-up care.

This information is based on the ISOO/MASCC/ASCO guideline, “Management of Salivary Gland Malignancy.” Please note that this link takes you to another ASCO website.

Watching for recurrence

One goal of follow-up care is to check for a recurrence, which means that the cancer has come back. Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms.

People with a history of salivary gland cancer need to be monitored throughout their lifetime for the possibility of recurrence or distant metastasis.

During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer first diagnosed and the types of treatment given.

The anticipation before having a follow-up test or waiting for test results can add stress to you or a family member. This is sometimes called “scan-xiety.” Learn more about how to cope with this type of stress.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. Other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may have certain physical examinations, scans, or blood tests to help find and manage them.

For people who had radiation therapy, regular ear examinations are necessary to remove dried earwax buildup. Prevention of dental cavities is also important. Fluoride application is recommended whenever radiation therapy is directed at the oral cavity (mouth) and the salivary glands.

Rehabilitation may be a major part of follow-up care after head-and-neck cancer treatment. People may need physical therapy and speech therapy to regain skills, such as talking and swallowing. Palliative care to manage symptoms and maintain nutrition during and after treatment may be recommended. Some people may need to learn new ways to eat or to have foods prepared differently. if there is nerve function loss, special care of the eye is necessary. Procedures such as moving a paralyzed vocal cord to improve voice may be necessary after a large skull-base tumor has been removed. If radiation therapy has been part of your treatment plan, avoid exposing the affected skin to direct sunlight.

After treatment for salivary gland cancer, people may look different, feel tired, and be unable to talk or eat the way they used to. Many people experience depression. The health care team can help people cope and connect them with support services.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to discuss any concerns you have about your future physical or emotional health. ASCO offers forms to keep track of the cancer treatment you received and develop a survivorship care plan when treatment is completed.

This is also a good time to talk with your doctor about who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with them and with all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Survivorship

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ON THIS PAGE: You will read about how to with challenges in everyday life after a cancer diagnosis. Use the menu to see other pages.

What is survivorship?

The word “survivorship” means different things to different people. Common definitions include

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and continues during treatment and through the rest of a person's life.

Survivorship is one of the most complicated parts of having cancer. This is because it is different for everyone. Some people continue to receive cancer treatment for a long time to reduce the risk of recurrence or to manage the cancer as a chronic disease. Learn more about living with chronic cancer.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain about coping with everyday life.

Survivors may feel some stress when their frequent visits to the health care team end after completing treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true when new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexual health and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing

  • Thinking through solutions

  • Asking for and allowing the support of others

  • Feeling comfortable with the course of action you choose

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the place where you received treatment.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make positive lifestyle changes.

People recovering from salivary gland cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

It is important to have recommended medical checkups and tests to take care of your health.

Talk with your health care team to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: Get this 44-page booklet (available as a PDF) that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The free booklet is available as a PDF, so it is easy to print.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes after finishing treatment.

  • Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including those in different age groups.

The next section offers Questions to Ask the Health Care Team to help start conversations with your cancer care team. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Questions to Ask the Health Care Team

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will find some questions to ask your doctor or other members of the health care team, to help you better understand your diagnosis, treatment plan, and overall care. Use the menu to see other pages.

Talking often with the health care team is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment. It may also be helpful to ask a family member or friend to come with you to appointments to help take notes.

Questions to ask after getting a diagnosis

  • What type of salivary gland cancer do I have? What does this mean?

  • Where is the cancer located?

  • Can you explain my pathology report (laboratory test results) to me?

  • What stage is the cancer? What does this mean?

  • What is the grade of the cancer? How likely is it to grow and spread?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options?

  • What clinical trials are available for me? Where are they located, and how do I find out more about them?

  • What treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • Should I get a second opinion?

  • What are the possible side effects of each treatment, both in the short term and the long term?

  • Who will be part of my health care team, and what does each member do?

  • When should I talk with a dentist? Can you recommend an oncologic dentist?

  • Should I talk with other specialists, such as a speech pathologist, before treatment begins?

  • Who will be leading my overall treatment?

  • How will this treatment affect my daily life? Will I be able to work, exercise, or perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?

  • If I’m worried about managing the costs of cancer care, who can help me?

  • What support services are available to me? To my family?

  • If I have questions or problems, who should I call?

Questions to ask about having surgery

  • Can the tumor be completely removed with surgery?

  • What type of surgery will I have? Will lymph nodes need to be removed?

  • If lymph nodes will be removed, what type of neck dissection will be done? What does this mean?

  • Will it be necessary to remove part or all of the facial nerve? If so, can this nerve be reconstructed or can some of the function be recovered?

  • Will it be necessary to have reconstructive surgery to replace lost tissue?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term effects of having this surgery?

  • Do you recommend additional treatment, such as radiation therapy?

Questions to ask about having radiation therapy or therapies using medication

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • Will I receive this treatment at a hospital or clinic? Or will I take it at home?

  • What side effects can I expect during treatment?

  • Who should I contact about any side effects I experience? And how soon?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

Questions to ask about planning follow-up care

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will those tests be needed?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources. It offers more resources on this website that may be helpful to you. Use the menu to choose a different section to read in this guide.

Salivary Gland Cancer - Additional Resources

Approved by the Cancer.Net Editorial Board, 05/2020

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Salivary Gland Cancer. Use the menu to go back and see other pages.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer, for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Here are a few links to help you explore other parts of Cancer.Net:

This is the end of the Cancer.Net’s Guide to Salivary Gland Cancer. Use the menu to select another section to continue reading this guide.