Cancer begins when cells in the body become abnormal and multiply without control or order. These cells form a mass of tissue, called a tumor. A tumor can be benign or malignant. A benign tumor is not cancerous and usually can be removed without growing back. A malignant tumor is cancerous and can invade and damage the body’s healthy tissue and organs.

Cancer of the salivary gland is a malignant tumor of the tissues that produce saliva. Saliva is the fluid that is released into the mouth to keep it moist and contains enzymes that begin breaking down food. Saliva also helps prevent infections of the mouth and throat. There are clusters of salivary glands below the tongue, on the sides of the face (in the cheek area) just in front of the ears, in the area of the upper jaw along the inside of the teeth and the soft palate, as well as under the jawbone. There are also smaller clusters of salivary glands in parts of the upper digestive tract mucosa (tissue lining) and the windpipe.

Most cancerous tumors of this type begin in the largest of the salivary glands, the parotid gland, found on either side of the face in front of the ears, and in the submandibular glands, found under the jawbone. Salivary gland cancer can also begin in the sublingual glands or the minor salivary glands.

Most tumors (80%) in the parotid gland and about half of the tumors in the submandibular gland are benign (noncancerous). Sublingual gland tumors are almost always malignant (cancerous).

There are lymph nodes (tiny, bean-shaped organs that fight infection) located inside and surrounding the parotid gland and next to the submandibular gland that can contain cancer cells that have metastasized (spread) from skin cancer or melanoma. For more information about cancer that started in another part of the body and spread to the salivary glands, please see Cancer.Net’s guide for that type of cancer.

Salivary gland cancer is one of the five main types of cancer in the head and neck region, a grouping called head and neck cancer.

Statistics

Salivary gland cancer is rare in the United States. An estimated two adults out of 100,000 will be diagnosed with salivary gland cancer this year. Two out of every three salivary gland cancers are found in people 55 and older, with an average age of 64. Survival rates for people with this type of tumor vary depending on the type and the stage (extent) of the cancer. The five-year survival rate (percentage of people who survive at least five years after the cancer is detected, excluding those who die from other diseases) of people with cancer that has not spread at the time of diagnosis  is 96%. If the cancer has spread to the surrounding lymph nodes (local spread) the five-year relative survival rate is 73%. If the cancer has spread to parts of the body far away from the salivary gland (distant spread) the five-year relative survival rate is 37%.

Cancer survival statistics should be interpreted with caution. These estimates are based on data from thousands of cases of this type of cancer in the United States each year, but the actual risk for a particular individual may differ. It is not possible to tell a person how long he or she will live with salivary gland cancer. Because the survival statistics are measured in five-year intervals, they may not represent advances made in the treatment or diagnosis of this cancer.

Source: American Cancer Society

Find out more about basic cancer terms used in this section.

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A risk factor is anything that increases a person’s chance of developing cancer. There are risk factors that can be controlled, such as smoking, and risk factors that cannot be controlled, such as age and family history. Although risk factors can 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. However, knowing your risk factors and communicating them to your doctor may help you make more informed lifestyle and health-care choices.

The main risk factors for salivary gland cancer are unknown, but may include:

Radiation exposure. Radiation to the head or neck for other medical reasons may increase the risk of salivary gland cancer.

Radioactive substance exposure.In some reports, exposure to certain radioactive substances has been linked to an increased risk may increase the risk of salivary gland cancer; in other reports, there is not 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.

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.

There is no known way to prevent salivary gland cancer.

People with salivary gland cancer may experience the following symptoms. Sometimes, people with salivary gland cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom on this list, please talk with your doctor.

• Lump on face, neck, or mouth (usually painless)
  
  
• Numbness in the face
  
  
• Inability to move some facial muscles, especially if the face muscle on one side of the face stops moving and the area affected slowly expands (progressive facial muscle paralysis)
  
  
• Pain or swelling in the face, chin, around the jawbone, or neck
  
  
• Difference between the size and/or shape of the left and right sides of the face or neck

People who notice any of these warning signs should consult a doctor and/or dentist right away. When detected early, cancers of the head and neck have a much better chance of cure.

Because many of these symptoms can be caused by other, noncancerous health conditions as well, it is always important to receive regular health and dental screenings. This is particularly important for those people who routinely drink alcohol or use tobacco products or have used them in the past.

In fact, people who use alcohol and tobacco should receive a general screening examination at least once a year. This is a simple, quick procedure in which the doctor looks in the nose, mouth, and throat for abnormalities and feels for lumps in the neck. If anything unusual is found, the doctor will recommend a more extensive examination using one or more of the diagnostic procedures mentioned under Diagnosis.

Doctors use many tests to diagnose cancer and determine if it has metastasized. Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. For a salivary gland tumor, a fine needle aspiration biopsy (see below) is the preferred method of examination in making a diagnosis. A surgical (incisional) biopsy should be avoided in almost every case (with rare exceptions). Imaging tests may be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:

• Age and medical condition
• The type of cancer suspected
• Severity of symptoms
• Results of previous tests

A medical history and physical examination should be done carefully, and the doctor will ask about potential risk factors. A thorough examination of the skin by a doctor is particularly important if the patient has 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 (voicebox) will also be done.

In addition to a physical examination, the following tests may be used to diagnose salivary gland cancer:

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. The sample removed from the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease).

Fine needle aspiration (cytology). In this type of biopsy, cells are withdrawn using a thin needle inserted directly into the tumor. The cells are examined under a microscope for signs of cancer, and should be examined by a cytologist with expertise in salivary gland cancer.

Endoscopy. This test allows the doctor to see inside the body. A thin, flexible tube with an attached light and view lens is inserted through the mouth or nose to examine the head and neck areas. 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). It is performed using an anesthetic spray to numb the area or general anesthesia to make the person more comfortable.

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail.

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. A contrast medium may be injected into a patient’s vein to create a clearer picture.

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

Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive substance is injected into a patient’s body and absorbed by the organs or tissues being studied. This substance gives off energy that is detected by a scanner, which produces the images.

Panorex. This is a rotating, or panoramic, x-ray of the upper and lower jawbones to detect cancer, or to evaluate teeth before cancer treatment.

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

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: Newly Diagnosed.

To learn more about what to expect during common diagnostic tests, read Cancer.Net: Tests and Procedures.

Staging is a way of describing cancer, such as where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine 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 patient’s prognosis (chance of recovery). There are different stage descriptions for different types of cancer.

One tool that doctors use to describe the stage is the TNM system. This system uses three criteria to judge the stage of the cancer: the tumor itself, the lymph nodes around the tumor, and if the tumor has spread to other parts of the body. The results are combined to determine the stage of cancer for each person. There are five stages: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

TNM is an abbreviation for tumor (T), node (N), and metastasis (M). Doctors look at these three factors to determine the stage of cancer: 

• How large is the primary tumor and where is it located? (Tumor, T)
  
  
• Has the tumor spread to the lymph nodes? (Node, N)
  
  
• Has the cancer metastasized to other parts of the body? (Metastasis, M)

Tumor. 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. Some stages are also 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: No evidence of a tumor is found.

T1: Describes a small, noninvasive (has not spread) tumor that is 2 centimeters (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, that 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 invades the skin, jawbone, ear canal, and/or facial nerve.

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

Node. The “N” in the TNM staging system is for lymph nodes, the tiny, bean-shaped organs that help fight infection. 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 assessment of lymph nodes is an important part of staging cancer of the major salivary glands.

NX: Indicates the regional lymph nodes cannot be evaluated.

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

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

N2: Describes any of these conditions:

N3: Cancer found in lymph nodes is larger than 6 cm.

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

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.

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

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

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Stage IVA: Describes 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 one-sided nodal involvement (N1), but no metastasis (M0), or any tumor (T) with extensive nodal involvement (N2).

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

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Stage IVC: Describes any cancer with distant metastasis (M1).

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Recurrent: Recurrent cancer is cancer that comes back after treatment.

Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Sixth Edition (2002) published by Springer-Verlag New York, www.springer-ny.com.

Histologic classification of salivary gland tumors

In addition to the stage of the cancer, doctors will classify the subtype of salivary gland tumor using a histologic evaluation (how cells look under a microscope). There are many subtypes of salivary gland cancer, and your doctor can provide more information regarding your specific diagnosis:

Benign tumor subtypes

Pleomorphic adenoma (benign mixed tumor)
Papillary cystadenoma-lymphomatosum (Warthin’s tumor)
Oncocytoma
Monomorphic adenoma

Malignant tumor subtypes

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

The treatment of salivary gland cancer depends on the size and location of the tumor, whether the cancer has spread, and the person’s overall health. In many cases, a team of doctors will work with the patient to determine the best treatment plan.

This section outlines treatments that are the standard of care (the best treatments available) for this specific type of cancer. Patients are also encouraged to consider clinical trials when making treatment plan decisions. A clinical trial is a research study to test a new treatment to prove it is safe, effective, and possibly better than standard treatment. Your doctor can help you review all treatment options. For more information, visit the clinical trials section.

Cancer of the salivary gland 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.

Head and neck cancer specialists often form a multidisciplinary team to care for each person, and an evaluation should be done before any treatment begins. The team may include medical, surgical, and radiation oncologists; otolaryngologists (ear, nose, and throat doctors); maxillofacial prosthodontists (specialists who perform restorative surgery in the head and neck areas); dentists; physical therapists; speech pathologists; psychiatrists; nurses; dietitians; and social workers.

Surgery

During surgery, a doctor performs an operation to remove the cancerous tumor and some of the healthy tissue around it (called a margin). The goal of surgery is to remove as much of the tumor as possible and leave negative margins (no trace of cancer in the healthy tissue). Surgery is performed in nearly all cases of salivary gland cancer.

Depending on the location, stage, and the subtype of the cancer, some people may need more than one operation to remove the cancer and to help restore the appearance and function of the tissues affected. Reconstructive (plastic) surgery may be used to replace normal tissues and nerves that have to be removed to eliminate the cancer. Surgery is followed by additional treatment, most often radiation therapy.

Sometimes, it is not possible to completely remove the cancer during surgery. Surgery is often risky because the cancer may be close to the eyes, mouth, brain, and important nerves and blood vessels in the area.

The type of surgery depends on the extent of the tumor:  

Parotidectomy. The removal of the parotid gland is called a parotidectomy. This surgery may involve the facial nerve. If cancer has spread to the facial nerve, frequently a nerve graft is necessary for the person to regain use of some facial muscles. Any tissue that is removed can often be restored by reconstructive surgery and tissue transplantation. 

Endoscopic surgery. Occasionally, it is possible to remove the tumor by endoscopic surgery, which is less destructive to normal tissues than conventional 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, this procedure may find a tumor during a seemingly routine endoscopic surgery for what is believed to be chronic sinusitis.

Neck dissection. A neck dissection (lymph nodes in the neck are removed) may be performed if the doctor suspects that the cancer has spread. 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.

Surgical side effects can include swelling of the face, mouth, and throat, making it difficult to breathe and swallow. Frequently, a person may receive a temporary tracheostomy (hole in the windpipe) to make breathing easier.
 
Facial nerves may also be affected, either temporarily or permanently. Facial disfigurement may need to be addressed using reconstructive plastic surgery. If the maxilla (upper jaw) is removed, prosthodontists play a large role in the rehabilitation process.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. When radiation is given using implants, it is called internal radiation therapy or brachytherapy. Internal radiation therapy involves tiny pellets or rods containing radioactive materials that are surgically implanted in or near the cancer site. The implant is left in place for several days while the person stays in the hospital.

A new method of external radiation therapy, known as intensity modulated radiation therapy (IMRT), allows for more effective doses of radiation therapy to be delivered while reducing the damage to nearby healthy cells and causing fewer side effects.

Radiation treatment can be the main treatment for certain type of tumor or if a person cannot have surgery or decides not to have surgery. It is most often used in combination with surgery, given either before or after the operation. It may also be given along with chemotherapy. Proton radiation therapy may be used in instances where a tumor is located close to structures of the central nervous system (brain and spinal cord).

Before beginning radiation treatment for salivary gland cancer, a person should receive a thorough examination from an oncologic dentist (a dentist experienced in treating people with head and neck cancer). Since radiation therapy can cause tooth decay, damaged teeth may need to be removed. Often, tooth decay can be prevented with proper treatment from a dentist before beginning treatment.

Radiation therapy to the head and neck may cause the following side effects:

• Redness or skin irritation to the treated area
  
  
• Dry mouth (xerostomia) or thickened saliva, from damage to salivary glands
  
  
• Bone pain
  
  
• Nausea
  
  
• Fatigue
  
  
• Mouth sores and/or sore throat
  
  
• Dental problems (usually preventable)
  
  
• Painful 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
  
  
• Buildup of earwax, which 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.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. It is seldom used in the initial treatment of salivary gland cancer. Combined treatments of chemotherapy with radiation therapy are used as part of clinical trials to research the effectiveness of the combination. For salivary gland cancer, chemotherapy is most often used in advanced cancer or to treat symptoms. Some chemotherapy drugs are available in clinical trials that may treat cancer at an earlier stage, or hope to cure the cancer.

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 if any may be permanent. In general, chemotherapy may cause the following side effects:

• Fatigue
  
  
• Nausea
  
  
• Vomiting
  
  
• Hair loss
  
  
• Dry mouth
  
  
• Loss of appetite, often due to a change in sense of taste
  
  
• Weakened immune system
  
  
• Diarrhea and/or constipation
  
  
• Open sores in the mouth; this condition coupled with a low immunity can lead to infections

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. Learn more about your prescriptions through Cancer.Net’s Drug Information Resources, which provides links to searchable drug databases.

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: During Treatment.

Doctors and scientists are always looking for better ways to treat patients with salivary gland cancer. A clinical trial is a way to test a new treatment to prove that it is safe, effective, and possibly better than a standard treatment. Patients who participate in clinical trials are among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that finding new drugs and other therapies is the only way to make progress in treating salivary gland cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with salivary gland cancer.

To join a clinical trial, patients must complete a learning process known as informed consent. During informed consent, the doctor should list all of the patient’s options, so the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different than the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment. Learn more about clinical trials , including patient safety, phases of a clinical trial, deciding to participate in a clinical trial, questions to ask the research team, and links to find cancer clinical trials.

Cancer and its treatment can cause a variety of side effects. However, doctors have made major strides in recent years in reducing pain, nausea and vomiting, and other physical side effects of cancer treatments. Many treatments used today are less intensive but as effective as treatments used in the past. Doctors also have many ways to provide relief to patients when such side effects do occur.

Fear of treatment side effects is common after a diagnosis of cancer, but it may be helpful to know that preventing and controlling side effects is a major focus of your health-care team. Before treatment begins, talk with your doctor about possible side effects of the specific treatments you will be receiving. The specific side effects that can occur depend on a variety of factors, including the type of cancer, its location, the individual treatment plan (including the length and dosage of treatment), and the person’s overall health.

Ask your doctor which side effects are most likely to happen (and which are not), when side effects are likely to occur, and how they will be addressed by the health-care team if they do happen. Also, be sure to communicate with the doctor about side effects you experience during and after treatment. For more information on the most common side effects of cancer and different treatments, along with ways to prevent or control them, visit Cancer.Net’s section on Managing Side Effects, based on ASCO’s curriculum.

After treatment for salivary gland cancer ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years.

Most recurrences happen in the first two or three years after diagnosis, so follow-up visits will be more frequent in the first two years. Diagnostic examinations, including CT scans, may be done to watch for any recurrences or to monitor how treatment is working. People with a history of salivary gland cancer need to be monitored throughout their lifetime for the possibility of recurrence or distant metastasis.

Follow-up visits will also help manage any late or long-term side effects from cancer treatment, such as buildup of earwax. Periodic ear examinations are necessary to remove buildup of dried earwax. Prevention of dental cavities is also important. Fluoride application is recommended whenever the oral cavity and the salivary glands receive radiation treatment.

Rehabilitation is a major part of follow-up care after head and neck cancer treatment. People may receive physical therapy and speech therapy to regain skills, such as talking and swallowing. Supportive 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 eat foods prepared differently.

Rehabilitation of functions in the head and neck is often necessary following treatment. For example, special care of the eye is necessary if there is nerve function loss. Rehabilitation of swallowing is often needed, and special procedures (moving a paralyzed vocal cord to improve voice, for example) may be necessary after removal of a large skull base tumor. Exposure to direct sunlight is to be avoided if radiation therapy has been used as part of the treatment.

Fatigue and other symptoms that are due to treatment can be helped by special rehabilitative efforts.

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.

People recovering from salivary gland cancer are encouraged to follow established guidelines for good health, such as maintaining a healthy weight, not smoking, eating a balanced diet, and having recommended cancer screening tests. Talk with your doctor to develop a plan that is best for your needs. Moderate physical activity can help rebuild your strength and energy level. Your doctor can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about Healthy Living After Cancer.

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: After Treatment.

Research for salivary gland cancer is ongoing. The following advances may still be under investigation in clinical trials and may not be approved or available at this current time. Always discuss all diagnostic and treatment options with your doctor.

Combining therapies. There is ongoing research as to the benefit of the different treatment approaches, especially the use of concomitant treatment (combining more than one treatment).

Biologic therapy.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 bolster, target, or restore immune system function. It is always important to discuss treatment options and possible enrollment in clinical trials with your doctor.

Salivary gland cancer requires additional scientific understanding regarding the genetic events that affect this type of cancer. As scientists make advances in the basic fundamental knowledge of genetics and how these cancers develop, new therapies based upon these findings will develop.

Regular communication with your doctor is important in making informed decisions about your health care. Consider asking the following questions of your doctor:

• What type of salivary gland cancer do I have? What does this mean?
  
  
• Where exactly is it located?
  
  
• Can you explain my pathology report (laboratory test results) to me?
  
  
• What stage is the cancer? What does this mean?
  
  
• What are my treatment options?
  
  
• What clinical trials are open to me?
  
  
• What treatment do you recommend? Why?
  
  
• Should I get a second opinion?
  
  
• Can the tumor be completely removed by surgery? Do you recommend additional treatment (such as radiation therapy)?
  
  
• What are the possible side effects of each treatment, both in the short term and the long term?
  
  
• How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?
  
  
• Will it be necessary to remove part or all of the facial nerve? If so, can this nerve be reconstructed or some of the function be recovered?
  
  
• If surgery is needed, will it be necessary to have reconstruction to replace lost tissue (mandible)?
  
  
• If surgery is needed, will there be a need for a neck dissection (removing lymph nodes)? If so, what type of dissection will be done? What does this mean?
  
  
• What is the likely behavior of this tumor? Can it recur?
  
  
• When should I get a dental consultation? Can you recommend an oncologic dentist?
  
  
• Who else will be part of my health-care team, and what is each person’s role?
  
  
• What follow-up tests will I need, and how often will I need them?
  
  
• What support services are available to me? To my family?

Support for People with Oral, Head, and Neck Cancer, Inc.
P.O. Box 53
Locust Valley, NY 11560-0053
Toll Free: 800-377-0928
www.spohnc.org

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