Salivary Gland Cancer

Treatment

Some of the treatment options for salivary gland tumors include:

• Surgery: Patients with salivary gland tumors undergo different types of surgeries, depending upon the location and severity of the tumor. Some of the surgeries include:
  Removal of a part of the salivary gland: The oncosurgeons remove a part of the salivary gland in case the tumor is small and is limited to only a particular part of the salivary gland.
  Removal of complete salivary gland: In case the tumor is in the advanced stage and is large enough to affect the entire salivary gland, the patients undergo surgery to remove the complete salivary gland. The parotid, submandibular, sublingual, and minor glands may be removed depending on the type of salivary gland affected. The doctor may also remove facial nerves, bones, or skin if cancer affects these issues.
  Removal of the lymph nodes: The lymph nodes are also removed if the patient is diagnosed with salivary gland cancer and there is an increased risk of cancer spreading to the lymph nodes. The cancer specialist examines the nearby lymph nodes and removes those that are abnormal or have a high cancer risk.
  Supportive surgery: In some patients with salivary gland cancer, cancer spreads to nearby tissues that reduce the ability of the patients to swallow the food. It results in malnutrition. In such cases, a gastrostomy tube is placed into the stomach through the skin and abdominal muscles.
  Reconstructive surgery: The patients may undergo reconstructive surgery after removing the tumor. The bone, skin, or facial nerves may be replaced or repaired during the reconstructive surgery.
• Radiation therapy: Radiation therapy may be conducted after surgery in advanced-stage disease, high-grade histology, and incomplete removal. However, in cases where the complete tumor cannot be removed by surgery, radiation therapy alone may be used. Neutron radiation therapy may have improved outcomes in patients with macroscopic diseases. However, the risks of moderate to severe complications are also higher in neutron radiation therapy.
• Chemotherapy: Surgery and radiation therapy are the mainstays in treating salivary gland tumors. However, chemotherapy may be used in some cases, such as metastatic cancer or recurrent salivary gland cancer. Sometimes, radiation therapy may also be combined with chemotherapy (chemoradiation therapy) to improve outcomes.
• Targeted therapy: Targeted therapy is used in patients who do not respond to chemotherapy or suffer from advanced-stage salivary gland cancer. Targeted therapy targets the proteins and other chemicals essential for the growth of cancer cells, such as HER2 protein, NTRK gene, and androgen receptor. These substances enhance the growth of salivary gland cancer. Targeted therapy targets these substances and inhibits them from expressing themselves.
• Immunotherapy: Salivary gland cancer cells use proteins, also known as checkpoints, to evade the attack of the immune system. Immunotherapy inhibits these checkpoints and makes the cancer cells more vulnerable to getting killed by the immune cells.