Salivary Gland Cancer

Overview

What is salivary gland cancer?

“Salivary gland cancer” is a term used to describe malignant tumors that affect your salivary glands. Your salivary glands are located in your mouth and throat. They produce saliva — or spit — that helps your digestive system begin breaking down food.

Salivary gland tumors may be benign (noncancerous) or malignant (cancerous). Both types may affect any of your salivary glands.

How common is salivary gland cancer?

Salivary cancer is rare. Only 1% of tumors affecting the head and neck are salivary cancer. The most common types of salivary gland cancer are mucoepidermoid carcinoma and adenoid cystic carcinoma. Together, they make up half of all malignant salivary gland tumors.

Who is likely to have salivary gland cancer?

Anyone can develop salivary gland cancer, but men and people assigned male at birth are more likely to have malignant salivary gland tumors. You’re also more likely to develop cancer in a salivary gland if you:

  • Are 55 or older.
  • Smoke or use alcohol frequently.
  • Have received radiation therapy to your head or neck.
  • Work in certain occupations, including plumbing, rubber products manufacturing, asbestos mining and leatherwork.

Studies have shown that some rare types of salivary gland cancer may occur more commonly in people with certain viral infections, like Epstein-Barr virus and human papillomavirus (HPV). Still, these infections don’t cause salivary gland cancer. More research is needed to understand the connection.

Symptoms and Causes

What causes salivary gland cancer?

The exact cause of most salivary gland cancers is unknown. Salivary gland tumors can occur in any salivary gland located in or near your mouth. Most commonly, tumors occur in the three major salivary glands. These include your:

  • Parotid glands (inside each cheek).
  • Submandibular glands (below your jawbone).
  • Sublingual glands (along the floor of your mouth).

Most salivary gland tumors — both malignant and benign — start in your parotid glands.

Salivary gland cancer also occurs within the microscopic minor salivary glands. These glands are within the roof or floor of your mouth, the lining of your tongue and lips, and the inside of your cheeks, sinuses, nose and voice box. Tumors rarely form in minor salivary glands, but most that do are malignant.

Left untreated, pieces of these tumors can break away and spread to other parts of your body through your bloodstream or lymphatic system (metastasize). Cancer that’s metastasized is more challenging to treat than cancer that stays in your salivary gland. Salivary gland cancers can metastasize to your lungs, bone and liver.

What are the symptoms of salivary gland cancer?

A small number of people with salivary gland cancer don’t have symptoms. In most cases, salivary gland cancer causes a painless lump on a salivary gland.

If you have a malignant salivary gland tumor, you’re more likely to experience other symptoms, including:

  • Weakness or numbness in your face, neck, jaw or mouth.
  • Persistent pain in your face, neck, jaw or mouth.
  • Difficulty opening your mouth fully or moving your facial muscles.
  • Trouble swallowing.
  • Bleeding from your mouth.

Diagnosis and Tests

How is salivary gland cancer diagnosed?

Your healthcare provider diagnoses salivary gland cancer with a physical examination and a review of your medical and personal history. They’ll check for lumps in your salivary glands and see how your facial nerves respond to stimulation. They’ll ask about your symptoms and previous cancer diagnoses.

Your provider may order additional tests to confirm the presence of a tumor or cancer cells. These tests may include:

  • CT scan: A CT scan uses X-rays to provide images of masses within salivary glands. It can provide information on a tumor’s size and show if the cancer’s spread to other parts of your body, like your lungs or bone tissue.
  • Magnetic resonance imaging (MRI): An MRI uses magnets and radio waves to create pictures of internal body structures. Like a CT scan, an MRI scan can provide information on a tumor’s size. An MRI is especially good at showing if cancer’s spread to soft tissue, like muscles, blood vessels and nerves.
  • Positron emission tomography (PET) scan: A PET scan uses small amounts of radioactive materials to see if cancer has spread to your lymph nodes or elsewhere in your body. You may receive a PET scan and a CT scan simultaneously (a PET-CT).
  • Biopsy: A biopsy collects a small tissue and fluid sample from a salivary gland tumor. A medical specialist called a pathologist examines the sample in a lab for signs of cancer cells. To collect the sample, your provider may perform a fine-needle aspiration or a core needle biopsy.

A biopsy is the only way to confirm that a salivary gland tumor is cancerous.

How is salivary gland cancer staged?

Your healthcare provider will stage your cancer as part of your diagnosis. Cancer staging provides information about your tumor that can help guide treatment.

The staging system used for tumors that form in your parotid glands, submandibular glands and sublingual glands follows the TLM system:

  • T: Tumor size and location.
  • L: Whether the cancer has spread to your lymph nodes.
  • M: Whether the cancer has metastasized, or spread to organs.

A different system is used to stage cancers that form in minor salivary glands.

Understanding your cancer stage is important to understanding both your treatment options and likely outcomes. Ask your provider to explain your cancer stage and what this means for your diagnosis.

Management and Treatment

How is salivary gland cancer treated?

Surgery is usually the best treatment option for tumors that can be safely removed. If a tumor is growing fast or if it’s spread to other parts of your body, your healthcare provider may recommend additional treatments.

Treatments include:

  • Surgery: Surgery is the primary treatment for malignant salivary gland tumors. In addition to removing the tumor, your provider may remove your lymph nodes (lymphadenectomy) if they suspect the cancer’s spread there. After surgery, you’ll likely receive radiation therapy to kill any remaining cancer cells, so the cancer doesn’t return.
  • Radiation therapy: Radiation therapy uses a machine that directs radiation toward the part of your body with cancer cells, destroying them. Photon-beam and neutron beam radiation therapy are two types of radiation therapy used to treat salivary gland cancer. You may also receive radiation as a part of palliative care. Palliative care provides symptom relief and can improve your quality of life.
  • Chemotherapy: Chemotherapy uses drugs to destroy cancer cells. You may receive chemotherapy if your cancer has spread from your salivary glands to other tissues outside of your head and neck.

Your healthcare provider may recommend that you participate in a clinical trial. A clinical trial is research that studies the safety and effectiveness of new treatments. These treatments include:

  • Immunotherapy: Immunotherapy uses drugs to help your immune system identify cancer cells and fight them. Researchers are studying the role of a specific type of immunotherapy called checkpoint inhibitors in fighting metastasized cancer.
  • Targeted therapy: Targeted therapy uses drugs that target weaknesses in a cancer cell’s genetic code (DNA) to destroy the cancer or stop it from growing. Researchers are studying the effectiveness of targeted therapies in people with adenoid cystic carcinomas that have metastasized.
  • Radiosensitizers: Radiosensitizers are drugs that make cancer cells more sensitive to radiation. Research is ongoing into how radiosensitizers and radiation therapy can help with salivary gland cancer treatment.

Depending on your cancer, you may receive a combination of treatments to remove the cancer and prevent it from growing back (recurring).

What complications are associated with benign salivary gland tumors?

Benign salivary gland tumors may become malignant over time. The symptoms of salivary gland cancers include rapid enlargement of a pre-existing mass in or around your mouth, numbness, weakness and facial pain. These symptoms may interfere with your ability to speak and swallow properly.

Prevention

Can salivary gland cancer be prevented?

There’s no way to prevent salivary gland cancer. You can reduce your overall cancer risk by avoiding certain risk factors, like smoking and drinking too much alcohol.

Outlook / Prognosis

Is salivary gland cancer curable?

Most people recover fully from salivary gland tumor treatment if the cancer is diagnosed and treated early. Your prognosis will depend on factors like:

  • The tumor’s size.
  • Whether the cancer’s spread.
  • Whether the cancer has recurred.
  • Which salivary gland contains the cancer cells.
  • How abnormal the cancer cells appear when viewed with a microscope.
  • Your overall health status.

What is the survival rate of salivary gland cancer?

Cancer survival rates reflect research that tracks how many people with a particular cancer diagnosis are alive over a period of time, usually five years. With salivary gland cancer, survival rates depend on the type of cancer. For example, the survival rate for mucoepidermoid carcinoma ranges from 75% to 90% at five years. The location of the tumor matters, too. If it’s only in your salivary gland, the survival rate is 94%. The survival rate is lower if the cancer’s spread.

It’s important to keep in mind that this data doesn’t consider factors unique to you — like your health, your response to treatment, etc.

Ask your healthcare provider about your likely outcomes based on your unique situation.

Living With

When should I call my doctor?

If you have any symptoms of a salivary gland tumor, especially if your symptoms last for more than two weeks, make an appointment with a healthcare provider.

A note from Cleveland Clinic

Schedule a visit with a healthcare provider if you notice a lump in your mouth or throat that doesn’t disappear within a few weeks. Lumps don’t always mean cancer. For instance, the lump may be a cyst or a benign salivary gland tumor. Only your provider can know for sure. Even if your tumor is malignant, you have a better chance of a positive prognosis if you get diagnosed and treated early.

Last reviewed by a Cleveland Clinic medical professional on 09/13/2022.

References

  • Carlson ER, Schlieve T. Salivary gland malignancies. (https://pubmed.ncbi.nlm.nih.gov/30449524/) Oral Maxillofac Surg Clin North Am. 2019;31(1):125-144. Accessed 9/13/2022.
  • Cohen RB, Delord JP, Doi T, et al. Pembrolizumab for the treatment of advanced salivary gland carcinoma: findings of the phase 1b KEYNOTE-028 study. (https://pubmed.ncbi.nlm.nih.gov/29462123/) Am J Clin Oncol. 2018;41(11):1083-1088. Accessed 9/13/2022.
  • Gatta G, Guzzo M, Locati LD, McGurk M, Prott FJ. Major and minor salivary gland tumours. (https://pubmed.ncbi.nlm.nih.gov/32485526/) Crit Rev Oncol Hematol. 2020;152:102959. Accessed 9/13/2022.
  • Merck Manual Professional Version. Salivary Gland Tumors. (https://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/tumors-of-the-head-and-neck/salivary-gland-tumors) Accessed 9/13/2022.
  • National Cancer Institute. Salivary Gland Cancer Treatment (Adult)(PDQ®) – Health Professional Version. (https://www.cancer.gov/types/head-and-neck/hp/adult/salivary-gland-treatment-pdq) Accessed 9/13/2022.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy