Parotidectomy

A parotidectomy is a procedure in which the doctor removes all or part of the parotid gland. This procedure is tedious and difficult because the facial nerves pass directly through the middle of the parotid glands. These nerves control facial movement on each side of the face. Fortunately, many parotid gland tumors start on the outer part of the gland, which can be removed without excessive manipulation on the nerve fibers, therefore it is generally rare to have lasting facial nerve weakness for these tumors. For tumors that are more extensive, the entire parotid gland may need to be removed. In these cases, it is important to ask the doctor about the process of facial nerve preservation despite the expected surgical manipulation of the nerve fibers. The doctor may be able to remove the gland while preserving the long-term function of the facial nerve.

Submandibular/Sublingual gland surgery

For tumors in the submandibular and sublingual glands, surgery to remove the gland is the primary treatment. Low-grade tumors and benign tumors can often be treated by completely removing the gland. The single branch of the facial nerve which controls the lower lip movement crosses over the submandibular gland and your doctor will take care in preserving the function of this nerve branch. More severe tumors may require that the tumor bed and nearby soft tissues, or even part of the lower jaw bone, also be removed. The surgeon will pay close attention to the facial nerves in these areas, and will preserve them if possible.

Radiation therapy

Radiation therapy uses waves of high energy rays produced by a machine to destroy cancer cells. Radiation therapy is often given after surgery for salivary gland cancer, in order to kill any remaining cancer cells and prevent a local or regional recurrence. Radiation therapy may also be used as the primary treatment for tumors that can't be removed with surgery, or as a palliative treatment in patients with advanced cancer in order to relieve symptoms. Chemotherapy may be combined with radiation therapy in some cases. Patients with head and neck cancer should meet with an oncologic dentist before this treatment, as radiation can cause tooth decay and other side effects when administered to the head and neck region.

Proton beam radiation therapy

Proton therapy is an advanced type of radiation therapy that uses “protons” rather than X-ray “photons” to deliver radiation to the tumor. In conventional radiotherapy, the photon beams can deposit radiation and damage healthy cells as they pass through the body. Proton therapy deposits most of the radiation directly at the tumor site, resulting in less damage to healthy tissue and fewer side-effects.

• Please see Understanding Proton Therapy to learn more.

Chemotherapy

Chemotherapy is the use of drugs to target rapidly growing cells in an effort to destroy cancer cells. Chemotherapy is rarely used to treat salivary gland cancer, but may be combined with radiation in some cases. Chemotherapy may also be given to patients whose cancer has metastasized in order to shrink the tumor and relieve symptoms.

Targeted Therapy

Targeted therapy is a type of cancer treatment that uses medicines to attack specific molecules involved in the growth and survival of cancer cells. These treatments work by blocking certain chemicals or signals within the cancer cells, which can cause the cells to stop growing or die.

In salivary gland cancer, targeted therapy may be an option when the tumor cannot be removed with surgery. It can also be used for advanced cancers that have spread to other parts of the body, or for cancers that return after initial treatment.

Some targeted therapies are effective only in patients whose cancer cells have specific genetic or molecular changes. To determine if targeted therapy may be helpful, your cancer cells can be tested in a lab to look for these changes.

Immunotherapy

Immunotherapy is a type of cancer treatment that uses medicine to help the body's immune system recognize and attack cancer cells. Normally, the immune system defends the body by targeting harmful invaders like bacteria and viruses. However, cancer cells can sometimes avoid detection by hiding from the immune system. Immunotherapy works by helping immune cells find and destroy these hidden cancer cells.

In cases of salivary gland cancer, immunotherapy may be considered when the cancer cannot be removed with surgery. It may also be used for advanced cancers that have spread to other parts of the body or for cancers that have returned after treatment.

Clinical Trials

Clinical trials allow patients to try a new treatment before it is available to the general public. In some cases, this may be a new drug that has not been used in humans before, or it may be a drug or drug combination that is not currently used for that specific type of cancer. Early phase clinical trials are often used to test side effects of a drug or drug combination, while later phase clinical trials are used to see how effective a new treatment might be for a certain type of cancer. Clinical trials allow doctors and researchers to improve the treatment of cancers with possibly more effective therapies. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation.