Diagnosis
If you have any symptoms of salivary gland cancer, your doctor will conduct a physical examination and ask you questions about your general health, lifestyle, and family history. It may be necessary to see a physician who specializes in diseases of the head and neck. These physicians are trained to do specialized examinations of the head and neck and to diagnose cancer. Your doctor will thoroughly examine the mouth, ears, and jaw, and may also check for any signs of facial numbness. The doctor may also examine the lymph nodes in the neck and order blood and urine tests to check for any conditions that may be related to cancer. If your doctor suspects salivary gland cancer, he or she may recommend any of the following diagnostic procedures:
Imaging Tests
Imaging tests produce pictures of the body and allow the doctor to determine if there is a tumor in the salivary glands, as well as the size, location, and extent of tumors in the salivary glands and other parts of the body.
Click Image to Enlarge.
X-Ray
If you have any symptoms of salivary gland cancer, the doctor may recommend a panorex X-ray. A panorex is a panoramic X-ray of your teeth and jawbone commonly used by dentists. Doctors use panoramic X-rays to help find cancer and to evaluate dental health prior to radiation therapy.
Click Image to Enlarge.
Computed Tomography (CT) Scan
If symptoms or examination raise concerns for the presence of cancer, your doctor may order a CT scan. A CT scanner rotates around your body taking pictures, and produces detailed cross-sectional images of your body. It allows doctors to pinpoint the exact location of the tumor and check for cancer spread. The doctor may also recommend a chest CT scan if he believes the cancer has spread to the chest.
Click Image to Enlarge.
Magnetic Resonance Imaging (MRI)
Magnetic resonance imaging (MRI) uses radio waves and a powerful magnet to create clear and detailed images of body parts. Magnetic waves affect the spin of the elements in the cells of the body and that energy is then released in a characteristic pattern, which is translated by a computer to show "slices" of the body. This test is very useful for examining specific areas of the body, especially the soft tissues in the head and neck region.
Click Image to Enlarge.
Positron Emission Tomography (PET) Scan
For a PET scan, the doctor injects a radioactive substance into the patient's bloodstream, typically labeled sugar molecules. The sugars are collected in malignant (cancerous) cells at a much higher amount than in the rest of the patient's body. The doctor then uses a PET scanner to detect these areas of increased sugar uptake and to find the exact locations concerning for cancer in the patient's body.
Biopsy
If any of these diagnostic tests indicate that you might have cancer, your doctor will conduct a biopsy to be certain. A biopsy is a procedure in which the doctor removes a tissue sample and a pathologist examines it under a microscope to determine if it contains cancer cells. A biopsy is the only way to be certain if you have cancer. The doctor may recommend the following types of biopsy:
Click Image to Enlarge.
Fine Needle Aspiration Biopsy
The doctor uses a fine needle connected to a syringe to extract a tissue sample from a tumor or suspicious area. This tissue sample is then examined under a microscope to determine if the tumor is benign or malignant.
Click Image to Enlarge.
Incisional Biopsy
The doctor may recommend an incisional biopsy if a fine needle aspiration (FNA) does not provide a large enough tissue sample for a definitive diagnosis. In this procedure, an incision is made and a scalpel (surgical knife) is used to remove the tumor for examination.
Click Image to Enlarge.
Surgical Biopsy
If the doctor strongly suspects salivary gland cancer, surgery to remove the gland completely may be recommended. This specimen is then sent to a laboratory for examination to confirm the diagnosis.
