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Referral to a specialist

Find out when GPs refer people to see a salivary gland cancer specialist and what happens.

Who should see a specialist

It can be very difficult for GPs to decide who may have a cancer and who may have something much more minor that will go away on its own.

With many symptoms, it is perfectly right that your GP should ask you to wait to see if they get better, or respond to treatment such as antibiotics.

If GPs referred everyone who came to see them to a specialist immediately, the system would get jammed and people needing urgent appointments wouldn't be able to get them.

UK Referral guidelines

The National Institute for Health and Care Excellence (NICE) has produced guidelines for GPs to help them decide which patients need to be seen urgently by a specialist.

These guidelines on referrals for head and neck cancers were revised in June 2015.

While reading these guidelines it is important to remember:

  • salivary gland cancers are rare – around 500 people are diagnosed each year in the UK
  • a number of risk factors affect your chances of developing a salivary gland cancer
  • general symptoms, such as a lump in or around your mouth, jaw or neck are much more likely to be something less serious

Referral guidelines for salivary gland cancer

According to the NICE guidelines, you should ideally get an appointment within 2 weeks for an urgent referral for suspected cancer.

The guidelines for GPs say that you might need urgent referral to a specialist for possible salivary gland cancer if you have:

  • swelling in your mouth that does not go away after 3 weeks
  • an unexplained lump in your neck that has changed in the previous 3 to 6 weeks
  • unexplained swelling that does not go away in the glands under your ear or around your lower jaw
  • unexplained pain on one side of your head or neck for more than 4 weeks, with earache for no apparent reason
  • any other signs or symptoms affecting your mouth that can't be explained and have lasted for more than 6 weeks
Your doctor might also want to refer you to a dentist urgently if you have a loose tooth for more than 3 weeks, for no apparent reason.

Some of the symptoms above can be caused by other less serious medical conditions. They do not necessarily mean that you have salivary gland cancer.

If you are still worried

Sometimes you might feel that your GP is not concerned enough about your symptoms. If you think they should be more concerned, print this page and the symptoms page. Ask your GP to talk it through with you. Together you can decide if you should see a specialist.

Last reviewed: 
24 Jun 2014
  • Improving outcomes in head and neck cancers
    The National Institute for Health and Clinical Excellence (NICE), November 2004

  • Improving outcomes in head and neck cancers: Evidence Update 
    The National Institute for Health and Clinical Excellence (NICE), May 2011

  • Referral for suspected cancer. A clinical practice guideline
    The National Institute for Health and Clinical Excellence (NICE), June 2005

  • Diagnosis and Management of Head and Neck Cancer (No 90)
    Scottish Intercollegiate Guidelines Network (SIGN), October 2006

Information and help

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