Treatment options for salivary gland cancer

The main treatments for salivary gland cancer are surgery, radiotherapy and chemotherapy. You might have one or more of these treatments.

Surgery alone will cure some salivary gland cancers. For other cancers, a combination of surgery and radiotherapy will work better. Doctors might use chemotherapy to control more advanced cancers or as part of a clinical trial. Or you might have a targeted cancer drug as part of a clinical trial for advanced salivary gland cancer.

Deciding what treatment you need

A team of doctors and other professionals recommend the best treatment and care for you. They are called a multidisciplinary team (MDT). The team usually includes:

a surgeon who specialises in operations of the face, mouth and jaw (oral and maxillofacial surgeon or maxfax surgeon)
cancer specialists (oncologists) who specialise in treating cancer with cancer drugs (medical oncologist) and radiotherapy (clinical oncologist)
a specialist cancer nurse (also called clinical nurse specialist)
a pathologist (an expert who examines any cancer or tissue the surgeon removes)
a speech and language therapist (if treatment might affect your speech or swallowing)
a radiologist (who looks at your scans and x-rays)
a dietician (who offers support and advice about eating and drinking)

Your doctor will plan your treatment according to:

the type of salivary gland cancer you have
whether the cancer has spread (the stage)
what the cells look like under a microscope (the grade)
how the treatment will affect your speech, chewing and swallowing
your general health and fitness

Treatment overview

You have one or more of these treatments depending on your situation.

Surgery

Surgery is the most common treatment for salivary gland cancer. It works very well for early stage cancers.

The type of operation you have depends on:

the size of the cancer
where it is – it can be harder to remove a cancer in the deeper parts of the salivary gland
whether there is a risk that the cancer has spread to the lymph nodes around your salivary gland or in your neck

Surgery to remove the lymph nodes in your neck

During surgery, the doctor will examine the area around your cancer. They may remove some of the lymph nodes near the tumour. This is called a selective neck dissection.

Your surgeon does this to help to find out where the cancer is (the stage) and to get rid of any remaining cancer cells. This reduces the risk of the cancer coming back in the lymph nodes.

Your surgeon is likely to remove all the nodes on one, or both sides of your neck if your cancer has already spread to lymph nodes in the neck. You may hear your doctor call this operation a modified radical neck dissection.

Radiotherapy

Radiotherapy uses high energy rays to kill cancer cells. Your doctor may recommend that you have radiotherapy after surgery. This helps to kill any cancer cells that might have been left behind and reduces the risk of the cancer coming back.

You might also have radiotherapy as the main treatment if it isn’t possible to remove your cancer in an operation. You may not be able to have surgery because:

the position of your tumour makes it difficult to reach
you have other illnesses or conditions and you can't have a long anaesthetic
the cancer is advanced and can’t be completely removed

Chemotherapy

Chemotherapy uses anti cancer (cytotoxic) drugs to disrupt and kill cancer cells. Chemotherapy doesn’t work as well as surgery and radiotherapy for salivary gland cancer. So this isn't a common treatment.

You may have chemotherapy:

to treat advanced cancers, or those that have spread to other parts of your body
if your cancer has come back after surgery and radiotherapy
as part of a clinical trial

Advanced salivary gland cancer

Salivary gland cancer can spread to other parts of the body. This is advanced cancer. When this happens, using surgery to remove the tumour in your salivary gland will not cure the cancer. But surgery may still help to control your symptoms and the disease for some time.

Your doctor might recommend surgery to remove all or part of the cancer and help relieve symptoms if your tumour is large. They may also suggest radiotherapy and chemotherapy.

Having treatment as part of a clinical trial

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.