The major salivary glands are located in the cheek area and under the jaw line. They produce saliva: a fluid containing enzymes and antibodies essential for digesting food and for preventing mouth and throat infections. Saliva also helps protect teeth from decay.

“One of the common things we see in the office are salivary gland tumors,” says Henry N. Ho, M.D., board certified otolaryngologist, specializing in head and neck cancer, president of The Ear, Nose, Throat and Plastic Surgery Associates and co-director of the Head and Neck Program at the Florida Hospital Cancer Institute.

The good news is that most salivary gland tumors of the parotid gland are benign, slow-growing, and painless, and can be removed usually without many side effects. Indeed, cancer of the salivary gland is relatively rare, representing less than 1% of all cancers in the United States.

What are the Symptoms and Risk Factors of Salivary Gland Tumors?

Roughly 80-85% of salivary gland tumors appear in the parotid glands which are located in the cheek area.

Most benign salivary gland tumors appear as painless growths and rarely affect more than one gland at a time. On the other hand, malignant tumors may invade nerves causing facial muscle weakness or pain. Cancers typically show a much faster growth rate as well.

Risk factors that can potentially increase one’s chances of developing salivary gland tumors include:

• Sjögren’s syndrome (a chronic autoimmune disorder)
• Skin cancer near the salivary gland
• Radiation exposure

How is a Salivary Gland Tumor Treated?

“Salivary gland tumor is something we see fairly commonly,” says Dr. Ho. “The location of the tumor has a bearing on risk of malignancy. For example, tumors of the parotid gland are about 70% benign. These are usually removed as there is no other treatment and they enlarge over time. Although rare, sometimes benign tumors can become malignant. Most malignant tumors are removed as the initial management.”

When removing salivary gland tumors, surgeons need to pay particular attention to protecting the delicate nerves in the face.

“In the vicinity of the cheek we’re concerned about the facial nerve,” says Dr. Ho. “The smaller the tumor is, the easier it is for us to remove without injury or risk to the facial nerve.”

In order to properly diagnose and treat a salivary gland tumor, an ear, nose and throat specialist will first do a physical exam, and then may order imaging tests such as an MRI or CT scan of the neck. If needed, a fine needle aspiration (FNA) biopsy is recommended in order to sample the cells and determine if they are cancerous. Surgical removal of the tumor is usually the next step in the treatment.

“Surgical removal depends on the location and the nature of the problem,” says Dr. Ho. “Whether it is benign or malignant influences the extent of surgery with regards to margin clearance and inclusion of related lymph nodes of the neck.”

After surgery, a cancerous tumor may require radiation and/or chemotherapy in order to provide the best chance for cure.

“Once we know the exact diagnosis rendered by our pathologists’ analysis of the surgical specimen, additional treatment will depend on the consensus opinion of our tumor board, whether or not radiation therapy and/or chemotherapy will be added.” says Dr. Ho.

When treating a benign tumor, surgical removal alone is usually sufficient to cure the patient. In the case of a malignant salivary gland tumor, the five-year survival rate for patients after diagnosis is about 72%.