Salivary Gland Cancer in India: Causes, Symptoms, Treatments & Outcomes
Salivary gland cancer is a rare group of malignancies that arise from the salivary glands, including major glands like the parotid, submandibular, and sublingual glands, as well as numerous minor glands in the mouth and throat. These cancers can affect speech, swallowing, taste, and overall quality of life.
Salivary Gland Cancer in India: Incidence & Epidemiology
Although uncommon compared to oral or oropharyngeal cancers, salivary gland malignancies are clinically significant in India. They show a slight male predominance and are most often diagnosed in middle-aged and older adults. Incidence varies regionally and is influenced by environmental, occupational, and genetic factors.
Causes & Risk Factors
- Previous exposure to ionizing radiation
- Occupational exposure to industrial chemicals (e.g., nickel, rubber)
- History of benign salivary tumors (rare malignant transformation)
- Genetic and environmental factors under investigation
- Tobacco and alcohol play a lesser role compared to other head and neck cancers
Symptoms & Early Warning Signs
Early signs may be subtle and overlap with benign salivary conditions:
- Painless or slowly enlarging lump in the affected gland
- Facial numbness or weakness if the facial nerve is involved
- Difficulty swallowing or opening the mouth
- Ulceration or bleeding in advanced lesions
Diagnosis & Staging
- Clinical examination
- Imaging: Ultrasound, CT scan, or MRI
- Fine-needle aspiration (FNA) biopsy
- Excisional biopsy and molecular profiling for subtype classification
Treatment Options for Salivary Gland Cancer
1. Surgery
Surgery is the primary treatment. Complete tumor resection with lymph node dissection is performed as needed. Radical parotidectomy with facial nerve preservation or grafting is often required for optimal outcomes.
2. Radiotherapy
Adjuvant radiotherapy improves local control, especially in high-grade tumors, advanced stages, or close/involved surgical margins. Modern techniques like Intensity-Modulated Radiotherapy (IMRT) minimize damage to nearby tissues.
3. Chemotherapy
Chemotherapy has a limited role but may be used in select advanced or recurrent cases. Platinum-based regimens and combination therapies are sometimes employed.
4. Targeted Therapy & Immunotherapy
Molecular profiling allows targeted therapies (e.g., HER2 inhibitors, androgen receptor antagonists) and immunotherapy for advanced or metastatic disease. These approaches are increasingly integrated into multidisciplinary care.
Recent Advances in Salivary Gland Cancer Care
- Molecular profiling identifies actionable genetic alterations
- Precision radiotherapy reduces exposure to healthy tissues
- Targeted and immunotherapy improve outcomes for advanced cases
- Multidisciplinary care enhances treatment personalization and quality of life
Potential Side Effects of Treatment
- Facial nerve weakness or sensory changes after surgery
- Scar formation and altered salivary function
- Mucositis, dry mouth, or taste changes after radiotherapy
- Systemic therapy side effects: nausea, fatigue, skin reactions, organ-specific toxicity
Outcomes & Survival
Survival depends on tumor subtype, stage, and treatment adequacy: Low-grade tumors like acinic cell carcinoma generally have favorable long-term survival, while high-grade tumors like salivary duct carcinoma are more aggressive. Adenoid cystic carcinoma may recur or metastasize late despite excellent local control.
Why Early Detection Matters
Early recognition allows timely intervention and improves outcomes. Regular medical evaluation, imaging, and biopsy of suspicious lumps are essential for optimal management of salivary gland cancer.