Treatment of stage 3 salivary gland cancer

The following are treatment options for stage 3 salivary gland cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Surgery

Surgery is the standard treatment for stage 3 salivary gland cancer. The type of surgery will depend on where the tumour is found.

Superficial parotidectomy is used to treat a tumour in the superficial lobe of a parotid gland. The superficial lobe is the part of the parotid gland that is closest to the front of the neck.

Total parotidectomy is used to treat a tumour in the deep lobe of a parotid gland.

Sialoadenectomy is used to treat tumours in the salivary glands in the lower jaw or under the tongue.

Wide local excision is used to treat tumours in the minor salivary glands.

Neck dissection is done for low-grade tumours that have spread to a lymph node or for high-grade tumours.

  • Selective neck dissection removes only the lymph nodes where the cancer is most likely to spread. This includes the lymph nodes close to and on the same side of the neck as the salivary gland tumour.
  • Radical neck dissection removes all of the lymph nodes around and on the same side of the neck as the salivary gland tumour. Other tissues are sometimes removed if the cancer has spread to them.

Reconstructive surgery may be needed after surgery for stage 3 salivary gland cancer. This may include skin, tissue and nerve grafts.

Radiation therapy

External radiation therapy is given after surgery if:

  • there are cancer cells in the tissue that was removed along with the tumour (positive margins)
  • the cancer is high-grade
  • the cancer has spread to the space around a nerve (perineural invasion)
  • the cancer has spread to the lymph nodes

External radiation may be offered instead of surgery for stage 3 salivary gland cancer if surgery to remove the tumour would cause a major change in your appearance or make it difficult for you to talk or eat. It may also be used if you aren't healthy enough to have surgery or if you don't want to have surgery.

Intensity-modulated radiation therapy (IMRT) is the most common type of external radiation therapy used to treat stage 3 salivary gland cancer.

Clinical trials

Talk to your doctor about clinical trials open to people with salivary gland cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

Expert review and references

  • Amirlak B . Malignant parotid tumors. eMedicine.Medscape.com. WebMD LLC; 2013: http://emedicine.medscape.com/article/1289616-overview.
  • Iqbal H, Bhatti ABH, Husain R & Jamshed A . Ten year experience with surgery and radiation in the management of malignat major salivary gland tumors. Asian Pacific Journal of Cancer Prevention. National Cancer Center Korea; 2014.
  • Lagha A, Chraiet N, Ayadi M, et al . Systemic therapy in the management of metastatic or advanced salivary gland cancers. Head & Neck Oncology. OA Publishing London;
  • Lee SC . Salivary gland neoplasms. eMedicine.Medscape.com. WebMD LLC; 2013: http://emedicine.medscape.com/article/852373-overview.
  • Mendenhall WM, Werning JW and Pfister DG . Treatment of head and neck cancer. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles & Practice of Oncology. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011: 72:729-80.
  • National Cancer Institute. Salivary Gland Cancer Treatment (PDQ®) Health Professional Version. 2014.
  • National Comprehensive Cancer Network. Head and neck cancers (Version 1.2014). 2014.
  • Terhaard CHJ . Salivary gland cancer. Halperin EC, Wazer DE, Perez CA et al. Perez and Brady's Principles and Practice of Radiation Oncology. 6th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013.