Close

Oral Salivary Gland Cancer

Signs and Symptoms of Oral Salivary Gland Cancer

For cancers in the mouth, you, your dentist or your general doctor can actually see or feel something abnormal in most cases. This is different from cancers in other parts of the head and neck, which can remain hidden for some time.

Symptoms to watch for include:

  • A lump or bump in the mouth: This is the most common way for an oral salivary gland cancer to present. This is different from the much more common squamous cell carcinomas that present with sores and patches in the mouth. The minor salivary glands are located under the outermost lining of the mouth, so they are described as submucosal masses.
  • Painful sores in the mouth: In some cases, oral salivary gland cancer can result in a painful sore in the mouth. In some cases, a dentist or dental hygienist will see a sore in the mouth that you didn’t even realize was there. In general, a patch or sore in the mouth that doesn’t heal after a few weeks should be evaluated in more detail by a specialist.
  • Numbness (for example in the lower teeth or lower lip/chin area): This means that the cancer cells have gotten into nerves that allow you to feel. The main nerve responsible for this when dealing with oral cancer runs just inside the lower jawbone, and a branch even runs in the middle of the jawbone and comes out under the skin of your chin.

Other symptoms might include:

  • Recurrent bleeding from the mouth: This can happen when the cancer makes a hole in some part of the mouth (this is called an ulcer) or if cancer cells are accidently rubbed off while brushing your teeth or eating certain foods.
  • Loose teeth or dentures that don’t fit correctly: This happens if the tumor gets into the tooth sockets or the bones in which the teeth are rooted.
  • Difficulty opening the mouth: This can happen if the cancer gets into any of the muscles that help to open and close the mouth. This is called trismus.
  • Pain or difficulty with swallowing: This can happen when tumors get large and either get in the way of eating or involve the muscles and nerves of swallowing.

In some cases, a dentist or oral surgeon will see something in the mouth, remove it and a week later get the report that it is a cancer.

  • If a lesion was removed and later found to be cancer: In this case, you should still see a specialist in head and neck cancers because it is important to review the pathology in detail to see if any more treatment is needed. Some questions to review are:
    • What type of cancer was it?
    • How big was it?
    • How deeply did it invade?
    • Was it completely removed with a rim of normal tissue around it? (This is known as having “clear margins.”)

In rare cases, the first sign of an oral cancer could be a lump in the neck.

  • A lump in the neck: This means that the tumor has spread to the lymph nodes in the neck. This is less common for oral cancers than other types of cancers in the head and neck because the primary cancer is usually the main problem.

But don’t jump to any conclusions. You could have one or more of these symptoms but NOT have an oral cancer. There are several non-cancerous causes of the same symptoms. That’s why you need to see a specialist.

References

1 Kakarala K, Bhattacharyya N. Survival in oral cavity minor salivary gland carcinoma. Otolaryngol Head Neck Surg. 2010 Jul;143(1):122-6.

2 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed November 9, 2016. To view the most recent and complete version of the guideline, go online to www.NCCN.org.

3 Petersen PE, Oral cancer prevention and control – The approach of the World Health Organization. Oral Oncol. 2008.

4 Johansen C, Boice Jr JD, McLaughlin JK, Olsen JH. Cellular telephones and cancer—a nationwide cohort study in Denmark. Journal of the National Cancer Institute. 2001;93:203-7.

5 Auvinen A, Hietanen M, Luukkonen R, Koskela RS. Brain tumors and salivary gland cancers among cellular telephone users. Epidemiology. 2002;13:356.

6 Atula T, Grenman R, Klemi P, et al. Human papillomavirus, Epstein-Barr virus, human herpes virus 8 and human cytomegalovirus involvement in salivary gland tumours. Oral Oncol. 1998;34:391-395.

7 Sun EC, Curtis R, Melbye M, et al. Salivary gland cancer in the United States. Cancer Epidemiol Biomarkers.1999;Prev 8:1095-1100.

8 Horn-Ross PL, Ljung BM, Morrow M. Environmental factors and the risk of salivary gland cancer. Epidemiology. 1997:414-9.

9 Spiro RH, Thaler HT, Hicks WF, Kher UA, Huvos AH, Strong EW. The importance of clinical staging of minor salivary gland carcinoma. Am J Surg. 1991 Oct;162(4):330-6.

10 Morton DL, Wen DR, Foshag LJ, Essner R, Cochran A. Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early-stage melanomas of the head and neck. J Clin Oncol. 1993;11:1751-6.

11 Civantos FJ, Zitsch RP, Schuller DE, Agrawal A, Smith RB, Nason R, Petruzelli G, Gourin CG, Wong RJ, Ferris RL, El Naggar A, Ridge JA, Paniello RC, Owzar K, McCall L, Chepeha DB, Yarbrough WG, Myers JN. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol. 2010 Mar 10;28(8):1395-400.

12 Koch WM, Choti MA, Civelek AC, Eisele DW, Saunders JR. Gamma probe-directed biopsy of the sentinel node in oral squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 1998;124:455-9.

13 Shoaib T, Soutar DS, MacDonald DG, Camilleri IG, Dunaway DJ, Gray HW, McCurrach GM, Bessent RG, MacLeod TIF, Robertson AG. 2001. The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck. Cancer. 91:2077-2083.

14 Agulnik M, McGann CF, Mittal BB, Gordon SC, Epstein JB. Management of salivary gland malignancies: current and developing therapies. Oncol Rev. 2008;2:86-94.

15 Eveson JW, Auclair PL, Gnepp DR, et al. Tumors of the salivary glands: introduction. In: Barnes EL, Eveson JW, Reichart P, Sidransky D, editors. World Health Organization classification of tumours: pathology & genetics. Head and neck tumours. Lyon: IARCPress; 2005:220-1.

16 WHO histological classification of tumors of the salivary glands. World Health Organization. 2005.

17 Seethala RR. An update on grading of salivary gland carcinomas. Head Neck Pathol. 2009 March;3(1):69-77.

18 Douglas JG, Koh WJ, Austin-Seymour M, Laramore GE: Treatment of salivary gland neoplasms with fast neutron radiotherapy. Arch Otolaryngol Head Neck Surg.2003;129:944-948.

19 Rentschler R, Burgess MA, Byers R. Chemotherapy of malignant major salivary gland neoplasms. A 256–94.de in oralinked above experience. Cancer. 2006;40:619-24.

20 Suen JY, Johns ME. Chemotherapy for salivary gland cancer. The Laryngoscope. 2009;92:235-9.

21 Kakarala K, Bhattacharyya N. Survival in oral cavity minor salivary gland carcinoma. Otolaryngol Head Neck Surg. 2010 Jul;143(1):122-6.

22 Terhaard CHJ, et al. Salivary gland carcinoma: independent prognostic factors for locoregional control, distant metastases, and overall survival: results of the Dutch head and neck oncology cooperative group. Head & Neck. 2004;26(8):681-693.

23 Spiro, et al. Stage means more than grade in adenoid cystic carcinoma. The American Journal of Surgery. 1992;164(6):623-628.