request an appointment online.
- Diagnosis & Treatment
- Cancer Types
- Salivary Gland Cancer
- Salivary Gland Cancer Diagnosis
Salivary Gland Cancer Diagnosis
An accurate diagnosis is the first step in successful salivary gland cancer treatment. MD Anderson has pathologists who specialize in diagnosing cancers of the head and neck, including rare diseases like salivary gland cancer.
If you have a suspected salivary gland cancer, your doctor will ask about your health and medical history. You will also undergo tests to diagnose the type of salivary gland cancer and the cancer stage. The following tests are used to diagnose salivary gland cancer and how much it has grown, as well as to monitor the disease and how it responds to treatment.
Biopsy
A biopsy is the only way to conclusively diagnose salivary gland cancer. In a biopsy, doctors retrieve suspected cancer tissue for study under a microscope. Different methods are used to obtain this tissue, depending on where the tumor is located. Common biopsy methods for salivary gland cancer include:
- Image guided core needle biopsy: The doctor uses a live image, often an ultrasound or CT, to guide a needle to the suspected cancer tissue.
- Conventional incisional biopsy: The doctor surgically removes part of the tissue that is suspected to have cancer.
- Excisional biopsy: This type of biopsy removes most or all of the suspected cancer tissue. This procedure is typically done in the operating room.
- Endoscopic biopsy: During this procedure, an endoscope (a long, thin tube with a light and lens through which the doctor can view organs and tissue) is inserted through the mouth, nose or a small cut in the head or neck. The endoscope has a tool to remove tissue samples.
- Fine-needle-aspiration biopsy (FNA): This type of biopsy may be used if you have a lump easily reached by a needle. A thin needle is inserted into the area, and cells are withdrawn and examined under a microscope. This is often coupled with an ultrasound to verify the placement of the needle. FNA may limit the ability to identify the exact type of tumor.
Imaging exams
Imaging exams can help locate the suspected cancer and show whether it has spread. They are important in helping to plan surgery and determine the cancer’s stage. They can also be used to monitor the disease and how it responds to treatment.
Imaging exams for salivary gland cancer may include:
- CT or CAT (computed axial tomography) scans
- PET (positron emission tomography) scans
- MRI (magnetic resonance imaging) scans
- Ultrasound
- Chest and dental X-rays
Learn more about imaging exams.
Blood and urine tests
These tests are not used to diagnose cancer. Instead, they help doctors monitor the patient’s overall health during treatment.
Swallowing exams
Doctors use swallowing tests to understand how well the patient’s throat is performing and help them plan treatment. There are different types of swallowing tests.
- Barium swallow: The patient drinks liquid barium, which makes certain areas of the body show up more clearly during X-rays. This study evaluates the passage from the throat to the stomach. It is used to look for changes in structure and muscle movement.
- Modified barium swallow: During a modified barium swallow, the patient ingests liquid, pudding and solid food, all containing barium. A speech pathologist and radiologist observe the swallowing in real time using a specialized X-ray exam, called a fluoroscopy. They then evaluate the structures and movements associated with swallowing.
- Fiberoptic endoscopic examination of swallowing (FEES): FEES relies on a small, flexible endoscope that is inserted through the nose. It allows the doctor or speech pathologist to examine swallowing.
Salivary gland cancer staging
If you are diagnosed with salivary gland cancer, your doctor will determine the stage (or extent) of the disease. The various stages classify how far and to which parts of the body the cancer has spread. Staging helps doctors plan the best treatment for you.
Salivary gland cancer stages
Source: National Cancer Institute
Stage 0 (carcinoma in situ)
In stage 0, abnormal cells are found in the lining of the salivary ducts or the small sacs that make up the salivary gland. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I
In stage I, cancer has formed. The tumor is in the salivary gland only and is 2 centimeters or smaller.
Stage II
In stage II, the tumor is in the salivary gland only and is larger than 2 centimeters but not larger than 4 centimeters.
Stage III
In stage III, one of the following is true:
- The tumor is larger than 4 centimeters, and/or cancer has spread to soft tissue around the salivary gland; or
- The tumor is any size, and cancer may have spread to soft tissue around the salivary gland. Cancer has spread to one lymph node on the same side of the head or neck as the tumor. The lymph node is 3 centimeters or smaller, and cancer has not grown outside the lymph node.
Stage IV
Stage IV is divided into stages IVA, IVB, and IVC as follows:
- Stage IVA:
- Cancer has spread to the skin, jawbone, ear canal, and/or facial nerve. Cancer may have spread to one lymph node on the same side of the head or neck as the tumor. The lymph node is 3 centimeters or smaller, and cancer has not grown outside the lymph node; or
- The tumor is any size, and cancer may have spread to soft tissue around the salivary gland or to the skin, jawbone, ear canal, and/or facial nerve. Cancer has spread:
- to one lymph node on the same side of the head or neck as the tumor or on the side opposite the primary tumor; the lymph node is 3 centimeters or smaller, and cancer has grown outside the lymph node; or
- to one lymph node on the same side of the head or neck as the tumor; the lymph node is larger than 3 centimeters but not larger than 6 centimeters, and cancer has not grown outside the lymph node; or
- to more than one lymph node on the same side of the head or neck as the tumor; the lymph nodes are 6 centimeters or smaller, and cancer has not grown outside the lymph nodes; or
- to lymph nodes on both sides of the head or neck or on the side opposite the primary tumor; the lymph nodes are 6 centimeters or smaller, and cancer has not grown outside the lymph nodes.
- Stage IVB:
- The tumor is any size, and cancer may have spread to soft tissue around the salivary gland or to the skin, jawbone, ear canal, and/or facial nerve. Cancer has spread:
- to one lymph node larger than 6 centimeters, and cancer has not grown outside the lymph node; or
- to one lymph node on the same side of the head or neck as the tumor; the lymph node is larger than 3 centimeters, and cancer has grown outside the lymph node; or
- to more than one lymph node on the same side of the head or neck as the tumor, on the side opposite the primary tumor, or on both sides of the head or neck; cancer has grown outside any of the lymph nodes; or
- to one lymph node of any size on the side of the head or neck opposite the primary tumor; cancer has grown outside the lymph node;
- The tumor is any size, and cancer may have spread to soft tissue around the salivary gland or to the skin, jawbone, ear canal, and/or facial nerve. Cancer has spread:
or
- Cancer has spread to the bottom of the skull and/or surrounds the carotid artery. Cancer may have spread to one or more lymph nodes of any size on either or both sides of the head or neck and may have grown outside the lymph nodes.
- Stage IVC: Cancer has spread to other parts of the body, such as the lungs.
Help #EndCancer
Give Now
Donate Blood
Our patients depend on blood and platelet donations.
Shop MD Anderson
Show your support for our mission through branded merchandise.