Salivary gland cancer

Surgery

There are a number of different types of operations that can be used to remove salivary gland cancer. The type of surgery used will depend on the size and the location of the cancer.

How can I prepare for the surgery?

Your doctor will explain details of the surgery, general risks and side effects of surgery. Ask your doctor if you have questions. They may recommend:

  • stopping blood thinners (e.g. aspirin) before surgery to reduce the risk of bleeding

  • special stockings to reduce the risk of blood clots

  • early mobilisation (i.e not staying in bed) to reduce the risk of blood clots and chest infection

  • antibiotics to lower the risk of wound infection.

Before starting treatment, it is important that you consider stopping smoking to reduce the risk of infection and help you fully recovery after your treatment.

Surgical procedures 

The different operations that can be used for salivary gland cancers are:

Parotidectomy

This is removal of one or both of the parotid glands (pair of major salivary glands located in front of each ear) and the surrounding tissue. 

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Submandibular gland surgery

This is removal of the submandibular glands (located beneath the floor of your mouth) and some of the surrounding tissue and/or bone.

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Sublingual gland surgery

This is removal of the sublingual glands (located in the mouth) and some of the surrounding tissue.

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Facial nerve sacrifice (radical parotidectomy)

This is removal of facial nerve, which controls facial expression. It is performed when a cancer in the parotid glands has spread to surrounding facial nerve.

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Lateral temporal bone surgery

This is the removal of some or all of the bone in the temple and behind the ear. It is used when a cancer in the parotid glands spreads into the nearby bone.

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Neck dissection

This involves taking out the lymph nodes from the neck. It is used when cancer of the salivary glands has spread to the lymph nodes in the neck or there is a risk of cancer in the lymph nodes of the neck.

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REconstructive surgery - Soft tissue free flap

This may be considered if you have a large area of tissue removed. This may involve taking tissue from another part of the body, this is called a free flap repair. This operation is carried out by a surgeon who specialises in reconstructive surgery, your head and neck surgeon or another surgeon.

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Tracheostomy

A tracheostomy is used to create an opening in the trachea (windpipe) after major head and neck surgery. A tube is inserted into the opening to help you breathe until normal breathing is possible.

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Feeding tubes 

  • A gastrostomy tube (called a PEG tube) goes through the skin and the muscles of your abdomian wall into the stomach, with part of the tube staying outside the stomach for as long as the tube is needed.  Gastrostomy is recommended if feeding is needed for a medium to longer time (months or years).
  • A nasogastric tube goes through the nose down into the stomach. Nasogastric feeding is used for short time (days or weeks).
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Dental extraction 

Tooth extractions may be recommended to remove any broken or infected teeth before radiation therapy. This is important because removal of unhealthy teeth after radiation therapy can cause problems with the jaw bone.

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Side effects of surgery

Treatment for salivary gland cancer may lead to a number of side effects. Possible side effects depend on the surgical approach that best suits your individual cancer. It depends on whether you need to have lymph nodes removed from the neck. You may not experience all of the side effects. Speak with your doctor if you have any questions or concerns about treatment side effects.