Salivary gland cancer

How is salivary gland cancer diagnosed? 

It is important that your doctor establishes the diagnosis of salivary gland cancer, assesses the size of the cancer and whether it has spread to the lymph nodes in the neck or elsewhere in the body.

To answer these questions, your doctor will need to do the following things:

  • talk with you about your medical history. This includes signs you may have noticed, any other health conditions, medications that you are taking, and whether you smoke or drink alcohol

  • perform a physical examination by feeling and looking at your face, scalp, mouth and neck 

  • order diagnostic tests, which may include scans. 

Not everyone will need to have every test for salivary gland cancer. Your doctor will recommend tests that are right for you.

Common diagnostic tests include:

Nasoendoscopy

Your doctor will use a very thin flexible tube with a tiny light and camera on it (endoscope) to look at your throat and voicebox.

   

Biopsy

This involves taking a small piece (sample) from the cancer. The sample is then examined under a microscope to check for cancer cells. This is often the only sure way to tell if you have cancer. Diagnosis of salivary gland cancers can be very difficult and, sometimes, a definite diagnosis cannot be made until the whole cancer is removed.
Your doctor may recommend an incision biopsy or a needle biopsy.

 

  • Incision biopsy: If you have a sore or a lump in the mouth, a small piece will be cut of it. This is usually done by your doctor or dentist in their clinic under a local anaesthetic, so that you don't feel any pain.

  • Needle biopsy (Fine Needle Aspiration or FNA): This is used when there is a lump (enlarged lymph node) in front of the ear or in the neck, that could have cancer cells in it. During the procedure, your doctor will take some cells from the lump using a needle. Usually this is done with guidance from an ultrasound to make sure the needle is in the right spot. You may feel a bit uncomfortable during the biopsy.

 

CT (Computed Tomography) scan

This uses X-rays to take pictures of the inside of the body. If the person has cancer, a CT scan can help the doctor see where it is, measure how big it is, and if it has spread into nearby organs or other parts of your body.

 

MRI (Magnetic Resonance Imaging) scan

This uses magnetic fields to take pictures of the inside of the body. MRI is very good at looking at the salivary glands and determining whether any cancer is spreading along the nerves.

 

PET (Positron Emission Tomography) scan

This is a whole body scan that uses a radioactive form of sugar which can show if salivary gland cancer has spread to other parts of the body. Low-grade salivary gland cancer may not show up on PET scan, because it tends to grow slowly. 

 

Ultrasound scan

This uses sound waves and helps the doctor to see salivary gland cancer. An ultrasound scan can show if a cancer is benign or malignant. Ultrasound scans are also often used to guide a needle biopsy and to look at lymph nodes.