Secretory carcinomacancer arising from tissues that line organs (SC) of salivary glands, also known as mammary analogue secretory carcinoma (MASC) of salivary glands, is a newly recognised form of carcinoma that develops in the salivary glands. Salivary glands are responsible for the production of saliva, which is a fluid that aids in digestion, prevents your mouth from becoming too dry and supports healthy teeth.
In humans, there are three pairs of major salivary glands located behind the jaw: parotid, sublingual and submandibular. The parotid glands are largest, and are found in the cheeks. The main role of the parotid glands is to initiate the first part of digestion. In most cases, SC of the salivary glands is found in the parotid glands. The sublingual glands are the smallest and are found on each side of the tongue. These glands produce the least amount of saliva. The submandibular glands are located on the floor of our mouths on each side, and produce the most saliva. There are also several minor salivary glands found in the lips, cheeks, mouth and throat.
This type of cancera disease where abnormal cells split without control and spread to other nearby body tissue and/or organs gets its name from an equally rare and also newly recognised type of cancer called secretory carcinoma of the breast, which is predominantly found in children. SC of salivary glands shares genetic and cellular features with this type of cancer.
SC of salivary glands is usually diagnosed in adults, but it can be diagnosed at any age.
Treatment
If SC of salivary glands is detected, it will be staged and graded based on size, metastasiswhen the cancer has spread to other parts of the body, also known as mets, and how the cancer cellsthe basic structural and functional unit of all living things look under the microscope. Stagingthe process of determining how big the cancer is, where it started and if it has spread to other areas and grading helps your doctors determine the best treatment for you.
Cancers can be staged using the TNM staging system:
- T (tumoura tissue mass that forms from groups of unhealthy cells) indicates the size and depth of the tumour.
- N (nodea small lump or mass of tissue in your body) indicates whether the cancer has spread to nearby lymph nodessmall bean-shaped structures that filters harmful substances from lymph fluid.
- M (metastasis) indicates whether the cancer has spread to other parts of the body.
This system can also be used in combination with a numerical value, from stage 0-IV:
- Stage 0: this stage describes cancer cells in the place of origin (or ‘in situ’) that have not spread to nearby tissuea group of cells that work together to perform a function.
- Stage I: cancer cells have begun to spread to nearby tissue. It is not deeply embedded into nearby tissue and had not spread to lymph nodes. This stage is also known as early-stage cancer.
- Stage II: cancer cells have grown deeper into nearby tissue. Lymph nodes may or may not be affected. This is also known as localisedaffecting only one area of body cancer.
- Stage III: the cancer has become larger and has grown deeper into nearby tissue. Lymph nodes are generally affected at this stage. This is also known as localised cancer.
- Stage IV: the cancer has spread to other tissues and organs in the body. This is also known as advancedat a late stage, far along or metastatic cancer.
Cancers can also be graded based on the rate of growth and how likely they are to spread:
- Gradea description of how abnormal cancer cells and tissue look under a microscope when compared to healthy cells I: cancer cells present as slightly abnormal and are usually slow growing. This is also known as a low-grade tumour.
- Grade II: cancer cells present as abnormal and grow faster than grade-I tumours. This is also known as an intermediate-grade tumour.
- Grade III: cancer cells present as very abnormal and grow quickly. This is also known as a high-grade tumour.
Once your tumour has been staged and graded, your doctor may recommend genetic testinga procedure that analyses DNA to identify changes in genes, chromosomes and proteins, which can be used to analyse tumour DNA to help determine which treatment has the greatest chance of success, which analyses your tumour DNA and can help determine which treatment has the greatest chance of success. They will then discuss the most appropriate treatment option for you.
Treatment is dependent on several factors, including location, stage of disease and overall health.
Treatment options for SC of salivary glands may include:
- Surgerytreatment involving removal of cancerous tissue and/or tumours and a margin of healthy tissue around it to reduce recurrence, potentially including:
- Parotidectomycomplete or partial removal of the parotid gland.
- Sublingual salivary gland excisionto surgically remove/cut out.
- Submandibular salivary gland excision.
- Chemotherapya cancer treatment that uses drugs to kill or slow the growth of cancer cells, while minimising damage to healthy cells.
- Radiation therapya treatment that uses controlled doses of radiation to damage or kill cancer cells.
- Clinical trialsresearch studies performed to test new treatments, tests or procedures and evaluate their effectiveness on various diseases.
- Palliative carea variety of practices and exercises used to provide pain relief and improve quality of life without curing the disease.
Risk factors
Because of how rare SC of salivary glands is, there has been limited research into the riskthe possibility that something bad will happen factors of this disease. However, genetic predisposition has been identified as a potential factor that may increase the likelihood of developing this disease.
Symptoms
Symptoms of SC in the salivary glands may include:
- A lump in the cheek and/or mouth. This may be slow-growing and painless, or fast-growing and painful.
- Changes in salivation, such as decreased or increased saliva production.
- Skin inflammation in surrounding tissue.
- Inflammation of the lymphatic glands.
Not everyone with the symptoms above will have cancer but see your general practitioner (GP) if you are concerned.
Diagnosis
If your doctor suspects you have a SC of the salivary glands,
they may order the following tests to confirm the diagnosisthe process of identifying a disease based on signs and symptoms, patient history and medical test results and refer you to a specialist for treatment:
- Physical examinationan examination of your current symptoms, affected area(s) and overall medical history.
- Imagingtests that create detailed images of areas inside the body tests, potentially including:
- Ultrasounda type of medical imaging that uses soundwaves to create detailed images of the body .
- CT (computed tomography) scana type of medical imaging that uses x-rays and computer technology to create detailed images of the body.
- MRI (magnetic resonance imaging)a type of medical imaging that uses radiowaves, a strong magnet and computer technology to create detailed images of the body.
- Blood teststesting done to measure the levels of certain substances in the blood.
- Biopsyremoval of a section of tissue to analyse for cancer cells.
