Salivary gland cancers in seniors primarily involve malignant tumors arising in the major salivary glands: the parotid, submandibular, and sublingual glands. Among these, the **parotid gland** is the most common site for both benign and malignant tumors, with about 20% of parotid tumors being cancerous. The most frequent types of salivary gland cancers in older adults include **mucoepidermoid carcinoma**, **adenocarcinoma not otherwise specified (AdCaNOS)**, and **acinic cell carcinoma**, with mucoepidermoid carcinoma being the most common malignant tumor overall.
The **parotid gland**, located just in front of and below each ear, produces the majority of saliva and is the largest salivary gland. Tumors here often present as painless lumps that may grow slowly or rapidly. While many parotid tumors are benign, such as pleomorphic adenomas, seniors are at increased risk for malignant forms. Mucoepidermoid carcinoma arises from the glandular tissue and can vary in aggressiveness, sometimes spreading to nearby lymph nodes or distant sites. Adenocarcinoma not otherwise specified is a rarer but aggressive cancer that also tends to form solid, painless lumps, often in the parotid or minor salivary glands like those on the palate. This type is more common in men and typically diagnosed in people in their late 50s or older.
The **submandibular glands**, located beneath the jawline, can also develop malignant tumors, though less frequently than the parotid glands. Tumors here may be more aggressive and have a worse prognosis compared to those in the parotid gland. The **sublingual glands**, found under the tongue, are the least common site for salivary gland cancers but can still be affected.
Risk factors for salivary gland cancers in seniors include **age-related changes**, **previous radiation exposure to the head and neck**, and certain occupational exposures such as to asbestos or rubber manufacturing chemicals. Family history is rarely a factor. Symptoms often start as a painless lump in the cheek, jaw, mouth, or neck, but can progress to pain, facial nerve weakness, or difficulty swallowing if the tumor grows or invades nearby structures.
Diagnosis typically involves a physical exam, imaging studies like CT scans or MRIs, and a biopsy to determine the exact tumor type. Treatment depends on the cancer’s type, size, and stage but usually involves surgery to remove the tumor, sometimes followed by radiation therapy. Chemotherapy is less commonly used unless the cancer has spread extensively.
In seniors, managing salivary gland cancer requires careful attention to overall health and potential treatment side effects. Maintaining good oral hygiene, eating soft foods if swallowing is difficult, and avoiding smoking and alcohol can help improve comfort during treatment. Early detection and treatment are crucial for better outcomes, as some salivary gland cancers can be aggressive and spread if left untreated.
In summary, the most common salivary gland cancers in seniors are mucoepidermoid carcinoma and adenocarcinoma not otherwise specified, primarily affecting the parotid gland. These cancers often present as painless lumps and require prompt medical evaluation for diagnosis and treatment.