When to Seek Diagnostic Testing

Most people first discover something is wrong when they notice a lump in their mouth or near their jaw. This discovery might happen during a routine dental checkup or when you’re brushing your teeth. Some people don’t have any symptoms at all, making regular dental and physical examinations even more important for catching problems early.^[1]

If you notice a painless lump in the area of your ear, cheek, jaw, lip, or inside your mouth, it’s time to see a doctor. The lump is usually painless, which might make you think it’s not serious, but this is actually one of the most common signs of salivary gland cancer. You should also seek medical attention if you experience weakness or numbness in your face, neck, jaw, or mouth, or if you have ongoing pain in these areas that won’t go away.^[1]

Other warning signs include trouble swallowing or difficulty opening your mouth all the way. Some people notice fluid draining from their ear, which can be confused with an ear infection. If you have bleeding from your mouth that you can’t explain, this is another reason to get checked out right away.^[1]

Because salivary gland cancer is rare and often doesn’t cause pain in its early stages, it may be discovered during a regular dental or medical checkup before you notice any symptoms yourself. This is why keeping up with routine health appointments is so important, even when you feel fine.^[7]

Classic Diagnostic Methods

Physical Examination and Medical History

Your journey through diagnosis begins with a thorough physical examination. Your healthcare provider will carefully feel the areas around your jaw, neck, and throat, checking for lumps or any swelling that seems unusual. They’ll examine the inside of your mouth and look at your salivary glands from different angles to get a complete picture of what’s happening.^[1]

During this appointment, your doctor will also take a detailed medical history. They’ll ask about your health habits, any past illnesses you’ve had, and what treatments you’ve received before. This conversation helps them understand your overall health and whether you might have risk factors for salivary gland cancer, such as previous radiation therapy to your head or neck, or exposure to certain workplace substances.^[4]

Imaging Tests

Imaging tests create detailed pictures of the inside of your body without surgery. These tests help doctors see where a tumor is located, how large it has grown, and whether it has spread to nearby tissues or other parts of your body. Different imaging tests show different types of information, so you might need more than one test to get a complete picture.^[1]

An MRI scan, which stands for magnetic resonance imaging, uses a powerful magnet, radio waves, and a computer to create detailed pictures of areas inside your body. This test is particularly good at showing soft tissues like salivary glands and can help doctors see the exact size and location of a tumor. The MRI machine looks like a large tube, and you’ll lie on a table that slides inside it during the test.^[4]

A CT scan, also called a CAT scan or computed tomography scan, takes a series of detailed pictures from different angles. A computer links these images together to create a complete view of the area being examined. Sometimes doctors inject a dye into your vein or ask you to swallow it before the scan to make certain organs or tissues show up more clearly in the pictures. This test is excellent for seeing bones and can show whether cancer has spread to nearby structures.^[4]

A PET scan, which stands for positron emission tomography, may be used to look for signs that cancer has spread beyond the salivary glands to other parts of your body. This test can detect areas where cells are more active than normal, which often indicates cancer.^[9]

Biopsy

A biopsy is the only way to know for certain whether a lump is cancerous. During a biopsy, your doctor removes a small sample of tissue from the suspicious area and sends it to a laboratory where specialists examine it under a microscope. This examination tells doctors exactly what types of cells are involved and whether those cells are cancerous.^[1]

To collect the tissue sample, doctors typically use a technique called fine-needle aspiration or core needle biopsy. A thin needle is carefully inserted into the salivary gland to draw out a sample of cells from the suspicious area. This procedure is usually done with local numbing medicine to minimize discomfort. The needle is guided to the right spot, and a small amount of tissue is collected. This sample then goes to the pathology lab where experts can determine whether cancer cells are present and, if so, what type of cancer it is.^[1]

Determining Cancer Spread

If cancer is found, additional tests help determine whether it has spread beyond the original salivary gland. Doctors need to know the stage of cancer, which describes how far it has progressed. Cancer that stays in the salivary gland is easier to treat than cancer that has spread to lymph nodes in your neck or to distant organs like your lungs, bones, or liver.^[1]

These staging tests often involve more imaging scans. Your doctor might order CT scans, MRI scans, or PET scans specifically to look for signs that cancer cells have traveled to your lymph nodes or other organs. The lymph nodes in your neck are examined closely because salivary gland cancer often spreads there first before reaching more distant parts of your body.^[9]

The staging process helps your medical team create the best treatment plan for your specific situation. Stages range from 0 to 4, with stage 0 meaning the cancer is very small and contained only in the gland, and stage 4 indicating that the cancer has grown larger or spread to other areas. Not every person needs every test. Your healthcare team will discuss which procedures are right for you based on your individual circumstances.^[9]

Diagnostics for Clinical Trial Qualification

Clinical trials test new treatments that might help patients with salivary gland cancer. Getting into a clinical trial requires meeting specific criteria to ensure the trial is safe for you and that the results will be scientifically meaningful. Diagnostic tests play a crucial role in determining whether you qualify for a particular study.^[23]

Before you can join a clinical trial, doctors need detailed information about your cancer. This includes knowing the exact type of salivary gland cancer you have, because some trials only accept patients with specific cancer subtypes. For example, some studies specifically focus on adenoid cystic carcinoma, which is one particular type of salivary gland cancer. If your biopsy shows a different type of cancer, that trial wouldn’t be appropriate for you.^[23]

The stage of your cancer also matters for trial eligibility. Some trials are designed for people with early-stage cancer that hasn’t spread, while others specifically study treatments for advanced cancer that has metastasized to other parts of the body. Your imaging tests and staging results help researchers determine if you’re in the right group for their study.^[11]

Clinical trials often require complete documentation of your medical history and current health status. You’ll need results from recent imaging tests, biopsy reports that show what your cancer cells look like under a microscope, and blood tests that show how well your organs are functioning. Trials have safety requirements to protect participants, so your overall health needs to be strong enough to handle the experimental treatment being tested.^[23]

Some trials study whether certain treatments work better for cancers with specific genetic or molecular characteristics. In these cases, additional specialized testing of your tumor tissue might be needed. These tests look at the genes or proteins in your cancer cells to see if they match what the trial is designed to study. This type of detailed analysis helps match you with treatments that are most likely to help your particular cancer.^[23]

Physical examinations and functional assessments are also part of clinical trial qualification. Researchers need to know that you can physically tolerate the treatment protocol and that your major organs are working well enough. This might involve tests of your heart function, kidney function, or liver function, depending on what treatment is being studied and what side effects it might cause.^[11]