There is no ribbon for salivary-cancer awareness. That's probably because the disease is so rare—fewer than 1 percent of cancer cases attack the salivary glands. But after Beastie Boy Adam Yauch (MCA) revealed that he had recently been diagnosed with the disease, its profile went way up. NEWSWEEK's Matt Berman asked Dr. Otis W. Brawley, chief medical officer of the American Cancer Society, for more information about the ailment. Excerpts below:
How common and threatening is salivary-gland cancer?
Salivary tumors are extremely rare. Using [National Cancer Institute] data from the years 2002 to 2006, malignant salivary tumors had an annualized incidence rate of 1.2 per 100,000 people. Death rates of malignant salivary tumors are 0.2 per 100,000 overall. Eighty-five percent of salivary-gland tumors are parotid [i.e., in the gland were Yauch's tumor is located].
A newly released study commissioned by the Israel Dental Association has found a link between increased cell-phone use and a rise in the incidence of salivary-gland cancer in Israel. Do you think there is anything to this?
They did not find a link, they found a time-wise association. They conclude maybe the increase is due to cell phones. They wrote, “We haven't gathered data on the use of cell phones on the part of the patients, but the rise [in cancer cases] absolutely could indicate increased exposure to cellular telephones and damage caused by radiation.” That is a very weak accusation. Many other things have changed over the past few years. I have seen other cancers flare in incidence because of changes in how a population prepares and stores food, how a population smokes, or even changes in sexual habits. While it is impossible to be definitive, it is still an open question as to whether cell phones cause parotid tumors, and it’s safe to say most epidemiologists with knowledge of the subject doubt that cell phones cause parotid tumors.
Are there any particular causes for the disease?
There is no known reason why people get parotid tumors. They are not associated with the typical head and neck cancer risk factors like smoking, alcohol, and HPV. The only real, established risk factor for parotid tumors is radiation therapy, which is an ionized form of radiation unlike cell-phone radiation. Ionized radiation is used to treat head and neck cancers and, ironically, parotid cancers. There were some folks who are now about 50 to 70 years of age who got radiation to the tonsils in the 1950s and 1960s who are at increased risk of radiation-induced cancer.
What are the different treatment options?
The treatment options depend on whether the cancer is benign or malignant, the stage of the cancer, the type of salivary gland the cancer is in, how the tumor looks under a microscope, and the patient’s age and general health. Some are treated with surgery, others with surgery and radiation therapy.
What are the major symptoms and long- or short-term setbacks related to the cancer?
I worry the most about dry mouth, which is a frequent side effect of surgery and radiation.
How are these cancers discovered?
These cancers are almost always found when the patient notices a lump in the jaw or cheek. Any change on the side of the mouth or face should be reported to one's physician and checked out.
