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Cancer Units

Parotid and salivary gland tumors

Salivary gland cancer is a relatively rare pathology, with most cases diagnosed in the parotid salivary glands. The incidence of salivary gland cancer is about 1% of all malignant pathologies and about 3% of head and neck tumors. 

Salivary gland tumors differ in their histological structure. The patient can first notice the presence of benign and malignant tumors when they reach a size of about 0.5 cm.

The most typical clinical manifestations include:

  • Visible or palpable lump near the jaw, inside the neck or mouth
  • Persistent pain in this region
  • Regional face numbness
  • One-sided face muscle weakness
  • Trouble eating solid food, opening the mouth widely
  • Difficulty swallowing

Malignant tumors of the parotid gland look like a solid nodule located on the surface or inside the salivary gland. Such neoplasms grow quite rapidly and have no precise boundaries. The skin above the tumor is also rapidly involved in the process, so a neoplasm becomes immobile. With the formation of the tumor, severe pain arises.

Parotid gland cancer early spreads to the lymphatic nodes. Metastases are detected in the form of a chain of solid lymph nodes in the head and neck region. The metastases are initially mobile, but they can grow quite rapidly and fuse. In these cases, the condition aggravates, and the pain becomes more severe.

Malignant tumors can develop against the background of the following conditions:

  • Chronic inflammation of the parotid gland
  • Sialadenitis
  • Mikulich disease
  • Skin carcinoma
  • Branchiogenic tumors
  • Osteomyelitis of the mandible
  • Chronic lymphadenitis
  • Treatment

Salivary gland cancer therapy includes a combination of surgery, radiotherapy and administration of chemotherapy drugs. Considering the stage of the process, a comprehensive therapeutic regimen is prescribed. 

In most cases, complete removal of the salivary gland with lymph nodes is indicated. Still, there are peculiarities in the surgical treatment of all salivary glands.

The proximity of the facial nerve complicates surgery in the parotid region. The incision is made in the skin in front of the ear and can go all the way down to the neck. Most parotid gland tumors are located in the outer part of the organ called the superficial lobe. They can be treated by removing this area, in which case surgery is called a partial parotidectomy. The facial nerve remains intact in this case. However, if the tumor has spread beyond the gland, the gland must be removed. If cancer has grown into the facial nerve, the nerve is subjected to transection. It is often necessary to remove the lymph nodes in the neck to prevent a recurrence. Lymph nodes dissection is performed when the tumor is large and metastases to the regional lymph nodes are detected.

  • Radiation therapy 

can be performed both before and after surgery. Its main goal is to reduce the neoplasm in size, suppress its metastases, and increase the mobility of the tumor. Radiation therapy after surgery is carried out to destroy the remaining malignant cells, which can lead to a recurrence.

In addition to surgery and irradiation, chemotherapy is performed, especially when it comes to inoperable tumors.

Modern radiotherapy techniques for salivary gland tumors are used as alternatives to conventional radiotherapy, reducing recurrence rates and increasing survival. For example, hyperfractionated radiotherapy as a treatment method for parotid gland cancer allows giving a double daily dose of radiation, reducing the overall treatment duration.

Three-dimensional radiotherapy is another method that can accompany treatment. It uses imaging techniques to precisely affect the tumor. Several beams irradiate the tumor from many sides simultaneously. Each beam is weak and does not damage normal tissue, but a high radiation dose is detected in the area where they converge.

Intensity-modulated radiation therapy is a more advanced technique. A machine with a radiation source moves around the patient during the procedure, irradiating the tumor from all sides. Besides, the irradiation dose and intensity can be adjusted according to the sensitivity of normal tissue. This allows the tumor to be irradiated with a higher dose without affecting healthy organs.

  • Chemotherapy

Chemotherapy is not used as a standard treatment for salivary gland cancer, although scientists are investigating its effectiveness in treating the disease.

Chemotherapy involves the destruction of abnormal cells by particular drugs that are injected into blood vessels or taken like regular pills. They enter the blood and spread throughout the body, thus working against all cancer cells at once. Often, such drugs are prescribed for patients with metastases.

Chemotherapy can shrink the tumor but cannot cure this type of cancer on its own. Some substances increase the effectiveness of radiation therapy and facilitate the destruction of altered cells by radiation. Such therapy is prescribed in cycles, which are necessarily followed by a rest period to allow the body to recover. As a rule, such cycles last from 3 to 4 weeks.

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  • Diagnosis:

The program includes:

  • Initial presentation in the clinic
  • clinical history taking
  • review of medical records
  • physical examination
  • laboratory tests:
    • complete blood count
    • tumor markers
    • inflammation indicators
  • ultrasound of the parotid gland, CT scan, MRI scan (on indication)
  • general otorhinolaryngological examination
  • aspiration biopsy of the tumor (on indication)
  • histological and immunohistochemical examination (on indication)
  • nursing services
  • consultation of related specialists
  • consultation of the chief physician and all leading experts
  • development of individual treatment plan
  • written statement

Required documents

  • Medical records
  • MRI/CT scan (not older than 3 months)
  • Biopsy results (if available)

Price from: On request

Type of program: Outpatient

Expected duration of the program: 5 days

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  • Surgery:

The program includes:

  • Initial presentation in the clinic
  • clinical history taking
  • review of medical records
  • physical examination
  • laboratory tests:
    • complete blood count
    • general urine analysis
    • biochemical analysis of blood
    • TSH-basal, fT3, fT4
    • tumor markers
    • inflammation indicators
    • indicators blood coagulation
  • ultrasound of the parotid gland, CT/MRI scans.
  • general otorhinolaryngological examination
  • preparation according to preoperative standard
  • operation: surgical parotid gland resection with or without neck dissection (as clinically indicated).
  • histologically and immunohistochemically examination
  • control examinations
  • the cost of essential medicines and materials
  • nursing services
  • full hospital accommodation
  • explanation of future recommendations

Required documents

  • Medical records
  • MRI/CT scan (not older than 3 months)
  • Biopsy results (if available)

Price from: on request

Type of program: Inpatient

Expected duration of the program: 7 days

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  • Radiotherapy:

The program includes:

  • Initial presentation in the clinic
  • clinical history taking
  • review of medical records
  • physical examination
  • laboratory tests:
    • complete blood count
    • biochemical analysis of blood
    • inflammation indicators (CRP, ESR)
    • TSH-basal, fT3, fT4
    • indicators of blood coagulation
  • CT simulation and planning of radiation therapy
  • Physics calculations
  • full course of radiation therapy with different modalities (3D, IMRT, VMAT).
  • symptomatic treatment
  • cost of essential medicines and materials
  • nursing services
  • control examinations
  • consultations of related specialists

How program is carried out

During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests and instrumental examinations. After that, you will undergo an additional examination, including complete blood count, laboratory assessment of liver and kidney function. Based on the received results, the physician will conduct radiotherapy planning with the help of CT or MRI, make the permanent tattoo marks on the skin and conduct CT simulation in order to assess the accuracy of the rays and the radiation dose. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).

Radiation therapy is carried out as the day hospital procedure, without mandatory admission to the hospital. At each visit, the physician will assess your general condition and the marks on the skin. After that, you will be placed in a shielded radiation therapy room, on a special table.

Each radiation therapy session lasts less than half an hour (including preparation). All this time, doctors and nurses are monitoring your condition, you can communicate with them through a loudspeaker. The procedure is completely painless. Depending on the planned course of treatment, you will visit the hospital from 1 to 3-5 times a week.

After the completion of the radiation therapy course, you will undergo control examinations aimed at assessing your condition and efficacy of treatment. After that you will receive the medical report with detailed recommendations regarding further follow-up and treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of treatment, if necessary.

Required documents

  • Medical records
  • MRI/CT scan (not older than 3 months)
  • Biopsy results (if available)

Price from: on request

Type of program: Outpatient

Expected duration of the program: 39 days

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  • Chemo-radiotherapy:

The program includes:

  • Initial presentation in the clinic
  • clinical history taking
  • review of medical records
  • physical examination
  • CT /MRI (if indicated clinically) 
  • laboratory tests:
    • complete blood count
    • general urine analysis
    • biochemical analysis of blood
    • tumor markers (If indicated clinically)
    • indicators of inflammation (CRP, ESR)
    • indicators of blood coagulation
  • CT simulation and planning of radiation therapy
  • Physics calculation
  • full course of radiation therapy with different modalities (3D, IMRT, VMAT) according to your treatment plan.
  • individual plan of the chemotherapy, the cost of medicines is included
  • symptomatic treatment (for side effects of chemo and radiotherapy that may developed).
  • cost of essential medicines and materials
  • nursing services
  • control examinations
  • consultations of related specialists
  • explanation of future recommendation

How program is carried out

During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests and instrumental examinations. After that, you will undergo an additional examination, including complete blood count, laboratory assessment of liver and kidney function. Based on the received results, the physician will elaborate the chemotherapy regimen, conduct radiotherapy CT or MRI SIMULATION then planning, make the permanent tattoo marks on the skin to assess the accuracy of the rays and the radiation dose. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).

Chemotherapy and radiation therapy are carried out as the day hospital procedure, without mandatory admission to the hospital. At each visit, the physician will assess your general condition and the marks on the skin. After that, you will be placed in a shielded linear accelerator radiation therapy room.

Each radiation therapy session lasts less than half an hour (including preparation). All this time, doctors and nurses are monitoring your condition, you can communicate with them through a loudspeaker. The procedure is completely painless. Depending on the planned course of treatment, you will visit the hospital from 1 to 3-5 times a week.

Chemotherapy may be through intravenous route according to your treatment plan, during the chemotherapy session, after the placement of a venous catheter, you will stay in a comfortable ward. An infusion system will be connected to the catheter, through which the required drug or a drug combination will be administered. All drugs are administered by intravenous drip, slowly, so the total duration of the infusion can be up to several hours. All this time, doctors and nurses will monitor your health condition closely.

During radiotherapy, you are under close follow-up daily from doctors and nurses.

After the completion of the chemotherapy and radiation therapy course, you will undergo control examinations aimed at assessing your condition and efficacy of treatment. After that you will receive the medical report with detailed recommendations regarding further follow-up and treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of treatment, if necessary.

 

Required documents

  • Medical records
  • MRI/CT scan (not older than 3 months)
  • Biopsy results

Price from: on request

Type of program: Outpatient

Expected duration of the program: 39 days

_______________________________________________________________________________________

  • Chemotherapy:

The program includes:

  • Initial presentation in the clinic
  • clinical history taking
  • analysis of medical records
  • physical examination
  • laboratory tests:
    • complete blood count
    • biochemical analysis of blood
    • tumor markers
    • inflammation indicators
    • indicators of blood coagulation
  • ultrasound scan, CT / MRI scan (if indicated).
  • 1 course of chemotherapy
  • consultations of related specialists
  • symptomatic and specific treatment
  • the cost of essential medicines and materials
  • nursing services
  • control examinations
  • full hospital accommodation
  • recommendations for further treatment

How program is carried out

During the first visit, the doctor will conduct a clinical examination and go through the results of previous laboratory tests. After that, you will undergo an additional examination, including laboratory assessment of liver and kidney function. Based on the received results, the doctor will elaborate the chemotherapy regimen. If necessary, related medical specialists will be involved in the elaboration of a treatment regimen (tumor board).

Chemotherapy is carried out as outpatient according to chemotherapy protocol type. After the placement of a venous catheter, you will stay in a comfortable ward. An infusion system will be connected to the catheter, through which the required drug or a drug combination will be administered. All drugs are administered by intravenous drip, slowly, so the total duration of the infusion can be up to several hours. All this time, doctors and nurses will monitor your health condition closely.

After the course of chemotherapy, you will stay under medical supervision in the ward for a few more hours. After the completion of the chemotherapy course and control examinations you will receive the medical report with detailed recommendations regarding further treatment. In the future, you will be able to have a distant consultation with your attending physician and schedule the next course of chemotherapy, if necessary.

Required documents

  • Medical records
  • Colonoscopy data, MRI/CT scan (not older than 3 months)
  • Biopsy results
  • Any recent laboratory results.

Price from: On request (regarding chemotherapy protocol)

Type of program: outpatient

Expected duration of the program: from 1 to 4 days per cycle (regarding chemotherapy protocol)

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