Diagnosis
Image credit: Courtesy of The Christie, Manchester
The majority of primary tumours are diagnosed as slow growing lumps. Diagnosis usually takes place using a combination of scans and a biopsy of the tumour.
Difficulty of diagnosis
Salivary Gland Cancers can often be asymptomatic or show symptoms that are confused with other less serious conditions. (You can hear more about ways in which this happens in the ‘Our Stories’ section of the website.) These difficulties in diagnosis can lead to missed opportunities. Delays in diagnosis can mean that the disease is further progressed and if so, that more extensive treatment may be needed.
Professor Ali Khurram, Honorary Consultant Pathologist, University of Sheffield talked about the 'Complexities in Diagnosis' of Salivary Gland Cancers, at one of our gatherings in 2021. You can watch a recording of his talk here.
You can also see a presentation from the SGC UK team at a Pulse 365 Virtual event 'Public Health, Pain and Rare Diseases' in April 2023 here. This was specifically aimed at the Primary Care/General Practitioner ('GP') audience and examples of presentations that they may encounter.
Magnetic Resonance Imaging (MRI)
This is a type of scan that uses strong magnetic fields and radio waves, to manipulate the protons in the water of your body to provide detailed images of your tissues. These scans are used for both diagnosis and monitoring.
The scanner itself is a large tube, which you lie inside. If you are claustrophobic then you should discuss this before the scan. The scans are loud, so you will wear headphones. They take between 15-90 minutes. If you have a metal fitting e.g. pacemaker, you may not be able to have the scan.
MRI scans are readily available on the NHS in centres across the UK.
Positron Emission Tomography (PET)
These scans produce detailed 3-dimensional images and highlight any abnormal areas. By injecting a radiotracer (which is essentially radioactive glucose) into your arm after you have been fasting, and analysing which tissues take up this glucose, cancer cells can be identified. MOST cancer cells take up glucose faster than normal cells and so will ‘light up’ on the PET scan.
One of the problems with diagnosing Adenoid Cystic Carcinoma is that it does not always take up glucose faster than other cells. This means a negative result on a PET scan, doesn’t necessarily mean that ACC tumours aren’t present.
PET scans are readily available on the NHS in centres across the UK.
PET-CT Scan: PET scans are often combined with CT scans to produce even more detailed images.
Computerised Tomography (CT) Scan (aka CAT scans)
This uses X-rays and a computer to create detailed images of your body structures while you pass through a tube. As well as being used for diagnosis, these scans can also be used for planning surgery and radiotherapy treatment or monitoring.
The scan takes around 10-20 minutes and may involve the use of a contrast dye that will be injected in your arm half way through.
CT scans are readily available on the NHS at many centres across the UK.
Biopsy
This is the term used for taking a small sample of tissue from your body for analysis and diagnosis. Where possible, this will be taken without general anaesthetic.