What is Adenoid Cystic Carcinoma?Adenoid Cystic Carcinoma (or AdCC) is a rare form of adenocarcinoma, which is a term used to describe types of cancer that begin in glandular tissues. The most common place for it to form is within the salivary glands of the head and neck. Other sites of origin include the trachea (windpipe), lacrimal gland (above the eye), breast, skin, and vulva. Adenoid Cystic Carcinoma usually spreads along nerves or through the bloodstream. This can result in it developing in more than one place. It is known to have long periods of little or no growth, followed by aggressive growth spurts. This can make Adenoid Cystic Carcinoma challenging to predict and treat. There are no risk factors associated with AdCC. This means that no one has been able to find a correlation with certain habits/activities and an increased risk of the cancer developing. Although the cause of AdCC is unknown, it appears to develop from non-inherited, genetic changes that occur during a person’s lifetime. These genetic changes are present only in the cancer cells, and are not carried genetically through reproduction.
Symptoms of Adenoid Cystic Carcinoma:The symptoms of Adenoid Cystic Carcinoma largely depend on where the cancer is located. If you are worried, it is always best to have your symptoms looked at by a professional. Early detection of AdCC can make a huge difference. It is also important to remember that Adenoid Cystic Carcinoma comes in many different forms, and there isn’t always a definite list of symptoms for each case. Sailvary glands – For Adenoid Cystic Carcinoma in the salivary glands, an early symptom is small lumps around the mouth or face. Initially, these lumps are usually slow growing and painless. You may notice these lumps underneath your tongue, on the palate (top) of your mouth, or the bottom of your mouth. As Adenoid Cystic Carcinoma develops, these lumps can be accompanied by numbness around your mouth, dull pains, paralysis of facial nerves and increased difficulty speaking or swallowing. Lacrimal glands – The lacrimal glands are located directly above your eyes. If a tumour is developing in the lacrimal gland, you may notice a small lump around your eye. Although these tumours can be slow growing, they can eventually lead to changes or impairments in vision, or proptosis (abnormal displacement of the eye). Larynx and respiratory system – The larynx sits above the windpipe (trachea) in the neck. Symptoms of Adenoid Cystic Carcinoma in the larynx include changes in speech such as hoarseness of difficulty speaking clearly. Tumours can also form in the tracheobronchial tree, which is a set of airways beginning at the larynx and leading to the lungs. This can cause respiratory symptoms, such as difficulty breathing.
Treatment for Adenoid Cystic Carcinoma:Since all forms of cancer are different, a unique plan of treatment is usually necessary for each case. When diagnosed with Adenoid Cystic Carcinoma, your team of doctors will work with you to create a treatment plan. Treatment options and recommendations depend on several factors, including the type and stage of Adenoid Cystic Carcinoma, possible side effects, and your overall health. Ultimately, it will be up to you to decide what kind of treatment you want to receive. It is worth considering all of your options because each treatment has varying side effects, risks and dangers associated with it. Below are some of the most common treatment options:
Surgery:Surgical removal of a tumour is usually the best and most effective type of treatment, as long is it can be done safely with little risk to the patient. During surgery, a surgeon will attempt to remove your tumour and its surrounding tissue. The surgeon should also closely examine surrounding nerves since Adenoid Cystic Carcinoma can spread along nerves. A potential side effect of surgery on the salivary glands is damage to nerves around the mouth. This can affect the function of the facial muscles. For this reason, it is important to talk to your doctor about the risks. In some cases, it will be impossible to remove a tumour via surgery. This is called an inoperable form of cancer. In this case, your doctor will discuss other methods of treatment with you.
Radiation Therapy:Radiation therapy is the use of x-rays or neutrons to target and destroy cancer cells. There are two common forms of radiation therapy. These include external beam therapy and neutron/proton therapy. External beam therapy – For AdCC, external beam therapy is most commonly used after surgery to remove any microscopic cancer cells that remain at the site of a tumour after surgery. This greatly reduces the likelihood of remission. During the process, a radiation oncologist will use a machine which applies radiation to the area of a tumour. The oncologist may create a schedule for you, which consists of several sessions. Side effects of external beam therapy include:
- Reduced amount of saliva (for mouth cancers)
- Scarring or fibrosis (hardening of tissue) around the applied area
- Reduced thyroid function (for thyroid cancers)