Imagine that you find a small lump inside your mouth, maybe under your tongue or inside your cheek. It doesn't hurt at all, so you might not pay much attention to it. But even something as small as this is important to be aware of. Today we're going to talk about a type of cancer that can start with symptoms like these, which is a bit rare but we should know about. That's Adenoid Cystic Carcinoma, or ACC.
What exactly is adenoid cystic carcinoma (ACC)?
Simply put, ACC is a very rare type of cancer. It most often starts in the salivary glands in our mouth. Did you know that there are three main types of salivary glands in our mouth?
1. Parotid glands: These are located near the ears, on either side of the cheeks.
2. Submandibular glands: These are located under our lower jaw.
3. Sublingual glands: These are located under the tongue.
ACC cancer most often starts in these glands, but it can sometimes develop in other parts of the mouth, throat, sweat glands, or even tear glands.
One of the unique features of this cancer is that it grows very quickly. So sometimes it can spread to other parts of the body before symptoms appear. And even after treatment and cure, it can recur years later.
What are the symptoms of this?
The main and earliest symptom of ACC cancer may be a painless lump that develops inside the mouth, under the tongue, or inside the cheek. These lumps grow larger and larger. In addition to this main symptom, several other symptoms may be seen.
| Symptom | Description |
|---|---|
| Difficulty swallowing | Feeling like you are choking when swallowing food and drink. |
| Voice change | Voice becoming hoarse or different than usual. |
| Facial numbness or pain | Because this cancer can spread along nerves, some parts of the face may experience numbness or pain. |
| Facial muscle weakness | Feeling like one side of the face is being pulled or having difficulty controlling muscles. |
| Difficulty breathing through the nose | Nasal congestion or nosebleeds. |
If you have any of these symptoms, please don't ignore them. See your family doctor right away. He or she will be able to determine the exact cause.
How do you find this, Doctor?
When you see a doctor, he will first ask you about your symptoms. That is, when did you notice the lump, whether it is growing, whether it is painful, whether you feel any numbness, etc. Then he will carefully examine your mouth, face, and neck. He will also check for any swollen lymph nodes in your neck.
In addition, several tests may be ordered to confirm the diagnosis.
- Imaging Tests: These scans help to determine the exact size of the tumor, its location, and whether the cancer has spread.
- MRI (Magnetic Resonance Imaging): Uses a magnetic field to obtain detailed images.
- CT scan (Computed Tomography): A series of X-rays are collected to create detailed images.
- PET scan (Positron Emission Tomography): Helps identify areas of cancer cells with color images.
- Biopsy: This is the test that is done to 100% confirm whether it is cancer or not. Here, a very small tissue sample is taken from the tumor and examined under a microscope. This is examined by a pathologist.
Why does this kind of cancer develop?
Doctors still don't know the exact cause of ACC, but they believe that this cancer is caused by certain changes (mutations) in our genes.
The important thing is that these genetic changes are not inherited. That is, they are not passed down from parent to child. They are changes that occur randomly during life, perhaps due to things like carcinogens in the environment.
What are the treatments?
The main treatment for ACC is surgical removal of the tumor and surrounding tissue.
1. Surgery
The type of surgery performed depends on the location of the tumor. The affected salivary gland is removed along with the tumor, either in whole or in part. Because ACC cancer can spread along nerves, doctors carefully examine the surrounding nerves during surgery. Sometimes the nerves that control facial movements can be damaged. However, if this happens, advanced surgical techniques such as facial reanimation can be used to restore those nerves to normal function.
2. Radiation Therapy
After surgery, radiation therapy is usually given to kill any remaining cancer cells. Sometimes, this treatment is used when surgery is not possible. However, this treatment can cause side effects such as dry mouth, difficulty swallowing, and tooth damage. Therefore, it is important to work closely with your doctor and dentist during treatment.
3. Other treatments
In some advanced cases, doctors may also consider things like chemotherapy or targeted therapy. These are treatments that are still in the research stage.
What happens after treatment?
ACC is a cancer that has a tendency to recur. Therefore, it is mandatory to attend regular checkups and scans after treatment. According to the doctor, by having these tests done on time, if the cancer recurs, it can be detected and treated at an early stage.
It is important to understand that while there are statistics on survival rates, they are only estimates. Every patient is different, and so are their responses to treatment. Therefore, the best information about your situation can be obtained from the doctor who is treating you.
Take-Home Message
- Adenoid cystic carcinoma (ACC) is a rare type of cancer that develops in the salivary glands.
- The first symptom may be a painless lump inside the mouth or in the neck.
- Also be aware of symptoms such as voice changes, difficulty swallowing, and facial numbness.
- If you have any of these symptoms, don't panic and see a doctor immediately.
- The main treatment is surgery, followed by radiation therapy.
- Even after treatment, cancer can recur, so regular medical checkups are essential.
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