Here we look at the common treatment options for adenoid cystic carcinoma (ACC).
Learn more about:
- Making treatment decisions
- Your healthcare team
- Surgery
- Radiation therapy
- Chemotherapy
- Clinical trials
- Complementary therapies
- Video: What are clinical trials?
- Podcast: Making treatment decisions
Making treatment decisions
It can be difficult to know which treatment is best for you. It is important that you speak with a specialist team before making your decision. Ask them to give you a clear plan of your treatment options, including written information about side effects.
Some people prefer to seek several opinions before feeling confident to go ahead with the treatment. If you are confused or want to check anything, ask your specialist questions. This will make sure you have all the information you need to make decisions about treatment and your future that you are comfortable with.
You may have to attend many appointments. It’s a good idea to take someone with you. They will be able to listen, ask questions and remember what the doctor says. It may help to take a list of questions with you, take notes (especially about anything you are unfamiliar with) or ask the doctor if you can record the discussion (many mobile phones have a recording function or you can use the CAN.recall app. Here are some suggestions for questions you could ask.
Your healthcare team
You will be cared for by a multi-disciplinary team of health professionals during your treatment for ACC.
The team may include a:
- surgeon
- radiation oncologist (to prescribe and coordinate a course of radiation therapy)
- medical oncologist (to prescribe and coordinate a course of systemic therapy including chemotherapy)
- nurse and allied health professionals such as a speech pathologist, dietitian, social worker, psychologist or counsellor and occupational therapist.
Discussion with your doctor will help you decide on the best treatment for your cancer depending on:
- where it is in your body
- whether or not the cancer has spread (stage of disease)
- your age, fitness and general health
- your preferences.
The main treatments include surgery, radiation therapy and chemotherapy. These can be given alone or in combination. Surgical removal of the cancer with follow-up radiation is the standard treatment for ACC where there is a primary tumour.
Surgery
Surgery is usually the most effective treatment for ACC if the cancer can be safely removed. Surgery usually involves removing the cancer and some healthy tissue around the cancer. This is called a wide local excision. The healthy tissue is removed to help reduce the risk of the cancer coming back in that area.
The extent of the operation depends on where the cancer is and how far it has spread. The surgeon will examine nearby nerves and lymph nodes and may remove them if they are involved. It can be a difficult decision to remove nerves, especially major nerves or those that control the face. It is important that your surgery is carried out by a surgeon with special expertise in this area.
For more on this see our general section on Surgery or call Cancer Council 13 11 20.
Radiation therapy
Radiation therapy (also known as radiotherapy) uses high energy rays to destroy cancer cells. It may be used effectively for ACC after surgery, to destroy any remaining cancer cells and stop the cancer coming back. It might also be used alone if surgery is not possible, for example:
- if the cancer is in a place in the body that is too hard to reach using surgery
- if the cancer has spread to other parts of the body (e.g. palliative radiation for the management of pain).
A course of radiation therapy needs to be carefully planned. During your first consultation session you will meet with a radiation oncologist. At this session you will lie on an examination table and have a CT scan in the same position you will be placed in for treatment. The information from this session will be used by your specialist to work out the treatment area and how to deliver the right dose of radiation. Radiation therapists will then deliver the course of radiation therapy as set out in the treatment plan.
Radiation therapy does not hurt and is usually given in small doses over a period of time to minimise side effects.
For more on this see our general section on Radiation therapy or call Cancer Council 13 11 20.
Chemotherapy
Chemotherapy (sometimes just called “chemo”) is the use of drugs to kill or slow the growth of cancer cells. You may have one chemotherapy drug, or a combination of drugs. This is because different drugs can destroy or shrink cancer cells in different ways.
Chemotherapy is not commonly used for ACC. It may be considered when the cancer is advanced as part of palliative treatment or as part of a clinical trial. Your medical oncologist will discuss options with you.
Chemotherapy is given through a drip into a vein (intravenously) or as a tablet that is swallowed. It is given in treatment cycles which may be daily, weekly or monthly. For example, one cycle may last three weeks where you have the drug over a few hours, followed by a rest period before starting another cycle. The length of the cycle and number of cycles depends on the chemotherapy drugs being given.
For more on this see our general section on Chemotherapy or call Cancer Council 13 11 20.
For an overview of what to expect during all stages of your cancer care, visit Guides to Best Cancer Care: Head and neck cancer. Also, visit Julie’s Story for a patient’s treatment journey for head and neck cancer.
Clinical trials
Your doctor or nurse may suggest you take part in a clinical trial. Doctors run clinical trials to test new or modified treatments and ways of diagnosing disease to see if they are better than current methods. For example, if you join a randomised trial for a new treatment, you will be chosen at random to receive either the best existing treatment or the modified new treatment. Over the years, trials have improved treatments and led to better outcomes for people diagnosed with cancer.
You may find it helpful to talk to your specialist, GP, or clinical trials nurse. If you decide to take part in a clinical trial, you can withdraw at any time.
For more information, see Clinical trials and research. To find current clinical trials near you, visit Cancer Institute NSW or Australian Cancer Trials.
You can also contact the Australian and New Zealand Head and Neck Cancer Society who have a special fund to support research into ACC.
Complementary therapies
Complementary therapies are designed to be used alongside conventional medical treatments (such as surgery, radiation therapy and chemotherapy) and can increase your sense of control, decrease stress and anxiety, and improve your mood.
Some Australian cancer centres have developed “integrative oncology” services where evidence-based complementary therapies are combined with conventional treatments to improve both wellbeing and clinical outcomes. Let your doctor know about any therapies you are using or thinking about trying, as some may not be safe.
For more on this see our general section on Complementary therapies or call 13 11 20.
Finding a specialist
- The Australian and New Zealand Head and Neck Cancer Society can be contacted for a directory of specialist teams in ACC care and treatment.
- Rare Cancers Australia have a directory of health professionals and cancer services across Australia.
- The Adenoid Cystic Carcinoma Research Foundation (ACCRF) have a global list of specialists in ACC treatment, including those in Australia.
→ READ MORE: Managing side effects
Video: What are clinical trials?
In this video, Medical Oncologist Dr Elizabeth Hovey explains what clinical trials are and how they can improve cancer treatment.
Podcast: Making Treatment Decisions
Listen to more of our podcast for people affected by cancer
Key resource
The information on this page is also available for download.
A/Prof Dion Forstner, Radiation Oncologist, St Vincent’s Hospital, Sydney, NSW; Nick Kelly, Consumer; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council WA.
View the Cancer Council NSW editorial policy.
