Una volta avuta la diagnosi di tumore delle ghiandole salivari è importante comprendere quali possibilità di cura possano essere possibili. I trattamenti a disposizione sono diversi a seconda dei casi e dunque nel dubbio è sempre opportuno parlare con il proprio medico per comprendere meglio ciò che si andrà a fare. In genere per approcciare ad una terapia sarà opportuno affidarsi ad un centro specializzato che si avvale di professionalità diverse e necessarie che lavorano insieme: un otorinolaringoiatra, un chirurgo, un oncologo e un radioterapista. Le opzioni di trattamento per il cancro delle ghiandole salivari sono infatti la chirurgia, la radioterapia, e la chemioterapia, a volte anche in sinergia tra loro.
Chirurgia
La chirurgia è spesso il principale trattamento per i tumori delle ghiandole salivari. Se è operabile, ovvero resecabile completamente, dipende da vari fattori, come la sua diffusione a strutture vicine, le dimensioni, eccetera. Nella maggior parte dei casi, vengono rimossi oltre al cancro anche tutta la ghiandola ed i tessuti circostanti. Prima dell’intervento è importante parlare con il chirurgo anche degli eventuali effetti collaterali. Il tipo di intervento dipende dalla ghiandola salivare interessata. Può essere necessario anche rimuovere i linfonodi.
Radioterapia
La radioterapia utilizza raggi X o particelle ad alta energia per distruggere le cellule tumorali o rallentare la loro crescita.
Può essere necessaria come terapia principale quando un intervento chirurgico non è possibile (da sola o in combinazione con la chemioterapia) oppure dopo la chirurgia per eliminare eventuali cellule maligne. La durata del trattamento e la potenza dei raggi utilizzati cambiano a seconda dei casi. In genere comunque si esegue 5 volte a settimana per 5-7 settimane. E’ una metodica indolore ma con effetti collaterali quali: arrossamento della parte trattata più o meno intenso (tipo scottatura da sole), nausea, vomito e stanchezza. Molto dipende dall’area trattata ed in generale si tratta di disturbi che scompaiono rapidamente. La radioterapia può però danneggiare la ghiandola della tiroide, con effetti invisibili anche per molti mesi o anni. Utili nel follow -up anche gli esami del sangue per controllare la funzionalità tiroidea.
Chemioterapia
La chemioterapia (o chemio) è il trattamento con farmaci anti-cancro somministrati per endovena o per via orale. Non si usa spesso per le ghiandole salivari. A volte si effettua per potenziare l’efficacia della radioterapia in concomitanza con questa, specie in presenza di una diffusione della malattia (metastasi). Alcuni dei farmaci chemioterapici utilizzati per il trattamento di tumori delle ghiandole salivari sono:
- Cisplatino
- Carboplatino
- Doxorubicina (Adriamycin®)
- 5-fluorouracile (5-FU)
- Ciclofosfamide (Cytoxan®)
- Paclitaxel (Taxol®)
- La vinorelbina (Navelbine®)
- Methotrexate
Questi farmaci possono essere usati da soli, ma sono più spesso riportati in combinazioni di 2 o più. Gli effetti collaterali della chemio dipendono dal tipo e dalla dose di farmaci dati oltre che dalla lunghezza della terapia. Possono includere:
- Caduta dei capelli
- Ulcere della bocca
- Perdita di appetito
- Nausea e vomito
- Diarrea o costipazione
- Maggiore probabilità di infezioni (pochi globuli bianchi)
- Ecchimosi o sanguinamento facile (poche piastrine nel sangue)
- Fatica (pochi globuli rossi)
Ci sono spesso modi per ridurre questi effetti collaterali che di solito comunque scompaiono a fine terapia.
Leggi anche:
Tumore ghiandole salivari maligno o benigno? Tutti i tipi
Tumore ghiandole salivari, sintomi e diagnosi
Tumore ghiandole salivari sopravvivenza e cause
Fonte: Cancer.org
Foto: Thinkstock
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