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What Tony Gwynn's Story Can Help Us Understand About Salivary Gland Cancer

The Hall of Fame baseball player died of salivary gland cancer in 2014. Here is what that kind of head and neck cancer means, explained calmly and simply.

By Cancer Explained Editorial TeamPublished Updated

A plain-language summary based on public reporting and trusted sources, linked below.

An older woman cooks or prepares food alone in a kitchen
An older woman cooks or prepares food alone in a kitchen — illustrative photograph, not of anyone named in this story.

Please note: this page is educational only — it is not medical advice, and it does not speculate about anyone’s health beyond reliable public reporting. For questions about your own health, talk with your healthcare team.

What Tony Gwynn said, and when

In October 2010, the Hall of Fame outfielder Tony Gwynn told the San Diego Union-Tribune that he had cancer in his parotid gland, one of the salivary glands. He was 50. He said the cancer was found during a third operation on that gland.

"I had surgery for a parotid tumor in 1997 and again three years ago and both those times there was no cancer," he told the paper. "But this time they found a malignancy. They took out three lymph nodes and did all the tests and the results showed cancer in the parotid." He said he would start radiation and planned to keep coaching at San Diego State.

Gwynn died in June 2014, at 54. He had taken a leave from coaching that April for cancer treatment. He said publicly that he believed years of chewing tobacco had caused his cancer.

Nobody can confirm what caused one person's tumor, and the science here is more limited than the headlines suggested. The rest of this page explains what is actually known.

What the salivary glands are

You have three pairs of major salivary glands. The parotid glands sit in front of and just below each ear. The submandibular glands sit under the jaw. The sublingual glands sit under the tongue. Hundreds of minor glands line the mouth, palate and throat.

Salivary gland tumors are rare. From 2018 to 2022 the rate of new salivary gland cancers in the United States was 1.3 per 100,000 people a year. They make up about 3 to 5 percent of all head and neck cancers.

Most salivary tumors are not cancer at all. More than half are benign. Between 70 and 80 percent start in the parotid, and only about 20 to 25 percent of parotid tumors turn out to be malignant. The odds flip at the other end: more than 90 percent of sublingual gland tumors are malignant.

Nearly 40 kinds under one name

NCI calls salivary gland tumors the most varied group of tumors found in any tissue in the body. Almost 40 types exist. The most common malignant one is mucoepidermoid carcinoma, which accounts for roughly 35 percent of malignant salivary tumors and most often appears in the parotid.

Because the types differ so much, NCI advises patients to ask that their tissue be checked by a pathologist experienced with salivary gland tumors. This is one of the few cancers where NCI says that outright.

How it shows up

Most parotid tumors, benign or malignant, appear simply as a lump that does not hurt. That is why the warning signs that carry real weight are the neurological ones. Numbness or weakness caused by nerve involvement usually points to cancer. Facial nerve weakness with a parotid or submandibular tumor is a serious sign. Persistent facial pain strongly suggests malignancy, though only 10 to 15 percent of malignant parotid tumors cause pain.

When to get checked

NCI says to see a doctor about any of these if they do not go away:

  • A lump, usually painless, near the ear, cheek, jaw, lip or inside the mouth.
  • Fluid draining from the ear.
  • Trouble swallowing, or trouble opening the mouth wide.
  • Numbness or weakness in the face.
  • Face pain that does not settle.

A lump you can feel in front of the ear that has been there more than two to three weeks deserves an appointment, even without pain. Salivary gland cancer often causes no symptoms at all and is sometimes spotted at a routine dental check-up, which is one more reason to keep those.

Getting to a diagnosis

Imaging comes first: MRI, CT, sometimes PET. An endoscope may be passed through the mouth to look at the throat and voice box.

The usual biopsy is fine needle aspiration, in which a thin needle draws out cells or fluid. If that does not settle the question, a surgeon may take part of the lump, or remove the whole mass so it can be examined. Grade, meaning how abnormal the cells look, is worked out at the same time as the type.

What treatment involves

Surgery is the backbone. NCI states that early-stage, low-grade salivary gland cancers are usually curable by adequate surgical removal alone. Large or high-grade tumors are often treated with surgery plus radiation afterward, and radiation can improve local control and survival when clean margins cannot be achieved. Tumors that cannot be removed, or that come back, may respond to chemotherapy or to specialized radiation.

Two complications of parotid surgery are worth knowing about in advance. One is facial nerve dysfunction, because the facial nerve runs directly through the parotid gland. The other is Frey syndrome, in which the face flushes and sweats while eating. Botulinum toxin injections have treated it successfully.

What shapes the outlook

NCI lists the gland the tumor started in, the tissue type, the grade, the size and extent of the tumor, and whether it involves the facial nerve, is stuck to skin or deeper structures, or has reached lymph nodes or distant sites. Tumors in a major gland do better than those in minor glands, with the parotid the most favorable site. Overall, stage — especially tumor size — may matter more than grade.

What this does not mean

NCI is direct: for most salivary gland cancers, the cause cannot be determined. Ionizing radiation has been implicated. Certain jobs carry raised risk, including rubber manufacturing, asbestos mining, plumbing and some woodworking.

Smokeless tobacco is genuinely dangerous. NCI says at least 28 chemicals in it cause cancer, and that it causes oral, esophageal and pancreatic cancer. But salivary gland cancer is not on that list, and NCI's salivary gland summary does not name tobacco as a risk factor. Gwynn's belief about his own illness was sincere, and it moved players to quit dipping. It is not, on its own, evidence of cause. Both of those things can be true.

Our pages on salivary gland cancer and head and neck cancer go into the types in more detail, and emotions and cancer covers the waiting that comes with a rare diagnosis.

Sources

An AI-assisted editorial system helped prepare this page. No named medical reviewer has reviewed it unless one is listed.

See an error, old source, or unclear wording? Tell us.

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Put the story in context

Prevention, possible warning signs, screening, and diagnosis

This story relates to Salivary gland cancer (head and neck cancer). The information below is general: it does not reveal anything else about a public person’s health, and not every point applies to every cancer. Personal advice depends on age, symptoms, family history, exposures, and medical history.

  • Prevention and risk reduction

    Not every cancer can be prevented. Avoiding tobacco, protecting skin from ultraviolet radiation, limiting alcohol, staying active, and receiving recommended HPV or hepatitis B vaccination can lower the risk of certain cancers. A risk factor is not a prediction or a cause in one individual.

    NCI prevention information

  • Symptoms and possible early signs

    Possible signs vary and are often caused by conditions other than cancer. Changes worth discussing include a new lump, unexplained bleeding or weight loss, a persistent cough, lasting bowel or bladder changes, a changing skin spot, or symptoms that persist or worsen. Some early cancers cause no symptoms.

    NCI signs and symptoms

  • Screening and early detection

    Screening looks for certain cancers before symptoms begin. Recommended tests exist only for some cancers and depend on age and risk. Screening can have benefits and harms; it is not the same as evaluating a new symptom, and there is no single routine scan or blood test that reliably screens for every cancer.

    NCI cancer screening information

  • How cancer is diagnosed

    Diagnosis may involve a history and exam, imaging, laboratory tests, and often a biopsy. Pathology can identify the cancer type and may test biomarkers that guide treatment. Symptoms, screening results, tumor markers, or online stories alone cannot confirm cancer.

    NCI diagnosis information

A public story may encourage questions, but it should not be used to estimate your risk or choose testing. Contact a healthcare professional about a persistent or concerning change. Seek urgent care for severe or rapidly worsening symptoms.

Go deeper with NCI