Parotid Tumor Podcast

Parotid Patient Q&A

May 25, 2023 Parotid Patient Project Episode 10
Parotid Patient Q&A
Parotid Tumor Podcast
Chapters
1:16
How easily are lymph nodes distinguished from tumors? What would cause a lymph node to be enlarged within the parotid gland?
3:35
Does age figure into treatment recommendations for parotid tumors?
5:32
What is a myxoid predominant pleomorphic adenoma?
6:37
What medical advances have been made in both the research and treatment of Warthins tumors?
10:08
If a Warthins tumor is difficult to biopsy due to its location, is it better to just have it removed rather than worrying about it growing and getting more involved with the facial nerve even if it is potentially not cancerous?
11:58
Are there any non-surgical or minimally invasive treatments available, such as ablation?
13:19
Can cryoablation be used on tumors that are superficial and benign?
15:30
Is it ever appropriate to use the watch and wait approach for a parotid tumor? How often should it be scanned?
19:00
Are there studies on the efficacy of the combination of chemotherapy along with radiation for mucoepidermoid carcinoma and how can patients be sure this is the right treatment plan for them?
22:23
Why is chemotherapy often recommended along with radiation when patients have malignant tumors?
24:04
How common is it for patients to have recurring malignant tumors?
26:38
Have you seen patients with a good response and some quality of life after using Keytruda?
29:03
If a patient is not producing saliva making it difficult for them to eat, would you recommend a feeding tube to help the patient gain some quality of life?
30:02
Are there are any cases/evidence where a partial superficial parotidectomy and radiation was sufficient to keep a malignant tumor under control?
32:38
What is the chance of recurrence of acinic cell carcinoma in the deep lobe with negative margins after radiation?
33:31
What does an encapsulated carcinoma with 1 mm clear margin mean for the patient?
36:04
Is it normal for the treatment area to be sore and inflamed/swollen five months after the completion of radiation? How long does it typically take to heal?
37:58
Do patients with a high grade Mucoepidermoid Carcinoma located in the deep lobe typically have a good outcome after surgery and radiation?
38:41
In the case of adenoid cystic carcinoma, which invaded the nerve, what kind of radiation would be the best- traditional (photon), proton, or neutron?
41:45
What are the chances of success with facial nerve reconstruction surgery in restoring a patient’s smile, eyelid function, chewing function, and ability to open their mouth if the reconstruction surgery is performed 18 weeks after their initial surgery?
45:20
What is the probability of a recurrence of adenoid cystic carcinoma within 5-10 years after surgery and radiation?
47:22
What can a patient do about such scar tissue that is causing nerve pain and difficulty opening the jaw/ mouth?
49:55
What can be done in terms of ear wax removal for someone who has had radiation, has very hard and dry ear wax, and who has an ear drum perforation?
50:45
Why would a patient’s neck feel swollen and have limited range of motion two years after surgery and are there any potential remedies?
52:12
Should a patient expect their scar to be tender, the nerves in their face to occasionally get numb, or to get phantom feelings for the rest of their life?
54:21
Is there any remedy for seromas developed post-surgery?
56:58
Do patients recover from fluid build-up and leaking from the incision and how long can that process take?
57:49
If the facial/jaw muscle is cut to get the tumor out and/or nerve just moved out of the way, will the smile/lip completely heal and go back to normal?
59:49
Why does the ear become numb post-surgery? Are new techniques being looked at to help minimize the surgical side effects?
1:01:58
Does parotid surgery cause issues with patients’ ears, such as extremely itchy ears, excess fluid, and pulsatile tinnitus?
1:07:38
Any suggestions, recommendations, or ways to manage first bite pain?
1:09:37
Is it true that a high percentage of these tumors come back after being removed (even when encapsulated) and that removing part of, or the full parotid gland is the only way to prevent them from recurring?
1:13:02
Have studies have been done to assess what percentage of patients have a recurrence and what should the follow up plan be post-surgery?
1:16:01
Do you have recommended diet changes for patients to help mitigate recurrence of their benign or malignant tumors?
1:17:38
Is there any new research on causes of parotid tumors?
1:20:41
Is there any new research on preventing a recurrence of parotid tumors?
1:21:52
Are there any new treatments for parotid cancer and Dr. Moore’s thoughts on using the herpes simplex virus as a treatment for recurring malignant parotid tumors?
More Info
Parotid Tumor Podcast
Parotid Patient Q&A
May 25, 2023 Episode 10
Parotid Patient Project

It is parotid patient question and answer day at Parotid Tumor Podcast! Patients often share the same worries, concerns, and experiences as they navigate this diagnosis and treatment process. A great way to educate yourself and to become your own best advocate is by learning through questions that have been asked by fellow parotid patients.  

In this episode, Dr. Eric J. Moore; Chair, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic; Rochester, Minnesota, joins me to answer patient questions on a variety of parotid related topics. Dr. Moore will be sharing important information about benign and malignant masses, treatment side effects, recurrences, current research projects, and much more!

Listen in as Dr. Moore answers excellent questions that were submitted by the parotid community that will help educate and empower patients!

Please refer to the Chapter Markers for time stamps for each patient question.

Key Talking Points of the Episode:

  • Enlarged Lymph Nodes vs. Parotid Tumors
  • Treatment of Warthins Tumors
  • Use of Ablation Techniques for Parotid Tumors
  • Treatment Options for Malignant Parotid Tumors
  • Treatment Side Effects
  • Parotid Tumor Recurrences
  • Parotid Tumor Research and Advanced Treatment Options

Key Quotes from the Episode:

“Individualizing treatment is always a good practice.”

“In this country, we are not very keen on the idea of ablation type treatment, such as radiofrequency ablation or injection ablation of benign tumors in the parotid gland….the two problems with doing that in the parotid gland are one, the uncertainty of diagnosis, so you may potentially be ablating a benign tumor that is actually malignant, and the relationship of the tumor to the facial nerve.”

“Every decision to perform surgery or not to perform surgery or to perform any kind of treatment- I’ll even be more general- is a balance between a risk and benefit ratio.”

“What I usually tell patients is you know you have to go into the treatment having faith in your care providers that they are going to do exactly the right thing that they would want done for them to you, and then you have to have faith and positivity that treatment is going to be effective until proven that treatment is not effective and so having a powerful mindset of positivity I think helps you get through this period of adversity as well as anything.”

 “If the facial nerve is intact, it should go back to normal in almost every single circumstance.” 

“I definitely believe that parotid gland surgery volume leads to experience, which leads to better outcomes.”

“To do research requires core groups and funding and numbers of people and numbers of specimens, and those are lacking in many of the parotid gland tumors, and that’s why there is not a whole lot of beneficial research at the basic science level on genomics and novel targeted therapeutics actively being undertaken in those tumors.”

Connect with Us:

·        Parotid Patient Project

·        Instagram

·        Facebook

·        Twitter

·        Email: podcast@parotidpatientproject.org

Don't forget to like and subscribe to the podcast to stay fully up to date. As always, know that you are not alone in this journey. 



Show Notes Chapter Markers

It is parotid patient question and answer day at Parotid Tumor Podcast! Patients often share the same worries, concerns, and experiences as they navigate this diagnosis and treatment process. A great way to educate yourself and to become your own best advocate is by learning through questions that have been asked by fellow parotid patients.  

In this episode, Dr. Eric J. Moore; Chair, Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic; Rochester, Minnesota, joins me to answer patient questions on a variety of parotid related topics. Dr. Moore will be sharing important information about benign and malignant masses, treatment side effects, recurrences, current research projects, and much more!

Listen in as Dr. Moore answers excellent questions that were submitted by the parotid community that will help educate and empower patients!

Please refer to the Chapter Markers for time stamps for each patient question.

Key Talking Points of the Episode:

  • Enlarged Lymph Nodes vs. Parotid Tumors
  • Treatment of Warthins Tumors
  • Use of Ablation Techniques for Parotid Tumors
  • Treatment Options for Malignant Parotid Tumors
  • Treatment Side Effects
  • Parotid Tumor Recurrences
  • Parotid Tumor Research and Advanced Treatment Options

Key Quotes from the Episode:

“Individualizing treatment is always a good practice.”

“In this country, we are not very keen on the idea of ablation type treatment, such as radiofrequency ablation or injection ablation of benign tumors in the parotid gland….the two problems with doing that in the parotid gland are one, the uncertainty of diagnosis, so you may potentially be ablating a benign tumor that is actually malignant, and the relationship of the tumor to the facial nerve.”

“Every decision to perform surgery or not to perform surgery or to perform any kind of treatment- I’ll even be more general- is a balance between a risk and benefit ratio.”

“What I usually tell patients is you know you have to go into the treatment having faith in your care providers that they are going to do exactly the right thing that they would want done for them to you, and then you have to have faith and positivity that treatment is going to be effective until proven that treatment is not effective and so having a powerful mindset of positivity I think helps you get through this period of adversity as well as anything.”

 “If the facial nerve is intact, it should go back to normal in almost every single circumstance.” 

“I definitely believe that parotid gland surgery volume leads to experience, which leads to better outcomes.”

“To do research requires core groups and funding and numbers of people and numbers of specimens, and those are lacking in many of the parotid gland tumors, and that’s why there is not a whole lot of beneficial research at the basic science level on genomics and novel targeted therapeutics actively being undertaken in those tumors.”

Connect with Us:

·        Parotid Patient Project

·        Instagram

·        Facebook

·        Twitter

·        Email: podcast@parotidpatientproject.org

Don't forget to like and subscribe to the podcast to stay fully up to date. As always, know that you are not alone in this journey. 



How easily are lymph nodes distinguished from tumors? What would cause a lymph node to be enlarged within the parotid gland?
Does age figure into treatment recommendations for parotid tumors?
What is a myxoid predominant pleomorphic adenoma?
What medical advances have been made in both the research and treatment of Warthins tumors?
If a Warthins tumor is difficult to biopsy due to its location, is it better to just have it removed rather than worrying about it growing and getting more involved with the facial nerve even if it is potentially not cancerous?
Are there any non-surgical or minimally invasive treatments available, such as ablation?
Can cryoablation be used on tumors that are superficial and benign?
Is it ever appropriate to use the watch and wait approach for a parotid tumor? How often should it be scanned?
Are there studies on the efficacy of the combination of chemotherapy along with radiation for mucoepidermoid carcinoma and how can patients be sure this is the right treatment plan for them?
Why is chemotherapy often recommended along with radiation when patients have malignant tumors?
How common is it for patients to have recurring malignant tumors?
Have you seen patients with a good response and some quality of life after using Keytruda?
If a patient is not producing saliva making it difficult for them to eat, would you recommend a feeding tube to help the patient gain some quality of life?
Are there are any cases/evidence where a partial superficial parotidectomy and radiation was sufficient to keep a malignant tumor under control?
What is the chance of recurrence of acinic cell carcinoma in the deep lobe with negative margins after radiation?
What does an encapsulated carcinoma with 1 mm clear margin mean for the patient?
Is it normal for the treatment area to be sore and inflamed/swollen five months after the completion of radiation? How long does it typically take to heal?
Do patients with a high grade Mucoepidermoid Carcinoma located in the deep lobe typically have a good outcome after surgery and radiation?
In the case of adenoid cystic carcinoma, which invaded the nerve, what kind of radiation would be the best- traditional (photon), proton, or neutron?
What are the chances of success with facial nerve reconstruction surgery in restoring a patient’s smile, eyelid function, chewing function, and ability to open their mouth if the reconstruction surgery is performed 18 weeks after their initial surgery?
What is the probability of a recurrence of adenoid cystic carcinoma within 5-10 years after surgery and radiation?
What can a patient do about such scar tissue that is causing nerve pain and difficulty opening the jaw/ mouth?
What can be done in terms of ear wax removal for someone who has had radiation, has very hard and dry ear wax, and who has an ear drum perforation?
Why would a patient’s neck feel swollen and have limited range of motion two years after surgery and are there any potential remedies?
Should a patient expect their scar to be tender, the nerves in their face to occasionally get numb, or to get phantom feelings for the rest of their life?
Is there any remedy for seromas developed post-surgery?
Do patients recover from fluid build-up and leaking from the incision and how long can that process take?
If the facial/jaw muscle is cut to get the tumor out and/or nerve just moved out of the way, will the smile/lip completely heal and go back to normal?
Why does the ear become numb post-surgery? Are new techniques being looked at to help minimize the surgical side effects?
Does parotid surgery cause issues with patients’ ears, such as extremely itchy ears, excess fluid, and pulsatile tinnitus?
Any suggestions, recommendations, or ways to manage first bite pain?
Is it true that a high percentage of these tumors come back after being removed (even when encapsulated) and that removing part of, or the full parotid gland is the only way to prevent them from recurring?
Have studies have been done to assess what percentage of patients have a recurrence and what should the follow up plan be post-surgery?
Do you have recommended diet changes for patients to help mitigate recurrence of their benign or malignant tumors?
Is there any new research on causes of parotid tumors?
Is there any new research on preventing a recurrence of parotid tumors?
Are there any new treatments for parotid cancer and Dr. Moore’s thoughts on using the herpes simplex virus as a treatment for recurring malignant parotid tumors?