How do physicians decide upon treatment protocols?
The National Comprehensive Cancer Network (NCCN) publishes its Clinical Practice Guidelines in Oncology™. These guidelines generally define the “standard of care” for different types of cancer. The preponderance of ACC cases occur in the salivary glands and so guidelines may be found within the Head & Neck Cancer section of the NCCN guidelines. The NCCN practice guidelines for ACC call for surgery, (if possible), followed by radiation. When surgery is not possible, some patients have radiation therapy alone. Neutron beam radiation therapy has been used for some ACC patients – especially those with unresectable tumors. To date, no drugs (chemotherapy regimens) have been found to be effective in preventing the recurrence of ACC and thus chemotherapy is not typically recommended. If complete removal of the tumor is not an option for the primary site; if radiation alone has proved ineffective; or if the cancer has metastasized; then medical oncologists may suggest experimental chemotherapy
