His name was MCA, a founding member of the Beastie Boys. Adam Yauch died this week of parotid cancer which had been diagnosed originally in 2009. He was 47 years old. For those who loved the band, this “Ill Communication” was shocking. Many fans, themselves in their 40s, are asking, “What is cancer of the parotid gland?”

The parotid gland is one of a group in the head and neck area called salivary glands. Together they act to produce saliva and break down food for digestion. The pair of parotid glands are located where the back of the jawbone meets the front of each ear. We all have major and minor salivary glands, the largest of which is the parotid.

Most “head and neck cancers” are of a type called squamous cell (HNSCC). As a group, head and neck cancers are fairly common, diagnosed in roughly 40,000 patients per year in America: http://thecancermd.com/2012/04/13/top-3-causes-of-head-and-neck-cancer-in-2012/.  However, salivary gland cancers are a minority (only about 3%) of these diagnoses and are rarely of the squamous cell type. In the parotid gland specifically, the most common tumor is called a pleomorphic adenoma and is generally benign (not cancerous). The most common malignant (cancerous) tumor in the parotid is called a mucoepidermoid cancer. Unlike HNSCC, these cancers are not caused by smoking, drinking, or the human papillomavirus (HPV). The most common symptom of parotid tumors is a painless lump. Occasionally, patients can also develop numbness or pain related to the facial nerve that runs through the parotid gland: .http://www.cancer.gov/cancertopics/pdq/treatment/salivarygland/HealthProfessional/page1 

Apparently, Adam Yauch’s cancer was not only malignant (probably mucoepidermoid) but also high grade, meaning that the cancer cells were particularly aggressive. Generally, in this situation, the optimal treatment involves a combination of surgery followed by radiation therapy (RT). The potential benefit for chemotherapy delivered concurrently (at the same time) as RT for patients with high-risk salivary gland cancer is being actively studied: http://www.cancer.org/Cancer/SalivaryGlandCancer/DetailedGuide/salivary-gland-cancer-treating-chemotherapy.  

The Beastie Boys have been a powerful musical force for the past 30 years, recently inducted into the Rock & Roll Hall of Fame. Sadly, Adam Yauch missed the ceremony due to his illness. I have many fond memories listening to them in the late ’80s and 90′s, after learning to appreciate rap orignals by the likes of Grandmaster Flash and the Sugar Hill Gang. “License to Ill” will forever remain a classic. Adam Yauch was a major part of those fond memories for me and many of my generation. Here’s hoping he’s somewhere now sippin’ “the def ale with all the fly women!”

- Patrick Maguire MD (thecancermd.com)