Nasal & Paranasal Sinus Cavity Cancer

Cancer of the paranasal sinus and nasal cavity starts in the tissues in the small hollow spaces around the nose, known as the paranasal sinus and nasal cavity. These cancers are grouped because they are so close to one another.

The sinuses are the open spaces and tunnels around and behind your nose. Cancer can start in the cells of the membranes, bones or nerves that line the paranasal sinuses.

How Common is it?

According to the American Cancer Society, cancers of the nose and sinus cavity cancer are rare, as they make up about 3% to 5% of all head and neck cancers in the United States.

The immediate cause of cancer in all cases is abnormal cells dividing themselves into more abnormal cells over and over again until they form a cancerous tumor mass. For nasal and paranasal sinus cancer there are certain environmental risk factors or conditions that can cause damage to the cells in this area of the body.

Several risk factors may increase your chance of developing cancer of the nasal cavity and paranasal sinuses, including:

• Exposure to dust from wood, leather, flour, textile, nickel or chromium.

• Exposure to industrial chemicals at work.

• Human papillomavirus (HPV) infection.

• Exposure to radium.

• Smoking.

• Gender–nose and sinus cavity cancer is more common in men than women.

• Age–the American Cancer Society reports that 80% of people diagnosed with nose and sinus cavity cancer are above the age of 55.

While the causes of all types of cancer are generally unknown, prolonged exposure to certain chemicals, materials or other illnesses can increase the risks of DNA damage and abnormal cell division thereafter, which is where cancer starts.

Early symptoms of nose and sinus cavity cancer can look like symptoms of colds or infections. Early symptoms include:

• Blockage of sinuses, or congestion that doesn't go away or gets worse.

• Blockage of one side of your nose.

• Changes in your voice or breathing.

• Reduced or loss of sense of smell.

• Headaches.

• Numbness or pain in your face, eyes, ears or teeth.

• Teeth that become loose.

• Pus draining from your nose or postnasal drip.

• Frequent nosebleeds.

• Growth on your face or the roof of your mouth (palate).

• Eyes that continuously water.

• Bulging eyes.

• Loss of or vision change.

• Hearing loss.

• Trouble opening your mouth.

These symptoms will most likely be caused by other health problems, but it’s important to see a healthcare provider if you experience these symptoms. Only a healthcare provider can determine if you have cancer.

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse.

• Signs of an infection, such as a fever.

• Side effects of treatment that affect your daily function or don't get better with treatment.

Ask your healthcare provider what signs to watch for and when to call. Make sure you understand how to get help after office hours and on weekends and holidays.

If your provider thinks you may have cancer of the nose and sinus cavity, you will be referred to an otolaryngologist, who specializes in diseases of the ear, nose and throat.

Your otolaryngologist will talk with you about your health history and do a physical exam. The physical exam will include looking at your eyes, ears, nose, mouth, face, neck and throat. Any details you can provide about your symptoms can help with the diagnosis. This includes details about pain, such as is it sharp, burning, dull or achy, where it is and when you have it.

Your doctor might perform an endoscopy of your nasal and sinus cavities. This is a procedure in which a thin, flexible tube with a tiny light and a video camera on the end is put into your nasal and sinus passages– looking inside will help your doctor figure out the location and size of the tumor. Your otolaryngologist may refer you to another more specialized head and neck surgeon, medical oncologist, or radiation oncologist to help with your care.

Your doctor might also order these tests:

• Blood tests.

• Imaging tests of your skull, such as X-rays, CT scans or MRI of the nasal cavities and sinuses.

• Imaging tests of your chest.

• Biopsy.

Usually, a biopsy is needed to determine if the tumor is cancerous. A biopsy is when small pieces of tissue are taken from the tumor. These samples can be removed with a needle and checked under a microscope to see if there are cancer cells.

You will not know for sure if the tumor is cancer until after the biopsy results are finalized. The additional tests can help determine the stage of the cancer. The stage is how much and how far the cancer has spread (metastasized) in your body. It’s one of the most important things to know when deciding how to treat cancer.

Once your cancer is staged, your healthcare provider will talk with you about what the stage means for your treatment. Be sure to ask your healthcare provider to explain the stage of your cancer to you in a way you can understand.

Specific treatment for nose and sinus cavity cancer will be determined by your physician based on:

• Type, size and location of the tumor.

• Test results.

• Stage of the disease.

• Your overall health.

• Your age.

• Your personal needs and concerns.

• Side effects you find acceptable.

Types of treatment for nose and sinus cavity cancer include:

• Surgery.
• Radiation Therapy.
• Chemotherapy.
• Immunotherapy.

Talk with your healthcare providers about your treatment options and make a list of questions. Think about the benefits and possible side effects of each option. Discuss your concerns with your healthcare provider before making a decision.

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of the below:

• New symptoms or symptoms that get worse.
• Signs of an infection, such as a fever, if you are currently receiving treatment.
• Side effects of treatment that affect your daily function or don't get better with treatment.

Ask your healthcare provider what signs to watch for, and when to call. Know how to get help after office hours and on weekends and holidays.

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you may have. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are some tips:

• Talk with your family or friends.

• Ask your healthcare team or social worker for help.

• Speak with a counselor.

• Talk with a spiritual advisor, such as a minister or rabbi.

• Ask your healthcare team about medicines for depression or anxiety.

• Keep socially active.

• Join a cancer support group.

Cancer treatment is hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with as many protein rich foods as possible.

• Drink plenty of water, to stay hydrated.

• Keep physically active.

• Rest as much as needed.

• Talk with your healthcare team about ways to manage treatment side effects.

• Take your medicines as directed by your team.

Ask your healthcare provider what signs to watch for, and when to call. Know how to get help after office hours and on weekends and holidays.

What is the survival rate for nasal cavity and paranasal sinus cancer?

Prognosis, or survival, is different for each person and may also depend on the stage of the cancer diagnosis and the quality of care a person will receive. It is best to ask your Head and Neck Cancer specialist about this information for you specifically.

UC Health and the University of Cincinnati Cancer Center are the region's only adult academic medical center, meaning we are the best equipped to care for you or your loved one who is dealing with a nasal cavity cancer diagnosis.

With access to innovative treatment technologies powered by fellowship trained head and neck cancer physicians, a life-saving second opinion is just a phone call away.