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Paranasal sinus cancer is a rare type of head and neck cancer. You may find it helpful to read it alongside our general information about head and neck cancers|.
The spaces within the bones behind the nose and cheeks are called the paranasal sinuses. Each space, or sinus, is lined with cells that produce mucus, moisten the air that we breathe and prevent the lining of the nose from drying out. When a person talks, the voice echoes through the sinuses, giving it an individual tone.
Side view of the structures in the head and neck
View a large version of the side view of the structures in the head and neck|
Cancer of the paranasal sinuses is rare in the West, but more common in countries such as Japan or South Africa. About 400 new cases of paranasal sinus cancer are diagnosed in the UK each year.
This type of cancer can occur at any age, but it's very rare in people under 40. It's more common in men than women.
Like many other types of cancer, the exact causes of paranasal sinus cancer are unknown.
People who use snuff for many years, or those who work in the wood or furniture industry and are exposed to wood dust, are more likely to develop paranasal sinus cancer. Smoking and air pollution are also risk factors.
Paranasal sinus cancer is not infectious and can't be passed on to other people. It's not caused by an inherited faulty gene, so the relatives of someone with paranasal sinus cancer aren't more likely to develop it.
The symptoms can vary depending on which sinuses are affected. The most common symptoms include:
Your GP will examine you and arrange for any further tests that may be necessary. You will need to be referred to a hospital specialist for these tests, and for expert advice and treatment.
These may be taken to show the size and position of the cancer, and to check the bones of the face.
A CT scan takes a series of x-rays that build up a three-dimensional picture of the inside of the body. The scan is painless and takes 10-30 minutes. CT scans use a small amount of radiation, which is very unlikely to harm you and won't harm anyone you come into contact with. You will be asked not to eat or drink for at least four hours before the scan.
Before having the scan, you’ll be asked to remove any metal belongings, including jewellery. Some people are given an injection of dye into a vein in the arm. This is called a contrast medium and can help the images from the scan to show up more clearly.
During the test, you will be asked to lie very still on a couch inside a long cylinder (tube) for about 30 minutes. It's painless but can be slightly uncomfortable, and some people feel a bit claustrophobic during the scan. It’s also noisy, but you’ll be given earplugs or headphones.
During this procedure a fine tube with a light at the end (nasendoscope) is guided through the nose into the sinus area. If an abnormal area is seen, a small piece of tissue will be taken to be examined under a microscope for cancer cells (biopsy). This may be carried out under a local or general anaesthetic. This test can be uncomfortable and you may be given an anaesthetic spray beforehand to numb your nose and throat.
You will then be asked not to eat or drink anything for about an hour afterwards, until your throat has lost the numb feeling.
The stage of a cancer is a term used to describe its size and whether or not it has spread beyond its original site. Knowing the particular type and stage of the cancer helps the doctors decide on the most appropriate treatment for you.
The most commonly used staging system is called the TNM system:
The T, N and M will often have numbers attached to describe the detail. For example, a T1 tumour may be very small and just in one layer of tissue, whereas a T4 tumour may be a larger size and spread through several layers of tissue.
The exact details of the T, N and M will depend on the type of cancer.
In addition to TNM staging, you’ll probably hear the doctors use a number staging system. There are usually three or four number stages for each cancer type.
Stage 1 describes a cancer at an early stage when it is usually small in size and hasn’t spread. Stage 4 describes cancer at a more advanced stage when it has usually spread to other parts of the body. Stages 2 and 3 are in between these stages.
The number stages are made up of different combinations of the TNM stages. So a stage 1 cancer may be described as either T1, N0, M0 or T2, N0, M0.
Number stages may also be further subdivided to give more detailed information about tumour size and spread. For example, a stage 3 cancer may be subdivided into stage 3a, stage 3b and stage 3c. A stage 3b cancer might differ from a stage 3a cancer in either the tumour size or if the cancer has spread to lymph nodes.
You may hear other terms used to describe cancer:
Your doctors can give you more information about the stage of your particular cancer.
Grading refers to the appearance of the cancer cells under the microscope and gives an idea of how quickly the cancer may develop.
Low-grade means that the cancer cells look very like normal cells. They are usually slow-growing and less likely to spread. In high-grade tumours, the cells look very abnormal, are likely to grow more quickly, and are more likely to spread.
Paranasal sinus cancers can start in different types of cells within the sinuses. The type of treatment given will depend on a number of things, including the position and stage of the cancer, the type of cancer, the grade and your general health. The following treatments may be used alone or in combination with one another. Your doctor will discuss with you the most appropriate treatment for your situation.
Surgery| may be used, depending on the position of the cancer and whether or not it has spread into the surrounding area of lymph nodes. Surgery can sometimes be quite extensive, and in some cases skin grafts or flaps are needed.
If necessary, modern prostheses (false facial parts) can be used to give a good appearance to your face after the surgery. It can be difficult to prepare for and cope with this kind of surgery. However, help is available from the support organisations listed below.
Radiotherapy| treats cancer by using high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal tissue. Radiotherapy is given from a radiotherapy machine, much like an x-ray machine. It does not make you radioactive.
Sometimes radiotherapy may be given on its own to treat a paranasal sinus cancer (radical radiotherapy).
More commonly it’s given after surgery to reduce the chance of the cancer coming back (adjuvant therapy).
Depending on the type of radiotherapy treatment you receive, you may have some side effects. These may include feeling sick (nausea) and being sick (vomiting)|, eye irritations (conjunctivitis), dry eyes and headaches.
If side effects occur, it’s important to tell your doctor so they can prescribe appropriate medicines. The side effects generally start to reduce a couple of weeks after the treatment has finished.
Hair loss| only occurs where the treatment beam enters and leaves the body. Sometimes hair loss in these areas may be permanent. In many cases, however, the hair will start to grow back a few weeks after the treatment finishes.
Chemotherapy| is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells.
Paranasal sinus cancers are occasionally treated with chemotherapy, either before other treatments or at the same time as radiotherapy treatment (chemoradiation).
You may be asked to take part in a cancer research trial|. For example, you may be offered chemotherapy treatment as part of a trial. Before any trial is allowed to take place it must have been approved by an ethics committee, which checks that the trial is in the interest of patients.
After your treatment is completed you will have regular check-ups and possibly scans or x-rays. These will probably continue for several years. If you have any problems or notice any new symptoms between these times, let your doctor know as soon as possible.
You are likely to experience a number of different emotions|, from shock and disbelief to fear and anger. These feelings may be overwhelming and difficult to control, particularly if you have experienced changes in your appearance and feel self-conscious. These feelings are natural, and it's important for you to be able to express them.
Everyone has their own way of coping with difficult situations. Some people find it helpful to talk to family or friends, while others prefer to seek help from people outside their situation. Some people prefer to keep their feelings to themselves. There is no right or wrong way to cope, but help is there if you need it. You may wish to contact our cancer support specialists| for information about counselling in your area.
Changing Faces| provides free help, support and information for people with a facial disfigurement. Produces a variety of written information.
Let's Face It| provides support, information, social activities and advice on camouflage make-up for people with facial disfigurement.
This information has been compiled using information from a number of reliable sources, including:
Content last reviewed: 1 January 2013
Next planned review: 2015
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.
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© Macmillan Cancer Support 2013
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