Nasal and sinus cancer
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Nasal and sinus cancer are rare types of head and neck cancer that develop inside the nose or paranasal sinuses.
The space inside the nose is called the nasal cavity. This space warms, moistens and filters air as you breathe in. The bones around the nasal cavity have small hollow spaces in them. These spaces are called paranasal sinuses. The sinuses affect the sound and tone of your voice.
The symptoms of nasal sinus cancer can include:
- a blocked nose, usually only on 1 side, that does not go away
- pressure or pain behind your nose or in your upper teeth
- blood when you blow your nose
- losing your sense of smell.
With certain symptoms, your GP may refer you to see a specialist within 2 weeks.
You can read more about other urgent referral symptoms in our information about the signs and symptoms of head and neck cancer.
Other symptoms include:
- numbness in your cheek, your top lip, your top teeth or the side of your nose
- stiffness or pain in your jaw
- loose teeth in your top jaw
- speech changes
- visual problems
These symptoms can be caused by other conditions, but it is important to have them checked by your doctor. Nasal sinus cancer can be treated more successfully when it is diagnosed early.
We have more information about symptoms of head and neck cancer.
The exact causes of nasal and sinus cancer are not known but there are risk factors that can increase the chances of developing it.
Nasal and sinus cancer is more common in people who handle or breathe in certain chemicals or dust for many years because of their job. These include formaldehyde, wood dust and leather dust.
Smoking tobacco may also increase the risk of nasal and sinus cancer.
Some cases of nasal and sinus cancer may be linked to an infection called human papilloma virus (HPV). HPVs are a group of common infections that can affect areas such as the inside of the mouth, the throat, genital area or anus. Some types of high-risk HPV can increase the risk of certain cancers.
Most people have HPV at some time during their life. But most people with HPV do not develop nasal and sinus cancer.
As with other cancers, nasal and sinus cancer is not infectious and cannot be passed onto other people.
We have more information about the causes and risk factors of head and neck cancer.
You usually start by seeing your GP. If they think your symptoms could be linked to cancer, they will refer you to a specialist head and neck doctor. You will usually see a specialist within 2 weeks. You may see an ear, nose and throat (ENT) specialist.
The specialist doctor will ask you about your symptoms and general health. You may have some of the following tests.
A nasendoscope is a thin, flexible tube with a light and camera on the end. It allows your doctor to look inside your nose and also at the back of your nose and your throat.
To make a diagnosis, your doctor needs to remove a small piece of tissue or some cells (biopsy) from the area that looks abnormal. Your doctor may take a biopsy while they are examining you with the nasendoscope. Or they might arrange for you to have a general anaesthetic to take the biopsy.
A doctor who specialises in analysing cells is called a pathologist. They look at the sample under a microscope to check for cancer cells.
Fine needle aspiration (FNA) of the lymph nodes
You may have a fine needle aspiration to see whether there are any cancer cells in the neck lymph nodes. The doctor passes a fine needle into the lump. They withdraw (aspirate) some cells into the syringe. Sometimes they use an ultrasound scan to help the doctor to guide the needle into the correct area.
We have more information about tests for head and neck cancer.
Further tests for nasal and sinus cancer
These tests may be used to help diagnose nasal and sinus cancer or to check whether it has spread.
Waiting for test results can be a difficult time. We have more information that can help.
The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging.
The grade of the cancer gives an idea how quickly it may develop.
Knowing the stage and grade of the cancer helps your doctors plan the best treatment for you.
The staging systems most often used for nasopharyngeal cancer are the TNM and number staging systems. The number staging system is less commonly used.
TNM staging system
TNM stands for tumour, node and metastases.
T describes the size of the tumour and whether it has grown into nearby tissues such as bones, muscles or nerves. It is numbered between 0 and 4 depending on the size and extent of the tumour.
- T0 means that there are no signs of a tumour, but there may be abnormal cells that are pre-cancerous.
- Tis (carcinoma in situ) means the tumour is in the top layer of cells that line the inside of the nasal cavity and has not grown deeper.
- T1 nasal tumours are small and in one place in the nose and have not spread outside the nasal cavity.
- T2 nasal tumours have spread to parts of the surrounding tissue.
- T3 nasal tumours are larger and have spread further into the surrounding tissue.
- T4 nasal tumours have spread into nearby bones, nerves, tissue or areas of the skull. T4 is divided into T4a and T4b. T4a is less locally advanced than T4b.
N describes whether the cancer has spread to the [lymph nodes].
M describes whether the cancer has spread to another part of the body (called metastatic cancer).
We have more information about staging and grading of head and neck cancer.
Grading of nasal and sinus cancer
The grade describes how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread.
We have more information about grading of head and neck cancer.
Treatment for nasal and sinus cancers include surgery, radiotherapy and chemotherapy. Sometimes immunotherapies may be used.
A team of specialists will meet to discuss the best possible treatment for you. This is called a multidisciplinary team (MDT). Your doctor or specialist nurse will explain the different treatments, any possible side effects and the support you will have.
They will also talk to you about the things you should consider when making treatment decisions before you agree (consent) to have treatment. to have treatment. Your doctor and nurse will give you more information.
Your treatment will depend on:
- the position of the cancer
- the stage and grade of the cancer
- type of cell the cancer started in
- your general health.
You will also usually be given advice about preparing for your treatment (sometimes called prehabilitation). This helps to improve your fitness and diet and help to get you ready mentally before treatment. If you smoke, it can also help you with stopping smoking.
Treatment for nasal and sinus cancer may include:
Surgery is usually the main treatment for nasal and sinus cancer. If the area is small and has not spread, the surgeon may be able to remove just the tumour and a small margin around it.
If the cancer is larger, they may also need to remove nearby areas of tissue or bone affected by the cancer.
Sometimes, they may need to rebuild the area with tissue, skin or bone taken from somewhere else in the body (reconstructive surgery). If the surgeon needs to remove part of the roof of the mouth, they fit a special piece of plastic (obturator) into the missing area. This covers the gap in the roof of the mouth to help you speak and eat.
You may also have some lymph nodes in the neck removed. This is called a neck dissection. It is done when you have surgery to remove the nasal and sinus cancer. This aims to reduce the risk of the cancer coming back.
Depending on your operation, some people may have a feeding tube put in before or during surgery. It can usually be removed once you are able to swallow. If you are likely to need this, your team will discuss it with you before your operation.
We have more information about recovering from head and neck surgery.
Radiotherapy uses high-energy rays to destroy cancer cells. Usually, radiotherapy is given after surgery to reduce the chance of the cancer coming back. It may also be used to treat cancer in the neck or lymph nodes, or to reduce the risk of the cancer coming back in this area.
If tests show that surgery may not be able to remove all the cancer, you may have radiotherapy as the main treatment for nasal sinus cancer. Occasionally, radiotherapy may be given with chemotherapy for some types nasal and sinus cancers. This is called chemoradiation.
Radiotherapy may also be used to control symptoms, such as pain, if the cancer has spread to other areas of the body.
You may have side effects during and for a few weeks after radiotherapy. These usually get better slowly after treatment finishes.
Chemotherapy uses anti-cancer drugs to destroy cancer cells. Chemotherapy may be used if a nasal and sinus cancer has spread or come back after previous treatment. It may occasionally be given with radiotherapy (chemoradiation) for some types of nasal and sinus cancer. The chemotherapy drug most often used to treat nasal and sinus cancer is cisplatin.
Immunotherapies are treatments that use the immune system to find and attack cancer cells. An immunotherapy drug may be used to treat some nasal and sinus cancers in certain situations. Your doctors can tell you if immunotherapy drugs may be helpful in your situation.
You may have some treatments as part of a clinical trial.
After treatment, you will have regular follow-up appointments with your specialist doctor. These may continue for several years. You may also have regular follow-up appointments with your multidisciplinary team (MDT), including,a speech and language therapist (SLT), dietitian, restorative dentist and dental hygienist and sometimes a physiotherapist.
If you have any problems or notice new symptoms between appointments, let your doctor or nurse know as soon as possible.
Long-term or late effects
Some treatment side effects may take a long time to improve after treatment finishes, or they may become permanent. These are called long-term effects. Other side effects can develop months or even years after treatment has finished. These are known as late effects. We have more information about long-term and long-term and late effects of head and neck cancer treatment.
Head and neck cancer and its treatment can sometimes have an effect on your sex life.
If you are worried about this, talk to your doctor or nurse. You can read about things that may help in our information on cancer and sex.
Some cancer treatments can also affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.
We have more information about:
Well-being and recovery
Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes during and after treatment. For example, if you smoke or drink alcohol, it is best to avoid smoking or reduce the amount of alcohol.
Eating well and keeping active can improve your health and well-being. It can also help your body recover. Your dietitian can help with any difficulties you might have with eating after treatment.
We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:
- Call the Macmillan Support Line on 0808 808 00 00.
- Chat to our specialists online.
- Visit our head and neck cancer forum to talk with people who have been affected by head and neck cancer, share your experience, and ask an expert your questions.
Further support and information is available through The Swallows. The Swallows is a national head and neck cancer support charity. It offers support to people affected by head and neck cancer, their carers, friends and relatives.
Below is a sample of the sources used in our nasal and sinus cancer information. If you would like more information about the sources we use, please contact us at email@example.com
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Chris Alcock, Consultant Clinical Oncologist.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.