About nasal and sinus cancers:Nasal and sinus cancers are diseases in which malignant (cancer) cells form in the tissues of the paranasal sinuses and nasal cavity. Cancers of the nasal cavity and paranasal sinuses are rare, with about 2,000 cases in the United States each year. This type of cancer is prone to spreading through the lymph system or blood. This can cause it to begin growing in other areas of the body such as the lungs. The earlier cancer diagnosed, the easier it is to stop the spread of cancer cells. Paranasal sinus and nasal cavity cancers can often be caused by prolonged exposure to hazardous chemicals or dust. For this reason, people who work around these materials are at a much higher risk.
Types of nasal and sinus cancers:There are several different forms of cancer that can develop in the nasal cavity and sinuses. These include:
- Squamous cell carcinoma – The most common form of nasal/sinus cancer. This type of carcinoma forms in squamous cells, which line the sinuses and nasal cavity.
- Melanoma – A form of cancer that occurs in the skin cells of the nose.
- Sarcomas – A form of cancer that occurs in muscles and other connective tissue that surrounds the nose or sinuses.
- Inverting papilloma – A benign (non-cancerous) tumour that forms inside the nose. Sometimes, these tumours can turn into cancer.
Causes and risk factors for nasal/sinus cancers:There are several common risk factors associated with nasal and sinus cancer. A risk factor is something that increases the likelihood of cancer occurring. However, risk factors do not guarantee that nasal or sinus cancers will form. Common risk factors include:
- Exposure to hazardous chemicals – People who regularly handle or breath chemicals such as chromium, nickel, or formaldehyde are at a much higher risk of developing cancer in their nose or sinuses.
- Constant exposure to wood dust – People who work around wood are at an increased risk of developing nasal/sinus cancers. This may include people who work in carpentry, furniture making and sawmill work.
- Smoking – Tobacco smokers may be at an increased risk of developing nasal/sinus cancers.
- HPV – Human papillomavirus infection (HPV) is the most common sexually transmitted infection (STI). People who have had HPV may be at a slightly higher risk.
How are nasal and sinus cancers diagnosed?When you see a doctor, they will usually conduct a physical examination. This will often involve blood tests, asking questions about symptoms and physically examining the nose and sinuses. Following a physical examination, a doctor may recommend one or more of the following:
- X-rays or MRI – Imaging techniques such as x-rays and MRIs may be used to examine the suspected tumour more closely. These tests may also be used to look around other parts of the body and identify any cancer that has spread.
- Biopsy – A biopsy is when some tissue is removed from the source of a suspected tumour to test for abnormalities. For nasal cancers, the doctor will often use a thin needle to remove tissue and examine it under a microscope for signs of cancer.
- Nanoscopy – A nanoscopy is when a thin, tube-like instrument is inserted into the nose. The instrument will have a light and a leans, allowing doctors to get a better view. A special part of the tool may be used to remove tissue for sampling (see Biopsy above).
Symptoms of nasal and sinus cancer:There are several common symptoms associated with nasal and sinus cancer. In the early stages, there may be no signs at all. The symptoms will usually become more noticeable as the tumour starts to grow. If you notice any symptoms and are concerned, it is always best to see a doctor as soon as possible. Early diagnosis will allow doctors to treat cancer more effectively. Common symptoms include:
- Nosebleeds – Nasal/sinus cancers can make your nose bleed. You may notice blood when you blow your nose, or it may bleed on its own.
- Blocked or painful sinuses – You may experience blocked sinuses that do not clear over time. This can often be accompanied by pain, pressure and headaches around the sinus areas.
- A lump or sore – A common sign of a tumour is a lump or sore that does not heal and grows in size over time. These lumps can be noticed inside or around the nose, or on the roof of the mouth.
- Facial swelling – Sufferers of nasal cavity/sinus cancer may experience swelling around their nose and eyes. This swelling can lead to other symptoms, such as facial numbness and double vision
- Ear pain – Blocked sinuses can lead to noticeable pain or pressure from inside the ear.
Treatment options for nasal and sinus cancers:The recommended treatment for nasal and sinus cancer varies depending on the location, stage and size of the tumour. Doctors will aim to treat cancer as effectively as possible while minimising any damage to the nose, mouth or face. Below are the most common treatments for nasal cancer:
Surgery:Surgery is the most common form of treatment for nasal and sinus cancers. During surgery, surgeons will attempt to remove as much of the tumour as possible while preserving the nose and other facial features. If the tumour has spread, the surgeons may have to remove the surrounding tissue or bone that has been affected by cancer. DEpending on the location of the tumour surgical removal may affect certain facial functions. This can lead to changes in appearance or affect vision, speech or swallowing. Following surgery, treatment may continue to reduce the risk of cancer reoccurring. This may be in the form of radiation therapy of chemotherapy.
Radiation therapy:Radiation therapy is when a radiation oncologist uses radiation to target and destroy cancer cells. It is often used pre-surgery to weaken cancer cells or post-surgery to prevent cancer from reoccurring. The way radiation therapy is administered varies depending on the stage, type and size of the tumour. External beam therapy is the most common form of radiation therapy. It is when a machine is used to target cancer cells with radiation. Sometimes, a doctor will use internal radiation therapy, which is when radioactive substances are administered via a needle around the area of the tumour. Radiation therapy may cause side effects. These can include:
- Red and irritated skin around the targeted area
- Tiredness and fatigue
- Loss of hair around the targeted area
Chemotherapy:Chemotherapy is the use of drugs to target and destroy cancer cells, or prevent them from growing. It is often used post-surgery to reduce the likelihood of cancer reoccurring. The type of drugs and frequency of chemotherapy varies depending on the size, location and stage of cancer. Chemotherapy is administered either orally or intravenously throughout several sessions. This gives the body time to recover from the side effects. Common side effects associated with chemotherapy include:
- Fatigue and tiredness
- Nausea or vomiting
- Loss of hair
- Increased risk of infection