Nasal and Sinus Cancers

Overview of Nasal and Sinus Cancers

Nasal and sinus cancers are a type of head and neck cancer that occur in the nasal cavity and the sinuses. The nasal cavity is the space just behind your nose where air passes to your throat, and the sinuses are hollow spaces in the bones around the nose. They are filled with air and are connected to the nasal cavity. The sinuses help regulate the temperature and humidity of the air you breathe.

Nasal and sinus cancers can be of various types, depending on the kind of cells they start in. Squamous cell carcinoma is the most common type. It arises from the lining of the nasal cavity or sinuses.

Symptoms of nasal and sinus cancers can vary but often include blockages in one side of your nose that do not clear, nosebleeds, decreased sense of smell, mucus draining from the nose or down the throat, swelling or other trouble with your eyes, pain or pressure in one of your ears, a lump or sore inside your nose that doesn’t heal, and pain or swelling in your face, forehead, or roof of your mouth. A lump in your neck may also be a sign of a sinus or nasal cancer.

The exact cause of these cancers is not known. Still, certain factors can increase the risk of developing these cancers. These include:

• Smoking and use of tobacco
• Exposure to certain chemicals or dust in the workplace, such as wood dust, nickel, or chromium
• Previous radiation therapy to the head or neck

Diagnosing nasal and sinus cancers typically involves a physical examination, imaging tests (like CT scans or MRIs), nasal endoscopy (using a small camera to view the inside of your nose and sinuses), and sometimes a biopsy, where a small tissue sample is taken and examined under a microscope.

The treatment depends on several factors, including the type, size, location of the cancer, and whether it has spread. Common treatments include surgery to remove the tumor(s), radiation therapy, and chemotherapy.

Types of Nasal and Sinus Cancers

Nasal and sinus cancers can be classified based on where they originate and the type of cells involved.

• Squamous cell carcinoma is the most common type of nasal and sinus cancer. It starts in the squamous cells, the thin, flat cells lining the inside of the nasal cavity and sinuses. These cells are part of the epithelium, the tissue covering surfaces and organs throughout the body.
• Nasopharyngeal carcinomas are a subtype of squamous cell carcinoma that arise in the back of the nose, near the adenoid tonsils. The exact cause of this cancer is not fully understood, but it’s linked to genetic factors (most people who contract it are of Asian descent), viral infections (like Epstein-Barr virus), and certain environmental exposures.
• Adenocarcinomas begin in the glandular cells responsible for making and releasing mucus and other substances. This type of cancer is less common and can occur in the sinuses. People exposed to certain types of wood dust are particularly susceptible.
• Melanoma of the nasal cavity and sinuses is rare. Melanoma usually starts in skin cells that produce pigment, but it can also begin in other pigmented tissues, including the lining of the nose and sinuses.
• Sarcomas in the nasal and sinus areas are rare. They can arise from various tissue types, including bone, cartilage, and muscle. The specific type of sarcoma is named after the tissue of origin, such as osteosarcoma (bone) or chondrosarcoma (cartilage).
• Esthesioneuroblastoma, or olfactory neuroblastoma, is a rare cancer that starts in the olfactory nerves, which are involved in the sense of smell. It occurs in the upper part of the nasal cavity.
• Lymphoma can occasionally occur in the nasal cavity and sinuses. However, it’s more commonly found in lymph nodes throughout the body. Lymphomas are cancers of the lymphatic system, part of the immune system.

Each type of nasal and sinus cancer can have different characteristics, treatment options, and outcomes depending on its specific location, size, and spread. Treatment often involves surgery, radiation therapy, chemotherapy, or a combination of these methods.

Here are some of the common signs you might notice:

• Blocked Nose: One side of your nose might always feel blocked or stuffy, making it hard to breathe through that nostril. While a blocked or stuffy nose is exceedingly common and almost always benign, you should consider seeing a doctor if it persists for more than two weeks.
• Nosebleeds: You might have nosebleeds, which could be more frequent than you’re used to.
• Change in Sense of Smell: Your sense of smell might not be as good as it used to be, or you might lose it altogether.
• Mucus Problems: You might notice more mucus running down the back of your throat, or your nose might always feel runny.
• Pain or Pressure: There could be pain or pressure in your sinuses, which are the spaces in your face around your nose, or you might feel pain in your teeth or upper jaw.
• Swelling or Changes in Your Face: You might see or feel swelling around your eyes, under your skin, or in your face that doesn’t go away.
• Vision Problems: In some cases, if the tumor is near your eyes, it might cause vision problems like double vision.

It’s important to remember that these symptoms can also be caused by more common and less serious conditions, like infections or a deviated septum. However, if you notice these symptoms, especially if they last long or worsen, you should check in with a doctor. A specialist can help determine what’s happening and ensure you get the proper treatment.

Treatments for Nasal and Sinus Cancers

When treating nasal and sinus cancers, doctors have several ways to help manage the condition and aim for the best possible outcome.

Radiation Therapy

This treatment uses high-energy beams to target and kill cancer cells. It’s often used when surgery isn’t possible or to eliminate cancer cells that might remain after surgery. Think of it as using a precise laser beam to zap away the bad cells without hurting the good ones around them.

Chemotherapy

Chemotherapy involves using special medicines to fight cancer. These medicines can kill or stop cancer cells from growing and making more cancer cells. Sometimes, chemotherapy is used before surgery to shrink the tumor and make it easier to remove. Other times, it might be used after surgery to catch any cells left behind or treat cancer that has spread.

Targeted Therapy and Immunotherapy

These newer types of treatments work by targeting specific parts of cancer cells or boosting your body’s immune system to help fight the cancer. Targeted therapy looks for specific markers on cancer cells and attacks those. At the same time, immunotherapy helps your immune system recognize and destroy cancer cells more effectively.

Combining Treatments

Often, a combination of these treatments is the best approach. The exact plan will depend on many factors, including the type and stage of the cancer, its location, and your overall health. The goal is always to treat the cancer as effectively as possible while minimizing side effects and preserving essential functions like breathing, speaking, and appearance.