Jane DoeWhat are nasal cavity and paranasal sinus cancers?
To understand these cancers, it helps to know a little about the nasal cavity and paranasal sinuses.
The nasal cavity
The nose opens into the nasal passageway, or cavity. This cavity is a space that runs along the top of the palate (the roof of the mouth, which separates your nose from your mouth) and turns downward to join the passage from the mouth to the throat.
The paranasal sinuses
Sinuses are cavities (spaces) or small tunnels. They are called paranasal because they are around or near the nose.
Normally, these sinuses are filled with air. When you have a cold or sinus infection the sinuses can fill with mucus and pus, often becoming obstructed (blocked) and causing discomfort.
The nasal cavity and paranasal sinuses have several functions:
- They help filter, warm, and moisten the air you breathe.
- They give your voice resonance.
- They lighten the weight of the skull.
- They provide a bony framework for the face and eyes.
Nasal cavity and paranasal sinus cancers
Any of the cells that make up the mucosa can become cancerous, and each type of cancer behaves or grows differently.
- Squamous epithelial cells can become squamous cell carcinomas. This is the most common type of cancer in the nasal cavity and paranasal sinuses. It makes up a little over half of cancers of these areas.
- Minor salivary gland cells can turn into adenocarcinomas and mucoepidermoid cancers. These are the next most frequent type of nasal and paranasal sinus cancers.
- Undifferentiated carcinoma is another type of cancer that can come from mucosa cells. This is a fast-growing cancer in which the cells look so abnormal that it's hard to tell what type of cell the cancer started in.
- Cells that give the skin its tan or brown color are called melanocytes. These cells give rise to a type of cancer called melanoma. This is typically a cancer that can grow and spread quickly.
- Esthesioneuroblastoma is a cancer that starts in the olfactory nerve (the nerve for the sense of smell). This tumor is also known as olfactory neuroblastoma. This type of cancer usually occurs on the roof of the nasal cavity and involves a structure called the cribriform plate. The cribriform plate is a bone deep in the skull, between the eyes, and above the ethmoid sinuses. These tumors can sometimes be mistaken for other types of tumors, like undifferentiated carcinoma or lymphoma.
- Lymphomas (cancers arising from immune system cells called lymphocytes) can also occur in the nasal cavity and paranasal sinuses. One type of lymphoma seen in this area, T-cell/natural killer cell nasal-type lymphoma, was previously called lethal midline granuloma. Information about the diagnosis and treatment of lymphomas can be found in our document, Non-Hodgkin Lymphoma.
- Sarcomas are cancers of muscle, bone, cartilage, and fibrous cells that can start anywhere in the body, including the nasal cavity and paranasal sinuses. Information about sarcomas can be found in some of our other documents.
Symptoms of Nasal Cavity and Paranasal Sinus Cancer
People with nasal cavity and paranasal sinus cancer may experience the following symptoms or signs. Sometimes, people with nasal cavity and paranasal sinus cancer do not show any of these symptoms. In fact, this type of cancer is usually diagnosed in its later stages because early cancer typically does not cause any symptoms. Nasal cavity or paranasal sinus cancer is often discovered when a person is being treated for seemingly benign, inflammatory disease of the sinuses, such as sinusitis. However, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom or sign on this list, please talk with your doctor.
- Nasal obstruction or persistent nasal congestion and stuffiness, which is often called sinus congestion
- Chronic sinus infections that do not respond to antibiotic treatment
- Frequent headaches or pain in the sinus region
- Pain or swelling in the face, eyes, or ears
- Persistent tearing of the eyes
- Bulging of one of the eyes or vision loss
- Decreased sense of smell
- Pain or numbness in the teeth
- Loosening of teeth
- A lump on the face, nose, or inside the mouth
- Frequent runny nose
- Frequent nosebleeds
- Difficulty opening the mouth
- A lump or sore inside the nose that does not heal
- Fatigue
- Unexplained weight loss
- A lump in the neck
Causes of Nasal Cavity and Paranasal Sinuses Cancer
Following are the causes of Causes of Nasal Cavity and Paranasal Sinuses Cancer
- Smoking
- Exposure to some chemicals
- Radiotherapy for hereditary retinoblastoma
Smoking
Smoking tobacco (cigarettes, cigars and pipes) increases your risk of nasal cavity cancer. If you smoke regularly you are at a higher than average risk of developing this type of cancer.
Cigarettes contain nitrosamines and other chemicals that cause cancer. When you smoke, the smoke may pass through your nasal cavity on its way to your lungs. Your risk increases the longer you smoke. If you smoke a lot, you increase your risk even more. If you give up smoking, your risk gradually falls.
Remember - cancers of the nasal cavity are quite rare, even in people who smoke. But if you do smoke, you are much more likely to develop a head and neck cancer than someone who doesn’t.
Exposure to some chemicals
Through your job, you could be exposed to harmful chemicals that can increase the risk of nasal cavity and paranasal sinus cancers. If you have been regularly exposed to wood dust over some years, you may be at an increased risk of adenocarcinomas of the nasal cavity and paranasal sinuses. There is a range of chemicals in treated wood, and we don’t know which ones are responsible for the increased risk. Other substances that have been linked to nasal cavity and paranasal sinus cancer in some studies include
- Leather dust
- Nickel
- Chromium dust
- Formaldehyde - an industrial chemical used to make other chemicals, building materials, and household products
If these irritants are around you, you are likely to breathe in and swallow small amounts. Chemicals in these substances can irritate the lining of your nose, mouth, throat and larynx (voice box).
Radiotherapy for hereditary retinoblastoma
A long term follow up study has shown a greatly increased risk of nasal cancer in people treated with radiotherapy for hereditary retinoblastoma. There is no increased risk if the retinoblastoma was not hereditary.
After your cancer is diagnosed and staged, your cancer care team will discuss your treatment options with you. Choosing a treatment plan is an important decision, so it is important to take time and think about all of the choices.
In creating your treatment plan, the most important factors to consider are the type, location, and the stage (extent) of the cancer. Your cancer care team will also take into account your general state of health and your personal preferences.
Treatment for nasal cavity or paranasal sinus cancer may include:
- Surgery
- Radiation therapy
- Chemotherapy
Surgery
Surgery (removing the cancer in an operation) is a common treatment for all stages of paranasal sinus and nasal cavity cancer. A doctor may remove the cancer and some of the healthy tissue and bone around the cancer. If the cancer has spread, the doctor may remove lymph nodes and other tissues in the neck.
Even if the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. The total dose of radiation therapy is sometimes divided into several smaller, equal doses delivered over a period of several days. This is called fractionation. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
External radiation therapy to the thyroid or the pituitary gland may change the way the thyroid gland works. The thyroid gland may be tested before and after treatment.
Chemotherapy
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Combination chemotherapy is treatment using more than one anticancer drug.
Lifestyle changes after Nasal Cavity and Paranasal Sinuses Cancer
You can't change the fact that you have had cancer. What you can change is how you live the rest of your life -- making choices to help you stay healthy and feel as well as you can. This can be a time to look at your life in new ways. Maybe you are thinking about how to improve your health over the long term. Some people even start during cancer treatment.
Making healthier choices
For many people, a diagnosis of cancer helps them focus on their health in ways they may not have thought much about in the past. Are there things you could do that might make you healthier? Maybe you could try to eat better or get more exercise. Maybe you could cut down on the alcohol, or give up tobacco. Even things like keeping your stress level under control may help. Now is a good time to think about making changes that can have positive effects for the rest of your life. You will feel better and you will also be healthier.
Eating better
If treatment caused weight changes or eating or taste problems, do the best you can and keep in mind that these problems usually get better over time. You may find it helps to eat small portions every 2 to 3 hours until you feel better. You may also want to ask your cancer team about seeing a dietitian, an expert in nutrition who can give you ideas on how to deal with these treatment side effects.
One of the best things you can do after cancer treatment is put healthy eating habits into place. You may be surprised at the long-term benefits of some simple changes, like increasing the variety of healthy foods you eat. Getting to and staying at a healthy weight, eating a healthy diet, and limiting your alcohol intake may lower your risk for a number of types of cancer, as well as having many other health benefits.
Rest, fatigue, and exercise
If you were sick and not very active during treatment, it is normal for your fitness, endurance, and muscle strength to decline. Any plan for physical activity should fit your own situation. An older person who has never exercised will not be able to take on the same amount of exercise as a 20-year-old who plays tennis twice a week. If you haven't exercised in a few years, you will have to start slowly – maybe just by taking short walks.
If you are very tired, you will need to balance activity with rest. It is OK to rest when you need to. Sometimes it's really hard for people to allow themselves to rest when they are used to working all day or taking care of a household, but this is not the time to push yourself too hard. Listen to your body and rest when you need to. (For more information on dealing with fatigue, please see Fatigue in People With Cancer and Anemia in People With Cancer.)
Keep in mind exercise can improve your physical and emotional health.
- It improves your cardiovascular (heart and circulation) fitness.
- Along with a good diet, it will help you get to and stay at a healthy weight.
- It makes your muscles stronger.
- It reduces fatigue and helps you have more energy.
- It can help lower anxiety and depression.
- It can make you feel happier.
- It helps you feel better about yourself.
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