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Nasal Cavity and Paranasal Sinus Cancer - Introduction

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will find some basic information about these diseases and the parts of the body they may affect. This is the first page of Cancer.Net’s Guide to Nasal Cavity and Paranasal Sinus Cancer. To see other pages, use the menu. Think of that menu as a roadmap to this full guide.

About the nasal cavity and paranasal sinuses

The nasal cavity is the space just behind the nose where air passes on the way to the throat. The paranasal sinuses are air-filled areas that surround the nasal cavity. The paranasal sinuses include:

  • Maxillary sinuses, located in the cheeks

  • Ethmoid sinuses, located on the bridge of the nose between the eyes

  • Frontal sinuses, located above the eyes

  • Sphenoid sinuses, located behind the ethmoids

See the Medical Illustrations section for a basic drawing of the location of the paranasal sinuses.

About nasal cavity and paranasal sinus cancer

Cancer begins when healthy cells in the body change and grow out of control, forming a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread. A benign tumor usually can be removed without it growing back.

Nasal cavity and paranasal sinus cancer are malignant tumors. They are 2 of the major types of cancer that develop in the head and neck region. They belong to a group of tumors known as head and neck cancer. Although paranasal sinus cancer can develop in any of the sinuses, it usually begins in the maxillary sinus.

Types of nasal cavity and paranasal sinus cancer

The nasal cavity and paranasal sinuses contain several types of tissue, and each contains several types of cells. Different cancers can develop from each kind of cell. The differences are important because they determine how fast the cancer is growing and the type of treatment needed.

The nasal cavity and paranasal sinuses are lined by a layer of mucus-producing tissue that contains these types of cells:

  • Squamous epithelial cells

  • Minor salivary gland cells

  • Nerve cells

  • Infection-fighting cells called lymphocytes

  • Blood vessel cells

The types of cancer that may develop from these cells include:

  • Squamous cell carcinoma. This is the most common type of nasal cavity and paranasal sinus cancer. Squamous cells are flat cells that make up the thin surface layer of the structures of the head and neck.

  • Adenocarcinoma. This is the second most common type of nasal cavity and paranasal sinus cancer. It begins in gland cells.

  • Melanoma. Melanoma develops from cells called melanocytes that give the skin its color. It is usually an invasive, fast-growing cancer. However, it only accounts for about 1% of tumors found in this area of the body.

  • Inverting papilloma. These are benign, wart-like growths that may develop into squamous cell carcinoma. Approximately 10% to 15% of these will develop into cancer.

  • Esthesioneuroblastoma. This type of cancer is related to the nerves that control the sense of smell. It occurs on the roof of the nasal cavity and involves a structure called the cribriform plate. The cribriform plate is a bone located deep in the skull between the eyes and the sinuses. This type of cancer looks similar to neuroendocrine cancer, so it is important to distinguish between them.

  • Midline granuloma. This refers to a group of several unrelated conditions that cause the breakdown of the healthy tissue of the nose, sinuses, and nearby tissues. Some cases are due to immune system problems, and many others are actually a type of lymphoma (see below).

  • Lymphoma. Lymphoma is a cancer of the lymphatic system. The lymphatic system carries lymph, a colorless fluid containing lymphocytes. Lymphoma may develop within the lymph tissue found in the lining of the nasal cavity and paranasal sinuses, called the mucosa.

  • Sarcoma. Sarcoma is a type of cancer that begins in muscle, connective tissue, or bone.

The next section in this guide is Statistics. It helps explain how many people are diagnosed with this disease and general survival rates. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will find information about how many people are diagnosed with this type of cancer each year. You will also learn some general information on surviving the disease. Remember, survival rates depend on several factors. To see other pages, use the menu.

Both nasal cavity and paranasal sinus cancer are uncommon. Each year, about 2,000 people are diagnosed with nasal cavity or paranasal sinus cancer in the United States. Cancer of the nasal cavity or paranasal sinus is more common as people grow older. Approximately 4 out of 5 diagnoses occur in people who are at least 55 years old.

The 5-year survival rate tells you what percent of people live at least 5 years after the cancer is found. Percent means how many out of 100. The 5-year survival rate for nasal cavity and paranasal sinus cancer varies and is based on several factors, including the stage and grade of the cancer. Talk with your doctor about what you can expect with your specific diagnosis.

It is important to remember that statistics on how many people survive these types of cancer are an estimate. The estimate comes from data based on people with these types of cancer in the United States each year. So, your own risk may be different. Doctors cannot say for sure how long anyone will live with nasal cavity or paranasal sinus cancer. Also, experts measure the survival statistics every 5 years. This means that the estimate may not show the results of better diagnosis or treatment available for less than 5 years. Learn more about understanding statistics.

Statistics adapted from the American Cancer Society.

The next section in this guide is Medical Illustrations. It offers drawings of body parts often affected by this disease. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Medical Illustrations

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will find a basic drawing of the nasal cavity and paranasal sinuses. To see other pages, use the menu.

Nasal Cavity and Paranasal Sinus Cancer

For medical illustrations showing the different stages of nasal cavity and paranasal sinus cancer, please visit the Stages and Grades section.

The next section in this guide is Risk Factors and Prevention. It explains what factors may increase the chance of developing these cancers and what people can do to lower their risk. Or, use the menu to choose another section to continue reading this guide.  

Nasal Cavity and Paranasal Sinus Cancer - Risk Factors and Prevention

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will find out more about the factors that increase the chance of developing these types of cancer and what people can do to lower their risk. To see other pages, use the menu.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

There are 2 risk factors that greatly increase the risk of nasal cavity and paranasal sinus cancer:

  • Tobacco use. Use of tobacco is the single largest risk factor for head and neck cancer. Tobacco products include cigarettes, cigars, pipes, chewing tobacco, and snuff. Eighty-five percent (85%) of head and neck cancer is linked to tobacco use. Secondhand smoke may also increase a person’s risk of developing head and neck cancer.

  • Alcohol. Frequent and heavy consumption of alcohol is a risk factor for head and neck cancer. Using alcohol and tobacco together increases this risk even more.

Other factors can raise a person’s risk of developing nasal cavity or paranasal sinus cancer.

  • Gender. Nasal cavity and paranasal sinus cancer occurs twice as often in men as in women.

  • Age. Nasal cavity and paranasal sinus cancer are most commonly found in people between the ages of 45 and 85.

  • Human papillomavirus (HPV). Research shows that infection with this virus is a risk factor for nasal cavity and paranasal sinus cancer. Sexual activity with someone who has HPV is the most common way someone gets HPV. There are different types of HPV, called strains. Research links some HPV strains more strongly with certain types of cancers. There are vaccines available to protect you from some HPV strains.

  • Specific inhalants. Breathing in certain substances, most commonly found work environments, may increase the risk of developing nasal cavity or paranasal sinus cancer. These substances include:

    • Dust from the wood, textiles, or leather industries

    • Flour dust

    • Nickel dust

    • Chromium dust

    • Mustard gas

    • Asbestos

    • Rubbing alcohol, also called isopropyl alcohol, fumes

    • Radium fumes

    • Glue fumes

    • Formaldehyde fumes

    • Solvent fumes used in furniture and shoe production

  • Exposure to air pollution. Being exposed to air pollution may increase a person’s risk of developing nasal cavity and paranasal sinus cancer.

  • Marijuana use. Recent research suggests that people who have used marijuana may be at higher risk for head and neck cancer.

Prevention

Different factors cause different types of cancer. Researchers continue to look into what factors cause these types of cancer. Although there is no proven way to completely prevent nasal cavity and paranasal sinus cancer, you may be able to lower your risk. Talk with your doctor for more information about your personal risk of cancer.

Stopping the use of all tobacco products is the most important thing a person can do, even for people who have been smoking for many years. Also, avoiding exposure to substances that have been known to increase the risk of cancer may help reduce this risk. Workers should wear a protective facemask to avoid breathing in potentially harmful substances. Workplace exposure and industrial-related hazards can also be reduced with appropriate air filtering. Workers in these areas need to be aware of their potential risk of exposure.

The next section in this guide is Screening. It explains how tests may find cancer before signs or symptoms appear. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Screening

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will find out more about screening for this type of cancer, including risks and benefits of screening. To see other pages, use the menu.

Screening is used to look for cancer before you have any symptoms or signs. Scientists have developed, and continue to develop, tests that can be used to screen a person for specific types of cancer. The overall goals of cancer screening are to:

  • Lower the number of people who die from the disease, or eliminate deaths from cancer altogether

  • Lower the number of people who develop the disease

Learn more about the basics of cancer screening.

Screening information for nasal cavity and paranasal sinus cancer

It is always important to receive regular health and dental screenings. This is particularly important for people who routinely drink alcohol, currently use tobacco products, or have used tobacco products in the past.

People who use alcohol and tobacco should receive a general physical examination at least once a year even if they do not have any symptoms. This is a simple, quick office visit in which the doctor looks in the nose, mouth, and throat for abnormalities and feels for lumps in the neck. If anything unusual is found, the doctor will recommend a more extensive examination using 1 or more of the diagnostic procedures mentioned in the Diagnosis section.

The next section in this guide is Symptoms and Signs. It explains what body changes or medical problems this disease can cause. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu.

People with nasal cavity or paranasal sinus cancer may experience the following symptoms or signs. However, the cause of a symptom may be another medical condition that is not cancer.

  • 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 

Sometimes, people with nasal cavity or paranasal sinus cancer do not show any of these symptoms. In fact, these types of cancer are usually diagnosed in their later stages because early-stage 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.

A person who notices any of these changes should talk with a doctor and/or dentist right away and ask for a detailed physical examination, particularly if the symptoms continue for several weeks. Nasal cavity and paranasal sinus cancer has a much better chance of being treated successfully when they are found early.

Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.

If cancer is diagnosed, relieving symptoms remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis. It explains what tests may be needed to learn more about the cause of the symptoms. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will find a list of common tests, procedures, and scans that doctors use to find the cause of a medical problem. To see other pages, use the menu.

Doctors use many tests to find, or diagnose, cancer. They also do tests to learn if cancer has spread to another part of the body from where it started. If this happens, it is called metastasis. For example, imaging tests can show if the cancer has spread. Imaging tests show pictures of the inside of the body. Doctors may also do tests to learn which treatments could work best.

For most types of cancer, a biopsy is the only sure way for the doctor to know whether an area of the body has cancer. In a biopsy, the doctor takes a small sample of tissue for testing in a laboratory. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis.

This list describes options for diagnosing these types of cancer. Not all tests listed will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:

  • The type of cancer suspected

  • Your signs and symptoms

  • Your age and medical condition

  • The results of earlier medical tests

Physical examination

To make the diagnosis, a complete medical history and physical examination are necessary. During a physical examination, the doctor feels for any lumps on the neck, lips, gums, and cheeks. The doctor will also inspect the nose, mouth, throat, and tongue for abnormalities, often using a light and/or mirror for a clearer view.

Signs of nasal cavity and paranasal sinus cancer are often very similar to symptoms of chronic or allergic sinusitis. The physical examination is important, and doctors may perform 1 or more of the tests listed below to reach a diagnosis. There are no specific blood or urine tests that can be performed to help make an early diagnosis of either of these types of cancer.

Other diagnostic tests

In addition to a physical examination, the following tests may be used to diagnose nasal cavity or paranasal sinus cancer:

  • Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. A pathologist then analyzes the sample(s). A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.

  • Endoscopy. An endoscopy allows the doctor to see inside the body with a thin, lighted, flexible tube called an endoscope. The person may be sedated as the tube is inserted through the mouth or nose to examine the head and neck areas. Sedation is the use of medication to help a person become more relaxed, calm, or sleepy. This examination has different names depending on the area of the body that is examined, such as laryngoscopy, which examines the larynx; pharyngoscopy, which examines the pharynx; or nasopharyngoscopy, which examines the nasal cavity and nasopharynx.

    In some cases, a diagnosis of paranasal sinus cancer will be made during endoscopic surgery for what is believed to be benign chronic sinusitis. Before completing the surgery, the surgeon should take a biopsy sample of healthy-looking tissue to confirm benign chronic sinusitis. This procedure is called a frozen section examination. For more information about surgery, see the Treatment Options section.

  • X-ray. An x-ray is a way to create a picture of the structures inside of the body, using a small amount of radiation. An x-ray can show if the sinuses are filled with something other than air. If they are, the issue is usually not cancer but, instead, an infection that is treatable. If treatment doesn’t work to clear the sinuses, then other more specialized x-ray tests may be done to identify the blockage. Signs of cancer on an x-ray may be followed up with a computed tomography scan, also called a CT scan (see below).

  • Computed tomography (CT or CAT) scan. A CT scan creates a 3-dimensional picture of the inside of the body using x-rays taken from different angles. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. A CT scan can also be used to measure the tumor’s size. Sometimes, a special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a liquid to swallow. CT scans are very useful in identifying cancer of the nasal cavity or paranasal sinus.

  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body, especially images of soft tissue, such as the eye in its socket and the part of the brain near the sinuses. An MRI can also be used to measure a tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow.

  • Bone scan. A bone scan may be done to see if cancer has spread to the bones. A bone scan uses a radioactive tracer to look at the inside of the bones. The tracer is injected into a patient’s vein. It collects in areas of the bone and is detected by a special camera. Healthy bone appears gray to the camera, and areas of injury, such as those caused by cancer, appear dark.

  • Positron emission tomography (PET) or PET-CT scan. A PET scan is usually combined with a CT scan (see above), called a PET-CT scan. However, you may hear your doctor refer to this procedure just as a PET scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is cancer, these results also help the doctor describe the cancer. This is called staging.

The next section in this guide is Stages and Grades. It explains the system doctors use to describe the extent of the disease and how the cancer cells look under a microscope. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Stages and Grades

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread, as well as what the cancer cells look like under a microscope. This is called the stage and grade. To see other pages, use the menu.

Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body.

Doctors use diagnostic tests to find out the cancer’s stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient’s prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

TNM staging system

One tool that doctors use to describe the stage is the TNM system. Doctors use the results from diagnostic tests and scans to answer these questions:

  • Tumor (T): How large is the primary tumor? Where is it located?

  • Node (N): Has the tumor spread to the lymph nodes? If so, where and how many?

  • Metastasis (M): Has the cancer metastasized to other parts of the body? If so, where and how much?

The results are combined to determine the stage of cancer for each person.

There are 5 stages for nasal cavity and paranasal sinus cancer: stage 0 (zero) and stages I through IV (1 through 4). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

Here are more details on each part of the TNM system for nasal cavity and paranasal sinus cancer.

Tumor (T)

Using the TNM system, the "T" plus a letter or number (0 to 4) is used to describe the size and location of the tumor. Some stages are also divided into smaller groups that help describe the tumor in even more detail. Specific tumor stage information is listed below.

TX: The primary tumor cannot be evaluated.

T0: No evidence of a tumor is found.

Tis: This is a very-early-stage cancer in which cancer cells are found only in 1 layer of tissue. It is also called carcinoma (cancer) in situ.

Tumors of the paranasal sinuses are also evaluated by their exact location. See the Introduction section for descriptions.

Primary tumor (T) in the maxillary sinus

T1: The tumor is limited to the inside of the sinus and does not erode or invade bone.

T2: The tumor erodes or invades the bone surrounding the sinuses.

T3: The tumor invades the surrounding bone, the skin of the cheek, or the other sinuses.

T4a: The tumor invades the bone surrounding the eye, the skin of the cheek, or the bones in the back of the throat.

T4b: The tumor invades any of the following: the back of the eye, the brain area, or the bones of the skull, other than those behind the nose and the back of the head.

Primary tumor (T) in the nasal cavity and ethmoid sinus

T1: The tumor is limited to the inside of the sinus and has no involvement with the bone.

T2: The tumor extends into the nasal cavity.

T3: The tumor extends into the maxillary sinus or to the bone surrounding the eye.

T4a: The tumor has spread throughout the facial bones or into the base of the skull.

T4b: The tumor invades any of the following: the back of the eye, the brain area, or the back of the head.

Node (N)

The “N” in the TNM staging system stands for lymph nodes. These tiny, bean-shaped organs help fight infection. Lymph nodes near the head and neck are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes. Since there are many nodes in the head and neck area, the doctor’s careful evaluation of lymph nodes is an important part of staging.

NX: The regional lymph nodes cannot be evaluated.

N0: There is no evidence of cancer in the regional lymph nodes.

N1: The cancer has spread to a single lymph node on the same side as the primary tumor. The cancer found is 3 centimeters (cm) or smaller.

N2a: The cancer has spread to a single lymph node on the same side as the primary tumor. It is between 3 cm and 6 cm in size.

N2b: The cancer has spread to more than 1 lymph node on the same side as the primary tumor, but none measures larger than 6 cm.

N2c: The cancer has spread to more than 1 lymph node on either side of the body, but none measures larger than 6 cm.

N3: The cancer is found in at least 1 nearby lymph node and is larger than 6 cm.

Metastasis (M)

The "M" in the TNM system indicates whether the cancer has spread to other parts of the body, called distant metastasis.

MX: Distant metastasis cannot be evaluated.

M0: The cancer has not spread to other parts of the body.

M1: The cancer has spread to another part(s) of the body.

Grade (G)

Doctors also describe this type of cancer by its grade (G), which describes how much cancer cells look like healthy cells when viewed under a microscope.

The doctor compares the cancerous tissue with healthy tissue. Healthy tissue usually contains many different types of cells grouped together. If the cancer looks similar to healthy tissue and contains different cell groupings, it is called differentiated or a low-grade tumor. If the cancerous tissue looks very different from healthy tissue, it is called poorly differentiated or a high-grade tumor. The cancer’s grade may help the doctor predict how quickly the cancer will spread. In general, the lower the tumor’s grade, the better the prognosis.

GX: The grade cannot be evaluated.

G1: The cells look more like healthy tissue and are well differentiated.

G2: The cells are only moderately differentiated.

G3: The cells don’t resemble healthy tissue and are poorly differentiated.

Cancer stage grouping

Doctors assign the stage of the cancer by combining the T, N, M, and G classifications.

Stage 0: This is a very early cancer (Tis) with no spread to lymph nodes (N0) or distant metastasis (M0).

Nasal Cavity and Paranasal Sinus Cancer Stage 0

Stage I: This is a noninvasive cancer (T1) with no spread to lymph nodes (N0) and no distant metastasis (M0).

Nasal Cavity and Paranasal Sinus Cancer Stage I

Stage II: This is an invasive cancer (T2) that has not spread to lymph nodes (N0) or to distant parts of the body (M0).

Nasal Cavity and Paranasal Sinus Cancer Stage II

Stage III: This includes invasive cancer (T3) with no spread to regional lymph nodes (N0) and no metastasis (M0), as well as invasive cancer (T1, T2, T3) that has spread to regional lymph nodes (N1) but shows no sign of metastasis (M0).

Nasal Cavity and Paranasal Sinus Cancer Stage III

Stage IVA: This is an invasive cancer (T4a) that either has no lymph node involvement (N0) or has spread to only 1 same-sided lymph node (N1) but with no metastasis (M0). It is also used for any cancer (any T) with more significant nodal involvement (N2) but with no metastasis (M0).

Nasal Cavity and Paranasal Sinus Cancer Stage IVA

Stage IVB: This is an invasive cancer (any T) that has spread to lymph nodes (any N) but has no metastasis (M0). It is also used for any cancer (any T) that is found in lymph nodes and is larger than 6 cm (N3) but has no metastasis (M0).

Nasal Cavity and Paranasal Sinus Cancer Stage IVB

Stage IVC: This refers to any tumor (any T, any N) when there is evidence of distant spread (M1).

Nasal Cavity and Paranasal Sinus Cancer Stage IVC

Recurrent: Recurrent cancer is cancer that has come back after treatment. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

Used with permission of the AJCC, Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Seventh Edition, published by Springer-Verlag New York, www.cancerstaging.org. Please note that AJCC’s Eighth Edition (2017) has been released; related changes to the information provided above are underway. Please check back soon for updated staging definitions or talk with your doctor about whether these changes affect your diagnosis.

Information about the cancer’s stage and grade will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Treatment Options

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will learn about the different ways doctors use to treat people with these types of cancer. To see other pages, use the menu.

This section tells you the treatments that are the standard of care for these types of cancer. “Standard of care” means the best treatments known. When making treatment plan decisions, patients are also encouraged to consider clinical trials as an option. A clinical trial is a research study that tests a new approach to treatment. Doctors want to learn if it is safe, effective, and possibly better than the standard treatment. Clinical trials can test a new drug, a new combination of standard treatments, or new doses of standard drugs or other treatments. Your doctor can help you consider all your treatment options. To learn more about clinical trials, see the About Clinical Trials and Latest Research sections.

Treatment overview

In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team.

For nasal cavity or paranasal sinus cancer, the team may include:

  • Medical and radiation oncologists: doctors who specialize in treating people with cancer

  • Surgeons

  • Otolaryngologists: doctors who treat ear, nose, and throat problems

  • Dentists

  • Maxillofacial prosthodontists: specialists who perform restorative surgery in the head and neck areas

  • Physical therapists

  • Speech pathologists

  • Psychiatrists

  • Neurosurgeons: doctors who specialize in surgery on the brain and spinal cord. If a tumor in the skull or facial area needs to be removed, a neurosurgeon should also be part of this team.

Cancer care teams also include a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Nasal cavity and paranasal sinus cancer can often be cured, especially if found early. Although curing the cancer is the primary goal of treatment, preserving the function of the nearby nerves, organs, and tissues is also very important. When doctors plan treatment, they consider how treatment might affect a person’s quality of life, such as how the person feels, looks, talks, eats, and breathes.

Descriptions of the most common treatment options for nasal cavity and paranasal sinus cancer are listed below. The 3 main treatment options are surgery, radiation therapy, and chemotherapy. One of these treatments, or a combination of them, may be used. Treatment options and recommendations depend on several factors, including the type and stage of cancer, possible side effects, and the patient’s preferences and overall health. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care.

Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Surgery

Surgery is frequently used to remove a tumor in the paranasal sinus or nasal cavity. During the operation, a surgical oncologist will remove the tumor and some surrounding healthy tissue, called a margin. A surgical oncologist is a doctor who specializes in treating cancer using surgery.

The goal of surgery is to remove all of the tumor and leave no trace of cancer in the healthy tissue, also called negative margins. It’s usually not possible to completely remove the cancer during an operation, so additional treatments may be necessary. This may include more than 1 operation to remove the cancer and to help restore the appearance and function of the affected tissues.

Common types of surgery for nasal cavity and paranasal sinus cancer include:

  • Excision. During an excision, the doctor performs an operation to remove the cancerous tumor and some of the healthy tissue around it.

  • Maxillectomy. This is a surgery that removes part or all of the hard palate, which is the bony roof of the mouth. Artificial devices called prostheses or, more recently, flaps of soft tissue with and without bone can be placed to fill gaps from this operation. A maxillectomy is sometimes recommended to treat paranasal sinus cancer. Occasionally, it is possible to save the eye on the side of the cancer.

  • Craniofacial resection/skull base surgery. This is an extensive surgery often recommended for paranasal sinus cancer. During this operation, the surgeon removes more tissue than a maxillectomy. It requires the close cooperation of the health care team, particularly cooperation between a neurosurgeon and a head and neck surgeon.

  • Endoscopic sinus surgery. This relatively new approach is less destructive to healthy tissue than traditional operations. Occasionally, it can be used for a nasal cavity and paranasal sinus tumor, especially if it is benign. The surgeon makes a small incision to remove the tumor using a thin, telescope-like tube inserted into the nasal cavity or sinus. As mentioned in the Diagnosis section, endoscopic sinus surgery is often used to treat chronic sinusitis, and cancer may be discovered during such surgery.

  • Neck dissection. This is the surgical removal of lymph nodes in the neck area. If the doctor suspects the cancer has spread, a neck dissection may be performed, often at the same time as another surgery. A neck dissection may cause numbness of the ear, weakness when raising the arm above the head, and weakness of the lower lip. The side effects are caused by injury to nerves in the area. Depending on the type of neck dissection, weakness of the lower lip and arm may go away in a few months. Weakness will be permanent if a nerve is removed as part of a dissection.

  • Reconstructive (plastic) surgery. If surgery requires removing large or specific areas of tissue, reconstructive surgery may be recommended. If the eye is removed, a specialist called a prosthodontist can provide an artificial replacement, called a prosthesis. More often, when the upper jaw, called the maxilla, is removed, a prosthodontist may play a large role in the rehabilitation process.

Surgery for nasal cavity and paranasal sinus cancer has risks because the eyes, mouth, brain, and important nerves and blood vessels are usually located near the tumor. Surgery often causes swelling of the face, mouth, and throat, making it difficult to breathe. Sometimes a hole in the windpipe, called a tracheostomy, may be necessary to make breathing easier after surgery. It is important to talk with your surgeon(s) about which side effects to expect before having surgery, as well as your plan for recovery. Learn more about the basics of cancer surgery.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist.

For nasal cavity and paranasal sinus cancer, radiation therapy is most often used in combination with surgery. It is given either before or after the operation. Radiation therapy may also be given along with chemotherapy (see below). For some types of tumors in the nasal cavity or paranasal sinus, radiation therapy may be the main treatment. It can also be an option if a person cannot have surgery or decides not to have surgery.

External-beam radiation therapy

The most common type of radiation treatment is called external-beam radiation therapy. External-beam radiation therapy is radiation given from a machine outside the body. An external-beam radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time. Specific types of external radiation therapy include:

  • Intensity-modulated radiation therapy (IMRT). IMRT allows effective doses of radiation therapy to be delivered while reducing the damage to healthy cells.

  • Proton therapy. Proton therapy is a type of radiation therapy that uses protons rather than x-rays. At high energy, protons can destroy cancer cells. Proton therapy may be used in nasal cavity or paranasal sinus cancer when the tumor is located close to the eye or central nervous system, which includes the brain and spinal cord.

Internal radiation therapy

When radiation treatment is given using implants, it is called internal radiation therapy or brachytherapy. Internal radiation therapy involves tiny pellets or rods containing radioactive materials that are surgically implanted in or near the tumor. The implant is left in place for several days while the person stays in the hospital.

Side effects of radiation therapy

Before beginning any type of radiation therapy, people should receive a thorough examination from a dentist experienced in treating people with head and neck cancer. Because radiation therapy can cause tooth decay, damaged teeth may need to be removed. Often, tooth decay can be prevented with proper treatment from a dentist before beginning cancer treatment. After radiation therapy for nasal cavity or paranasal sinus cancer, dental care should continue to help prevent further dental problems. People may receive fluoride treatment to prevent cavities, also called dental caries. Read more about dental and oral health.

Radiation therapy to the head and neck may also cause redness or skin irritation in the treated area, dry mouth or thickened saliva from damage to salivary glands, bone pain, nausea, fatigue, mouth sores, and sore throat. Other side effects may include pain or difficulty swallowing, loss of appetite due to a change in sense of taste, hearing loss due to buildup of fluid in the middle ear, and earwax buildup.

In addition, radiation therapy may cause a condition called hypothyroidism in which the thyroid gland, located in the neck, slows down. This causes people to feel tired and sluggish. Every patient who receives radiation therapy to the neck area should have his or her thyroid checked regularly. Researchers are conducting numerous studies to find ways to reduce or better relieve the side effects of radiation therapy.

Learn more about the basics of radiation therapy.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, usually by stopping the cancer cells’ ability to grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication.

Systemic chemotherapy gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or combinations of different drugs at the same time.

Doctors frequently recommend chemotherapy before or after surgery and/or radiation therapy for nasal cavity and paranasal sinus cancer. Chemotherapy may also be used in combination with radiation therapy. This is called concurrent chemoradiotherapy. Chemoradiotherapy is still being researched and should be done as part of a clinical trial. Chemotherapy may also be used to treat advanced cancer (see below) or to treat symptoms. Some chemotherapy is available in clinical trials that may treat cancer at an earlier stage.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

Learn more about the basics of chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Getting care for symptoms and side effects

Cancer and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the cancer, an important part of cancer care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of cancer, may receive palliative care. It works best when palliative care is started as early as needed in the cancer treatment process.

People often receive treatment for the cancer and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional support, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, or radiation therapy. Talk with your doctor about the goals of each treatment in the treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and palliative care options. And during and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it can be addressed as quickly as possible. Learn more about palliative care.

Metastatic nasal cavity and paranasal sinus cancer

If cancer spreads to another part in the body from where it started, doctors call it metastatic cancer. If this happens, it is a good idea to talk with doctors who have experience in treating it. Doctors can have different opinions about the best standard treatment plan. Also, clinical trials might be an option. Learn more about getting a second opinion before starting treatment, so you are comfortable with your chosen treatment plan.

Your treatment plan may include chemotherapy or a combination of surgery, radiation therapy, and chemotherapy. Palliative care will also be important to help relieve symptoms and side effects.

For most patients, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

Remission and the chance of recurrence

A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it’s important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.

If the cancer does return after the original treatment, it is called recurrent cancer. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the treatments described above, such as surgery, chemotherapy, and radiation therapy, but they may be used in a different combination or given at a different pace. Your doctor may also suggest clinical trials that are studying new ways to treat this type of recurrent cancer. Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with recurrent cancer often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with cancer recurrence.

If treatment fails

Recovery from cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and advanced cancer is difficult to discuss for many people. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have advanced cancer and who are expected to live less than 6 months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in a hospice environment. Nursing care and special equipment can make staying at home a workable alternative for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

The next section in this guide is About Clinical Trials. It offers more information about research studies that are focused on finding better ways to care for people with cancer. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. To see other pages, use the menu.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for patients with nasal cavity or paranasal sinus cancer. To make scientific advances, doctors create research studies involving people, called clinical trials. In fact, every drug that is now approved by the U.S. Food and Drug Administration (FDA) was tested in clinical trials.

Many clinical trials focus on new treatments. Researchers want to learn if a new treatment is safe, effective, and possibly better than the treatment doctors use now. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials can be some of the first to get a treatment before it is available to the public. However, there is no guarantee that the new treatment will be safe, effective, or better than what doctors use now.

Some clinical trials study new ways to relieve symptoms and side effects during treatment. Others study ways to manage the late effects that may happen a long time after treatment. Talk with your doctor about clinical trials for symptoms and side effects. There are also clinical trials studying ways to prevent cancer.

Deciding to join a clinical trial

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result. Other patients volunteer for clinical trials because they know that these studies are the only way to make progress in treating nasal cavity and paranasal sinus cancer. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with nasal cavity or paranasal sinus cancer.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” However, placebos are usually combined with standard treatment in most cancer clinical trials. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient’s options so that the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different than the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects. Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trial ends, and/or if the patient chooses to leave the clinical trial before it ends. 

Finding a clinical trial

Research through clinical trials is ongoing for all types of cancer. For specific topics being studied for nasal cavity and paranasal sinus cancer, learn more in the Latest Research section.

Cancer.Net offers a lot of information about cancer clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

In addition, this website offers free access to a video-based educational program about cancer clinical trials, located outside of this guide.

The next section in this guide is Latest Research. It explains areas of scientific research currently going on for these types of cancer. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Latest Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will read about the scientific research being done now to learn more about nasal cavity and paranasal sinus cancer and how to treat them. To see other pages, use the menu.

Doctors are working to learn more about nasal cavity and paranasal sinus cancer, ways to prevent them, how to best treat them, and how to provide the best care to people diagnosed with these diseases. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the diagnostic and treatment options best for you.

  • Combined therapies. Most research for head and neck cancer focuses on combining different types of treatments to improve treatment effectiveness and the patient’s quality of life.

  • Chemotherapy. As mentioned in the Treatment Options section, clinical trials are testing new and current drugs to treat different stages of nasal cavity and paranasal sinus cancer.

  • Immunotherapy. Immunotherapy, also called biologic therapy, is a type of cancer treatment designed to boost the body's natural defenses to fight the cancer. It uses substances either made by the body or in a laboratory to improve or restore immune system function. Immunotherapy is being studied in the treatment of head and neck cancers in general, so talk with your doctor to see if nasal cavity and paranasal sinus cancers are included.

  • Palliative care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current nasal cavity and paranasal sinus cancer treatments to improve patients’ comfort and quality of life.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding nasal cavity and paranasal sinus cancer, explore these related items that will take you outside of this guide:

The next section in this guide is Coping with Treatment. It offers some guidance on how to cope with the physical, emotional, and social changes that cancer and its treatment can bring. Or, use the menu to choose another section to continue reading this guide.  

Nasal Cavity and Paranasal Sinus Cancer - Coping with Treatment

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will find out more about steps to take to help cope with physical, emotions, social, and financial effects of cancer and its treatment. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu.

Every cancer treatment can cause side effects or changes to your body and how you feel. For many reasons, people don’t experience the same side effects even when given the same treatment for the same type of cancer. This can make it hard to predict how you will feel during treatment.

As you prepare to start cancer treatment, it is normal to fear treatment-related side effects. It may help to know that your health care team will work to prevent and relieve side effects. Doctors call this part of cancer treatment “palliative care.” It is an important part of your treatment plan, regardless of your age or the stage of disease.

Coping with physical side effects

Common physical side effects from each treatment option for nasal cavity and paranasal sinus cancer are described in the Treatment Options section. Learn more about side effects of cancer and its treatment, along with ways to prevent or control them. Changes to your physical health depend on several factors, including the cancer’s stage, the length and dose of treatment, and your general health.

Sometimes, physical side effects can last after treatment ends. Doctors call these long-term side effects. They call side effects that occur months or years after treatment late effects. Treating long-term side effects and late effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

Coping with emotional and social effects

You can have emotional and social effects as well as physical effects after a cancer diagnosis. This may include dealing with difficult emotions, such as anxiety or anger, or managing your stress level. Sometimes, patients have problems expressing how they feel to their loved ones, or people don’t know what to say in return.

Patients and their families are encouraged to share their feelings with a member of their health care team. You can also find coping strategies for emotional and social effects in a separate section of this website. This section includes many resources for finding support and information to meet your needs.

Coping with financial effects

Cancer treatment can be expensive. It is often a big source of stress and anxiety for people with cancer and their families. In addition to treatment costs, many people find they have extra, unplanned expenses related to their care. For some people, the high cost stops them from following or completing their cancer treatment plan. This can put their health at risk and may lead to higher costs in the future. Learn more about managing financial considerations, in a separate part of this website.

Caring for a loved one with cancer

Family members and friends often play an important role in taking care of a person with nasal cavity or paranasal sinus cancer. This is called being a caregiver. Caregivers can provide physical, practical, and emotional support to the patient, even if they live far away.

Caregivers may have a range of responsibilities on a daily or as-needed basis. Below are some of the responsibilities caregivers take care of:

  • Providing support and encouragement

  • Giving medications

  • Helping manage symptoms and side effects

  • Coordinating medical appointments

  • Providing a ride to appointments

  • Assisting with meals

  • Helping with household chores

  • Handling insurance and billing issues

Learn more about caregiving.

Talking with your health care team about side effects

Before starting treatment, talk with your doctor about possible side effects. Ask:

  • Which side effects are most likely?

  • When are they are likely to happen?

  • What can we do to prevent or relieve them?

Be sure to tell your health care team about any side effects that happen during treatment and afterward, too. Tell them even if you don’t think the side effects are serious. This discussion should include physical, emotional, and social effects of cancer.

Also, ask how much care you may need at home and with daily tasks during and after treatment. This can help you make a caregiving plan.

The next section in this guide is Follow-up Care. It explains the importance of check-ups after cancer treatment is finished. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Follow-Up Care

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will read about your medical care after cancer treatment is completed and why this follow-up care is important. To see other pages, use the menu.

Care for people diagnosed with cancer doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the cancer has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.

Your follow-up care may include regular physical examinations, medical tests, or both. Doctors want to keep track of your recovery in the months and years ahead. Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence. Cancer recurrence most commonly happens within the first 2 or 3 years after diagnosis, so follow-up visits will be more frequent during the first 2 or 3 years.

Cancer recurs because small areas of cancer cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will also ask specific questions about your health. Some people may have blood tests or imaging tests done as part of regular follow-up care, but testing recommendations depend on several factors, including the type and stage of cancer originally diagnosed and the types of treatment given. Diagnostic examinations, such as CT scans, may be needed to watch for any signs of recurrences or to monitor how well the current treatment is working.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. In addition, other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of cancer, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may also have certain physical examinations, scans, or blood tests to help find and manage them.

Rehabilitation is a major part of follow-up care after head and neck cancer treatment. People may receive physical therapy and speech therapy to regain skills, such as talking and swallowing. Some people may need to learn new ways to eat or adjust to eating foods that have been prepared differently. Palliative care to manage symptoms and maintain nutrition during and after treatment may be recommended.

After surgery, a prosthodontist can help with the restoration and rehabilitation of any oral cavity structures that were removed during surgery. Rehabilitation of physical changes resulting from a maxillectomy often requires a prosthesis. Many times when a maxillectomy is done, fluid will accumulate in the middle ear on the side of surgery. Surgery to the eardrum, called a myringotomy, to drain this fluid may be required.

Very frequently, especially after craniofacial resection, people will lose their sense of smell, called anosmia. It is important for these people to receive special coping strategies, especially around the house and work area, in case of chemical spills, smoke from a fire, and other potentially harmful situations.

Prevention of tooth decay with fluoride treatments is very important to avoid losing existing teeth. Special eye care may also be necessary.

People who have received radiation therapy should avoid exposing the skin that received treatment to the sun. If radiation therapy included the neck, the thyroid gland should be regularly checked with blood tests.

People who have received treatment for nasal cavity or paranasal sinus cancer may look different, feel tired, and be unable to talk or eat the way they did before treatment. Many people experience depression. The health care team can help people cope with these physical and emotional changes and connect them with support services. Support groups may help people cope with changes following treatment.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to ask about any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the cancer treatment you received and develop a survivorship care plan once treatment is completed.

This is also a good time to decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the general care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of cancer, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your cancer care will lead your follow-up care, be sure to share your cancer treatment summary and survivorship care plan forms with him or her, as well as all future health care providers. Details about your cancer treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship. It describes how to cope with challenges in everyday life after a cancer diagnosis. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Survivorship

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will read about how to with challenges in everyday life after a cancer diagnosis. To see other pages, use the menu.

What is survivorship?

The word “survivorship” means different things to different people. Common definitions include:

  • Having no signs of cancer after finishing treatment.

  • Living with, through, and beyond cancer. According to this definition, cancer survivorship begins at diagnosis and includes people who continue to have treatment over the long term, to either reduce the risk of recurrence or to manage chronic disease.

Survivorship is one of the most complicated parts of having cancer. This is because it is different for everyone.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a cancer diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain of how to cope with everyday life.

Survivors may feel some stress when frequent visits to the health care team end following treatment. Often, relationships built with the cancer care team provide a sense of security during treatment, and people miss this source of support. This may be especially true as new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexuality and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing,

  • Thinking through solutions,

  • Asking for and allowing the support of others, and

  • Feeling comfortable with the course of action you choose.

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the center where you received treatment.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with cancer, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the cancer diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make positive lifestyle changes.

People recovering from nasal cavity and paranasal sinus cancer are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

In addition, it is important to have recommended medical checkups and tests to take care of your health. Cancer rehabilitation may also be recommended, and this could mean any of a wide range of services, such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent and productive as possible. See the Follow-up Care section for more information about rehabilitation.

Talk with your doctor to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?

For more information about cancer survivorship, explore these related items. Please note that these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: Get this 44-page booklet that helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms. The booklet is available as a PDF, so it is easy to print out.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes next after finishing treatment.

  • Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including for survivors in different age groups.

The next section offers Questions to Ask the Doctor to help start conversations with your cancer care team. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Questions to Ask the Doctor

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. To see other pages, use the menu.

Talking often with the doctor is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about your cancer care and treatment. You are also encouraged to ask additional questions that are important to you. You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your care.

Questions to ask after getting a diagnosis

  • What type of nasal cavity cancer or paranasal sinus cancer do I have?

  • Where exactly is the tumor located?

  • What stage and grade is the tumor? What does this mean?

  • Can you explain my pathology report (laboratory test results) to me?

Questions to ask about choosing a treatment and managing side effects

  • What are my treatment options?

  • What clinical trials are available for me? Where are they located, and how do I find out more about them?

  • What treatment plan do you recommend? Why?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • What are the possible side effects of each treatment, both in the short term and the long term?

  • Who will be part of my health care team, and what does each member do?

  • Can you recommend an oncologic dentist before treatment begins?

  • Should I see a speech pathologist before treatment?

  • Who will be leading my overall treatment?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities? 

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?

  • If I’m worried about managing the costs of cancer care, who can help me?

  • What support services are available to me? To my family?

  • Whom should I call with questions or problems?

  • Is there anything else I should be asking?

Questions to ask about having surgery

  • What type of surgery do you recommend?  Why?

  • Who will perform my surgery? How much experience does the doctor or team have with this type of surgery?

  • Will my surgery include a neck dissection? If so, what does this mean?

  • How long will the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • Will it be necessary to remove part of my teeth or part of the palate (roof of my mouth)? If so, is rehabilitation by prosthesis available?

  • Will it be necessary to have reconstruction done to replace lost tissue in the lower jawbone (mandible)?

  • Will I lose my eye or my eyesight?

  • Will anything happen to my sense of smell?

  • What other types of side effects can I expect? What will be done to prevent or manage them?

  • Will other types of treatment, including additional surgery, be necessary?

Questions to ask about having radiation therapy or chemotherapy

  • What type of treatment is recommended?

  • What is the goal of this treatment?

  • How long will it take to give this treatment?

  • What side effects can I expect during treatment?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

Questions to ask about planning follow-up care

  • What is the chance that the cancer will come back? Should I watch for specific signs or symptoms?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will I need them?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be leading my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources. It offers some more resources on this website beyond this guide that may be helpful to you. Or, use the menu to choose another section to continue reading this guide.

Nasal Cavity and Paranasal Sinus Cancer - Additional Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 06/2016

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about cancer care and treatment. This is the final page of Cancer.Net’s Guide to Nasal Cavity and Paranasal Sinus Cancer. To go back and review other pages, use the menu.

Cancer.Net includes many other sections about the medical and emotional aspects of cancer, both for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Beyond this guide, here are a few links to help you explore other parts of Cancer.Net:

This is the end of Cancer.Net’s Guide to Nasal Cavity and Paranasal Sinus Cancer. Use the menu to select another section to continue reading this guide.