Cancer begins when cells in the body become abnormal and multiply without control or order. These cells form a growth of tissue, called a tumor. A tumor can be benign or malignant. A benign tumor is not cancerous and usually can be removed without growing back. A malignant tumor is cancerous and can invade and damage the body’s healthy tissues and organs.

Nasal cavity and paranasal sinus cancer is a malignant tumor that begins in the inside of the nose or paranasal cavities around the nose. 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 on the cheeks (maxillary sinuses), above and between the eyes (ethmoid and frontal sinuses), and behind the ethmoids (sphenoid sinuses). Cancer of the maxillary sinus is the most common type of 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 in each kind of cell. The differences are important because they determine how aggressive the cancer is and type of treatment needed.

The nasal cavity and paranasal sinuses are lined by a layer of mucus-producing tissue with the following cell types: squamous epithelial cells, minor salivary gland cells, nerve cells, infection- fighting cells, and blood vessel cells. Some tumor types in these cells and tissues are:

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

Adenocarcinoma. Beginning in the gland cells, this is the second most common form of nasal cavity and paranasal sinus cancer.

Malignant melanoma. Arising from cells called melanocytes that give the skin its color, this is an aggressive cancer, but only makes up about 1% of tumors in this area of the body. Read more in the Cancer.Net Guide to Melanoma.

Inverting papilloma. Benign, wart-like growths may develop into squamous cell carcinoma. Approximately 10% to 15% of these can develop into cancer.

Esthesioneuroblastoma. Related to the nerves that control the sense of smell, this type of cancer occurs on the roof of the nasal cavity and involves a structure called the cribriform plate, a bone deep in the skull between the eyes and the sinuses. It needs to be distinguished from neuroendocrine cancer, which looks similar.

Midline granuloma. This refers to a group of several, unrelated conditions that cause breakdown of the normal 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 (a cancer of the lymph system).

Lymphoma. This is a tumor that originates from the lymph tissue within the mucosa (lining) of the nasal cavity and paranasal sinuses.

Sarcoma. Sarcoma is a malignant tumor that begins in muscle, connecting tissue, or bone.

Nasal cavity and paranasal sinus cancer is one of the five types of cancer in the head and neck region, a grouping called head and neck cancer.

Statistics

Nasal cavity and paranasal sinus cancer is 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 and paranasal sinus is found twice as often in men than in women, and tends to occur in people between the ages of 45 and 85.

The overall five-year relative survival rate (the percentage of people who survive at least five years after the cancer is detected, excluding those who die from other diseases) of people with nasal cavity and paranasal sinus cancer is 54%.

Cancer survival statistics should be interpreted with caution. These estimates are based on data from thousands of cases of this type of cancer in the United States each year, but the actual risk for a particular individual may differ. It is not possible to tell a person how long he or she will live with nasal cavity or paranasal sinus cancer. Because the survival statistics are measured in five-year intervals, they may not represent advances made in the treatment or diagnosis of this cancer.

Source: American Cancer Society

Find out more about basic cancer terms used in this section.

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A risk factor is anything that increases a person’s chance of developing cancer. Some risk factors can be controlled, such as smoking, and some cannot be controlled, such as age and family history. Although risk factors can 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 communicating them to your doctor may help you make more informed lifestyle and health care choices.

Two risk factors greatly increase the risk of nasal cavity and paranasal sinus cancer:

• Use of tobacco (including cigarettes, cigars, pipes, chewing tobacco, and snuff) is the single largest risk factor for head and neck cancer
  
  
• Frequent and heavy consumption of alcohol

Eighty-five percent (85%) of head and neck cancer is linked to tobacco use. Using alcohol and tobacco together increases this risk even more. Recent research suggests that people who have used marijuana may be at higher risk for head and neck cancer. Secondhand smoke may also increase a person’s risk of head and neck cancer.

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

Human papillomavirus (HPV). Research indicates that infection with this virus is a risk factor for nasal cavity and paranasal sinus cancer. HPV is most commonly passed from person to person during sexual activity. There are different types, or strains, of HPV, and some strains are more strongly associated with certain types of cancers. Learn more about HPV and cancer.

Specific inhalants. Breathing in numerous substances, most commonly in the work environment, may increase the risk of nasal cavity and paranasal sinus cancer. The following are some of the substances:

• Dust from the wood, textiles, or leather industries
  
  
• Flour dust
  
  
• Nickel dust
  
  
• Chromium dust
  
  
• Mustard gas
  
  
• Asbestos
  
  
• Isopropyl (rubbing) 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 one’s risk of nasal cavity and paranasal sinus cancer.

Gender. Nasal cavity and paranasal sinus cancer is found twice as often in men than women.

Age. This type of cancer is most commonly found in people between 45 and 85.

Prevention

Although some risk factors for nasal cavity and paranasal sinus cancer cannot be changed, such as a person’s age, several can be avoided by making lifestyle changes. Avoiding exposure to substances that have been known to increase the risks of cancer or wearing a protective facemask to reduce inhalation of the substances may help to reduce risk. Workplace exposure and industrial-related hazards can be reduced by appropriate air filtering, and workers in these areas need to be aware of their potential risk of exposure. Also, 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.

Often, nasal cavity or paranasal sinus cancer is discovered when a person is being treated for seemingly benign, inflammatory disease of the sinuses, such as sinusitis. People with nasal cavity and paranasal sinus cancer may experience the following symptoms. 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 only at later stages, because early cancer does not usually cause any symptoms. In addition, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom on this list, please talk with your doctor.

• Nasal obstruction or persistent nasal congestion and stuffiness, which is often referred to as sinus congestion
  
  
• Chronic sinus infections that do not respond to treatment with antibiotics
  
  
• Frequent headaches or pain in the sinus region
  
  
• Swelling or other trouble with the eyes
  
  
• 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
  
  
• Lump on the face, nose, or inside the mouth
  
  
• Frequent runny nose
  
  
• Frequent nosebleeds
  
  
• Difficulty opening the mouth
  
  
• Lump or sore inside the nose that does not heal
  
  
• Fatigue
  
  
• Unexplained weight loss
  
  
• Lump in the neck

People who notice any of these warning signs should consult a doctor and/or dentist right away. And, particularly if symptoms persist for several weeks, the person is encouraged to seek a detailed physical examination. Like other types of cancer, nasal cavity and paranasal sinus cancer has a much better chance of cure when found early.

Because many of these symptoms can be caused by other, noncancerous health conditions, it is always important to receive regular health and dental screenings; this is particularly important for those people who routinely drink alcohol or currently use tobacco products or have used them in the past.

In fact, people who use alcohol and tobacco should receive a general screening examination at least once a year. This is a simple, quick procedure 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 one or more of the diagnostic procedures mentioned in the Diagnosis section.

Doctors use many tests to diagnose cancer and determine if it has metastasized (spread). Some tests may also determine which treatments may be the most effective. For most types of cancer, a biopsy is the only way to make a definitive diagnosis of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:

• Age and medical condition
  
  
• The type of cancer suspected
  
  
• Severity of symptoms
  
  
• Previous test results

To make the diagnosis, a complete medical history and physical examination are necessary. 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 any of several tests to reach a diagnosis. There are no specific blood or urine tests that can be performed to help make an early diagnosis of this type of cancer.

The following tests may be used to diagnose nasal cavity and paranasal sinus cancer:

Physical examination. The doctor feels for any lumps on the neck, lips, gums, and cheeks. Also, the doctor will inspect the nose, mouth, throat, and tongue for abnormalities, often using a light and/or mirror for a clearer view.

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. The sample removed from the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease).

Endoscopy. This test 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. The examination has different names depending on the area of the body that is examined, such as laryngoscopy (larynx), pharyngoscopy (pharynx), or a nasopharyngoscopy (nasal cavity, nasopharynx).

In some cases, the diagnosis of paranasal sinus cancer will be made during an endoscopic surgery for what is believed to be benign chronic sinusitis. During the endoscopic sinus surgery, it is important for the surgeon to obtain a biopsy sample of normal-looking tissues and confirm the diagnosis in a procedure called a frozen section examination before completing the endoscopic surgery for benign chronic sinusitis.

X-ray. An x-ray is a picture of the inside of the body. An x-ray can show if the sinuses are filled with something other than air. If so, it 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 (CT) scan.

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail. CT scans are very useful in identifying cancer of the nasal cavity and 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 brain adjacent to the sinuses. A contrast medium may be injected into a patient’s vein to create a clearer picture.

Bone scan. 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. This test may be done to see if cancer has spread to the bones.

Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive substance is injected into a patient’s body and absorbed by the organs or tissues being studied. This substance gives off energy that is detected by a scanner, which produces the images.

Learn more about what to expect when having common tests, procedures, and scans.

Find out more about common terms used during a diagnosis of cancer.

Staging is a way of describing cancer, such as where it is located, if or where it has spread, and if it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine 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 (chance of recovery). There are different stage descriptions for different types of cancer.

One tool that doctors use to describe the stage is the TNM system. This system uses three criteria to judge the stage of the cancer: the tumor itself, the lymph nodes around the tumor, and if the tumor has spread to other parts of the body. The results are combined to determine the stage of cancer for each person. There are five stages: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

TNM is an abbreviation for tumor (T), node (N), and metastasis (M). Doctors look at these three factors to determine the stage of cancer:

• How large is the primary tumor and where is it located? (Tumor, T)
  
  
• Has the tumor spread to the lymph nodes? (Node, N)
  
  
• Has the cancer metastasized to other parts of the body? (Metastasis, M)

Tumor. 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: A stage called carcinoma (cancer) in situ. This is a very early cancer where cancer cells are found only in one layer of tissue.

Tumors of the paranasal sinuses are also evaluated by their exact location. (See Overview.)

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 bone surrounding the sinuses.

T3: The tumor invades the surrounding bone, the skin of the cheek, or 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 bones of the skull other than behind the nose or 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 with 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. The “N” in the TNM staging system stands for lymph nodes, the tiny, bean-shaped organs that 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, careful assessment 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, and the cancer found is 3 centimeters (cm) or smaller.

N2: Describes any of these conditions:

N2a: Cancer has spread to a single lymph node on the same side as the primary tumor, and is larger than 3 cm, but not larger than 6 cm.

N2b: Cancer has spread to more than one lymph node on the same side as the primary tumor, but none measure larger than 6 cm.

N2c: Cancer has spread to more than one lymph node on either side of the body, but none measure larger than 6 cm.

N3: The cancer is found in lymph nodes larger than 6 cm.

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

MX: Distant metastasis cannot be evaluated.

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

M1: The cancer has spread to other parts of the body.

Cancer stage grouping

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

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

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

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Stage III: An invasive cancer (T3) with no spread to regional lymph nodes (N0) or metastasis (M0), as well as invasive cancers (T1, T2, T3) that have spread to regional lymph nodes (N1), but have no sign of metastasis (M0).

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

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Stage IVB: Any cancer (any T) with more extensive spread to lymph nodes (N2, N3) but no metastasis (M0).

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

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Tumor grade. Doctors also describe primary tumors by grade (G), which is determined by using a microscope to examine tissue from a tumor. The doctor compares the tumor tissue with normal tissue. Normal tissue contains many different types of cells grouped together, which is called differentiated. Tissue from tumors usually has cells that look more alike, called poorly differentiated. Generally, the more differentiated the tissue, the better the prognosis.

GX: The grade cannot be evaluated.

G1: The cells look more like normal tissue (well differentiated).

G2: The cells are only moderately differentiated.

G3: The cells don’t resemble normal tissue (poorly differentiated).

Recurrent: Recurrent cancer is cancer that comes back after treatment.

Used with permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Sixth Edition (2002) published by Springer-Verlag New York, www.cancerstaging.net

The treatment of nasal cavity and paranasal sinus cancer depends on the size and location of the tumor, whether the cancer has spread, and the person’s overall health. In many cases, a team of doctors will work with the patient to determine the best treatment plan. A neurosurgeon (a doctor who specializes in surgery on the brain and spinal cord) should be a part of this team when a tumor in the skull and facial areas needs to be removed.

This section outlines treatments that are the standard of care (the best treatments available) for this specific type of cancer. Patients are also encouraged to consider clinical trials as a treatment option when making treatment plan decisions. A clinical trial is a research study to test a new treatment to prove it is safe, effective, and possibly better than standard treatment. Your doctor can help you review all treatment options. For more information, visit the Clinical Trials section.

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.

Head and neck cancer specialists often form a multidisciplinary team to care for each person, and an evaluation should be done before any treatment begins. The team may include medical and radiation oncologists (doctors who specialize in cancer); surgeons; otolaryngologists (ear, nose, and throat doctors); dentists; maxillofacial prosthodontists (specialists who perform restorative surgery in the head and neck areas); physical therapists; speech pathologists; psychiatrists; nurses; dietitians; and social workers.

Descriptions of the most common treatment options for nasal cavity and paranasal sinus cancer are listed below. There are three main treatment options are: surgery, radiation therapy, and chemotherapy. One of these treatments, or a combination of them, may be used.

Surgery

During surgery, the doctor performs an operation to remove the cancerous tumor and some of the healthy tissue around it (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 negative margins (no trace of cancer in the healthy tissue). Surgery is frequently used to remove cancer of the paranasal sinus and nasal cavity. However, it’s not possible to completely remove the entire cancer; additional treatments may be necessary.

Depending on the location, stage, and the type of the cancer, a person may need more than one operation to remove the cancer and to help restore the appearance and function of the tissues affected. Surgery often has some risks because of the proximity of the eyes, mouth, brain, and important nerves and blood vessels in the area. A craniofacial resection or skull base surgery is often necessary in paranasal sinus cancer and demands the close cooperation between a neurosurgeon (a specialist who operates on the brain and spine)and a head and neck surgeon to completely remove the tumor. Maxillectomies (different types of tumor resection that remove part or all of the bony roof of the mouth) are sometimes recommended to treat paranasal sinus cancer, and occasionally it is possible to save the eye on the side of the cancer.

A relatively new approach called endoscopic sinus surgery is less destructive to normal tissue than conventional operations and can occasionally be used for nasal cavity and paranasal sinus tumors, especially if they are benign. The surgeon, using a thin, telescope-like tube inserted into the nasal cavity or sinus, makes a small incision to remove the tumor. As mentioned in the Diagnosis section, endoscopic sinus surgery is often used for chronic sinusitis, and during such surgery it may be that cancer is discovered.

Surgery often causes swelling of the face, mouth, and throat, making it difficult to breathe, and sometimes a tracheostomy (hole in the windpipe) to make breathing easier may be necessary for some period of time after surgery.

Reconstructive (plastic) surgery may be used after removal of the sinuses. If the eye is removed, a specialist called a prosthodontist can provide a prosthesis (an artificial replacement). More often, when the maxilla (upper jaw) is removed, a prosthodontist may play a large role in the rehabilitation process.

If the doctor suspects that the cancer has spread, a neck dissection (the lymph nodes in the neck are removed) may also be performed. 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.

Radiation therapy

Radiation therapy is the use of high energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation given from a machine outside the body. 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 cancer site. The implant is left in place for several days while the person stays in the hospital.

Specific types of external radiation therapy, include intensity modulated radiation therapy (IMRT), which allows for more effective doses of radiation therapy to be delivered while reducing the damage to healthy cells and causing fewer side effects. Proton therapy (also called proton beam therapy) is another type of external-beam 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 and paranasal sinus cancer when the tumor is located close to the eye or central nervous system (brain and spinal cord). Learn more about proton therapy.

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

Before beginning radiation therapy for any head and neck cancer, people should receive a thorough examination from an oncologic dentist (a dentist experienced in treating people with head and neck cancer). Since 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 treatment.

Radiation therapy to the head and neck may cause the following side effects:

• Redness or skin irritation to the treated area
  
  
• Dry mouth or thickened saliva, from damage to salivary glands
  
  
• Bone pain
  
  
• Nausea
  
  
• Fatigue
  
  
• Mouth sores and/or sore throat
  
  
• Dental problems (usually preventable)
  
  
• Painful or difficulty swallowing
  
  
• Loss of appetite, due to a change in sense of taste
  
  
• Hearing loss, due to a buildup of fluid in the middle ear
  
  
• Buildup of earwax, which dries out because of the radiation therapy’s effect on the ear canal

Radiation therapy may also cause a condition called hypothyroidism, in which the thyroid gland (located in the neck) slows down and causes the person to feel tired and sluggish. Every patient who receives radiation therapy to the neck area should have his or her thyroid checked regularly.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating cancer with medication. Some people may receive chemotherapy in their doctor’s office; others may go to the hospital. A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a specific time. The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

For nasal cavity and paranasal sinus cavity cancer, chemotherapy is most often used to treat advanced cancer or to treat symptoms. Some chemotherapy is available in clinical trials (research studies) that may treat cancer at an earlier stage. And, many combined treatments (such as chemotherapy and radiation therapy) are performed as part of a clinical trial.

The use of chemotherapy before or after surgery and/or radiation therapy, or in combination with radiation therapy (called concurrent chemoradiotherapy), is frequently recommended for this type of cancer. This treatment is still in an investigative phase and should be done as part of a clinical trial.

Learn more about 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.

Find out more about common terms used during cancer treatment.

Doctors and scientists are always looking for better ways to treat patients with nasal cavity and paranasal sinus cancer. A clinical trial is a way to test a new treatment to prove that it is safe, effective, and possibly better than a standard treatment. The clinical trial may be evaluating a new drug, a new combination of existing treatments, a new approach to radiation therapy or surgery, or a new method of treatment or prevention. Patients who participate in clinical trials are among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.

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 finding new drugs and other therapies is 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 and paranasal sinus cancer.

Sometimes people have concerns that, by participating in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill”. The use of placebos in cancer clinical trials is rare. 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.

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 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. Learn more about clinical trials , including patient safety, phases of a clinical trial, deciding to participate in a clinical trial, questions to ask the research team, and links to find cancer clinical trials.

For specific topics being studied for nasal cavity and paranasal sinus cancer, learn more in the Current Research section.

Cancer and its treatment can cause a variety of side effects. However, doctors have made major strides in recent years in reducing pain, nausea and vomiting, and other physical side effects of cancer treatments. Many treatments used today are less intensive but as effective as treatments used in the past. Doctors also have many ways to provide relief to patients when such side effects do occur.

Fear of treatment side effects is common after a diagnosis of cancer, but it may be helpful to know that preventing and controlling side effects is a major focus of your health-care team. Before treatment begins, talk with your doctor about possible side effects of the specific treatments you will be receiving. The specific side effects that can occur depend on a variety of factors, including the type of cancer, its location, the individual treatment plan (including the length and dosage of treatment), and the person’s overall health.

Ask your doctor which side effects are most likely to happen (and which are not), when side effects are likely to occur, and how they will be addressed by the health-care team if they do happen. Also, be sure to communicate with the doctor about side effects you experience during and after treatment. Learn more about the most common side effects of cancer and different treatments, along with ways to prevent or control them.

In addition to physical side effects, there may be psychosocial (emotional and social) effects as well. Learn more about the importance of addressing such needs, including concerns about managing the cost of your cancer care.

Learn more about late effects or long-term side effects by reading the After Treatment section or talking with your doctor.

After treatment for nasal cavity or paranasal sinus cancer ends, talk with your doctor about developing a follow-up care plan. This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years.

Most recurrences happen in the first two or three years after diagnosis, so follow-up visits will be more frequent in the first two or three years. Diagnostic examinations, such as CT scans, may be needed to detect any signs of recurrences or monitor the progress of current treatment.

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. Supportive care to manage symptoms and maintain nutrition during and after treatment may be recommended. Some people may need to learn new ways to eat or to eat foods prepared differently. After surgery, a prosthodontist can help in 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. Prevention of dental decay by fluoride application is very important to avoid loss of existing teeth. Special eye care may be necessary. When a maxillectomy is done, in many cases, fluid will accumulate in the middle ear on the side of surgery, and a myringotomy (surgery to the eardrum) to drain this fluid may be required. Very frequently, especially after craniofacial resection, people will lose their anosmia (sense of smell), and it is important that these people receive special coping strategies, especially around the house and work area (in case of chemical spills, smoke from a fire, and other situations). If the person has received radiation therapy, he or she should avoid exposing the skin that received treatment to the sun. If radiation therapy included the neck, the person should have his or her thyroid gland checked regularly through blood tests.

People may look different, feel tired, and be unable to talk or eat the way they used to. 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 can sometimes help people cope with changes following treatment.

People recovering from nasal cavity or paranasal sinus cancer are encouraged to follow established guidelines for good health, such as maintaining a healthy weight, not smoking, eating a balanced diet, and having recommended cancer screening tests. Talk with your doctor to develop a plan that is best for your needs. Moderate physical activity can help rebuild your strength and energy level. Your doctor can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about healthy living after cancer.

Find out more about common terms used after cancer treatment is complete.

Research for nasal cavity and paranasal sinus cancer is ongoing. Advances may still be under investigation in clinical trials and may not be approved or available at this current time. Always discuss all diagnostic and treatment options with your doctor.

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

Chemotherapy. As explained in Treatment, there are clinical trials to test new and existing drugs for different stages of this type of cancer.

Regular communication with your doctor is important in making informed decisions about your health care. Consider asking the following questions of your doctor:

• What type and stage of nasal cavity or paranasal sinus cancer do I have?
  
  
• Exactly where is the tumor located?
  
  
• Can you explain my pathology report (laboratory test results) to me?
  
  
• What are my treatment options?
  
  
• What clinical trials are open to me?
  
  
• What treatment do you recommend? Why?
  
  
• If surgery is needed, will there be a need for a neck dissection (removing lymph nodes)? If so, what type of dissection will be done? What does this mean?
  
  
• What are the possible side effects of this treatment, both in the short term and the long term?
  
  
• How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?
  
  
• If I’m worried about managing the costs related to my cancer care, who can help me with these concerns?
  
  
• Will I lose my eye or my eyesight?
  
  
• What will happen to my sense of smell?
  
  
• Will it be necessary to remove part of my teeth or part of the palate (roof of the mouth)? If so, is rehabilitation by prosthesis available?
  
  
• If surgery is needed, will it be necessary to have reconstruction done to replace lost tissue (mandible)?
  
  
• Can you recommend an oncologic dentist?
  
  
• Should I see a speech pathologist prior to treatment?
  
  
• What other specialists will be involved in my care? What role does each one play?
  
  
• What follow-up tests will I need, and how often will I need them?
  
  
• What support services are available to me? To my family?

In addition to Cancer.Net, there are other sources of information about this type of cancer available online. Cancer.Net maintains a list of national, not-for-profit organizations that may be helpful in finding additional information, services, and support. As always, be sure to talk with your doctor about questions you may have about information you find about this disease.

View organizations that offer information on this specific type of cancer.