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Nasal and Sinus Cancer

Nasal and sinus cancers develop in the nasal cavity or sinuses, which are air-filled structures inside and around the nose. This type of cancer is also called paranasal sinus cancer.  

These tumors can affect your ability to breathe, and they grow near vital organs and nerves, including the brain and eyes. That's why it is important to enlist a team of experts who are experienced in treating these rare cancers. 

Types of nasal and sinus cancer

Different types of cancer affect the nasal cavity and sinuses, including the following:  

  • Squamous cell carcinoma, which makes up more than half of all paranasal sinus cancers
  • Adenocarcinoma
  • Adenoid cystic carcinoma
  • Extranodal natural killer/T-cell lymphoma (nasal type)
  • Mucosal melanoma
  • Olfactory neuroblastoma, also called esthesioneuroblastomaSarcoma
  • Sinonasal undifferentiated carcinoma

In addition, some benign tumors, which are noncancerous, grow in the naval cavity and sinuses, including inverted papillomas and juvenile nasopharyngeal angiofibroma.

Nasal and sinus cancer symptoms

Some of the symptoms associated with nasal and sinus cancer are similar to those you may experience with allergies or sinusitis, including the following:

  • Nasal or sinus blockage
  • Headaches or pain around the sinuses
  • Pus or blood draining from the nose 
  • Decreased sense of smell

You should seek an appointment with your primary care doctor or an ear, nose and throat (ENT) specialist if these symptoms are severe, chronic or recurring, particularly if only one side of the nose is affected. Other serious symptoms that warrant a doctor visit include the following:

  • Growth or mass on the face, nose or roof of the mouth
  • Lump or sore inside the nose that does not heal
  • Eye swelling or change in vision
  • Numbness in the cheek or forehead
  • Loosening, pain or numbness of the teeth

How can I get help for nasal and sinus cancer?

If your doctor suspects paranasal sinus cancer, they may order advanced imaging tests, including CT scans or MRI.

You may also need a biopsy, in which a surgeon removes a small sample of the tumor to determine if it is cancerous.

Care for nasal and sinus cancer at Rush

The experienced team at Rush, which includes ENT surgeons, neurosurgeons, radiation oncologists and medical oncologists, is specially trained to treat these rare, often aggressive cancers. The team will work with you and your family to determine an optimal treatment approach that respects your values and wishes.

Your treatment plan may include one or more of the following:

  • Surgery: With advances in sinus endoscopy, many paranasal sinus tumors can now be removed in a minimally invasive manner. Sinus specialists at Rush have expertise in removing these tumors while preserving healthy surrounding tissues, which improves quality of life by minimizing loss of smell and taste, facial scarring and chronic sinusitis.
    • Endoscopic approaches. With endoscopic sinus surgery, ENT surgeons use a telescope with a tiny video camera and instruments to operate through the nose and remove the tumor. This approach means no facial scars and a much quicker recovery. Sinus and skull base surgeons at Rush are highly experienced in minimally invasive endoscopic procedures, and they are nationally recognized for their clinical and research contributions in this area.  
    • Traditional surgery. When traditional open surgery is required, ENT surgeons work side-by-side with neurosurgeons and eye surgeons, as needed, to achieve complete tumor removal while preserving brain and vision function as much as possible.
    • Reconstructive surgery. Facial plastic and reconstructive surgeons at Rush are specially trained to rebuild facial tissue or bones that must be removed to extract the tumor.  
  • Radiation therapy: The goal of radiation is to target cancer cells with minimal damage to healthy tissue.
    • Stereotactic radiosurgery: This nonsurgical radiation therapy may be used for small, well-defined nasal and sinus tumors. A single high dose of radiation is delivered to the tumor, using the TrueBeam STx system, which minimizes damage to healthy surrounding tissue and eliminates the need for weeks of radiation therapy.
    • Image-guided radiation therapy (IGRT): When treating a paranasal tumor with radiation, radiation oncologists at Rush may use an image-guided system (TomoTherapy Hi-Art or Varian Trilogy) to better pinpoint the tumor. IGRT can adjust for changes in the patient's position as well as tumor changes throughout treatment; this allows clinicians to deliver the radiation more precisely and minimize the amount of radiation to sensitive surrounding tissue.
    • Proton radiotherapy: This type of radiation therapy uses beams of protons (the positively charged particles in an atom) instead of X-rays to destroy cancer cells. Because proton beams can be better controlled and more precisely targeted to the tumor than X-ray beams, radiation oncologists are able to deliver higher doses with less risk to healthy tissue. As a result, proton radiation may be good option for recurrent paranasal sinus tumors located in the base of the skull near critical structures like the brainstem or spinal cord.
  • Drug therapy: Oncologists may recommend various cancer-fighting drugs:
    • Chemotherapy: These drugs speed up the death of cancer cells or stop them from duplicating.
    • Targeted therapies: Designed to attack genetic mutations in tumors and leave noncancerous cells alone, targeted therapies tend to cause fewer side effects than chemotherapy drugs.
    • Immunotherapies: These promising drugs, which help the body's immune system attack cancer cells, may help some people with nasal and sinus cancers.
  • Alternative and complementary therapies: Rush's Cancer Integrative Medicine Program offers counseling, massage, acupuncture and other therapies to cancer patients and their families.
  • Rehabilitation: Sometimes a paranasal tumor, or the approaches used to treat the tumor, can make it hard to swallow or eat. In these cases, you may be referred to one or more of the following:

Why choose Rush for nasal and sinus cancer care

  • Outstanding achievement award: Rush is one of only 11 U.S. hospitals to win the Outstanding Achievement Award — four times in a row — from the American College of Surgeons' Commission on Cancer. The award recognizes programs that excel in providing quality cancer care.
  • On the leading edge: Because many physicians at Rush are also researchers, they are on top of the latest discoveries and are involved in clinical trials of new head and neck cancer treatments. 
  • Support along the way: If you need financial, emotional, or spiritual support during or after cancer treatment, Rush has your back. Patient navigators can help you and your family find the help you need, including transportation to physician visits, information on clinical trials and financial assistance.

Departments and programs that treat this condition