Nasal Cancer

Nasal and paranasal tumors are abnormal growths that begin in and around the passageway between your nose and mouth (nasal cavity). Nasal tumors begin in the nasal cavity. The nasal cavity is the passageway just behind your nose. Air passes through it on the way to your throat as you breathe. Paranasal tumors begin in air-filled chambers around the nose called the paranasal sinuses. They are lined with cells that make mucus, which keeps your nose from drying out. Several types of nasal and paranasal tumors exist, and they can be noncancerous (benign) or they can be cancerous (malignant).

Cancers of the nasal cavity and paranasal sinuses are rare, with about 2,000 people in the United States developing these cancers each year. These tumors are more common as people age, with about 4 out of 5 cases occurring in people who are at least 55 years old. Men are more likely than women to get nasal or paranasal cancers. These cancers also occur more often in certain areas of the world such as Japan and South Africa than in the United States. Exposure to certain chemicals, infections with human papilloma virus, and smoking increase the risk of nasal and paranasal cancer.

People with nasal cancer may not symptoms at first, and later symptoms can be like those of infections. Treatment options for nasal and paranasal cancers include surgery, radiation, and chemotherapy.

In most cases, nasal and paranasal sinus cancers are found because of the symptoms they cause. Diagnosis in people without symptoms is rare and usually occurs by accident after tests are done to check for other medical problems. Possible symptoms of nasal and paranasal cancers include:

• nasal congestion and stuffiness that does not get better or worsens over time
• pain above or below the eyes
• blockage of one side of the nose
• post-nasal drip (nasal drainage in the back of the nose and throat)
• nosebleeds
• pus draining from the nose
• decreased sense of smell
• numbness or pain in parts of the face
• loosening or numbness of the teeth
• growth or mass of the face, nose, or palate
• constant watery eyes
• bulging of one eye
• loss or change in vision
• pain or pressure in one of the ears
• trouble opening the mouth
• lymph nodes in the neck getting larger (seen or felt as lumps under the skin)

Many of these symptoms are more likely to be caused by other conditions than by cancer. Still, if you have any of these symptoms, it is important to have them checked by a doctor so that the cause can be found and treated, if needed.

The exact cause of nasal and paranasal cancers is not known. In general, cancer begins when a series of genetic mutations occur within a cell, causing the cell to grow and multiply out of control. It is not clear what causes the initial genetic mutations that lead to nasal cancers, though researchers believe that some risk factors, such as workplace exposure to certain chemicals or substances, may cause these cancers by damaging the DNA of cells that line the inside of the nose and sinuses. Some people may also inherit DNA mutations (changes) from a parent that increase their risk for developing certain cancers. However, inherited changes in genes are not believed to cause very many cancers of the nasal cavity or paranasal sinuses.

Nasal cavity and paranasal sinus cancers are usually found because of signs or symptoms a person is having. First, the doctor will conduct a comprehensive physical exam and take a medical history. During an exam of the body, your doctor checks for general signs of health, including signs of disease such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken. The doctor will also look into the nose with a small, long-handled mirror to check for abnormal areas and check the face and neck for lumps or swollen lymph nodes.

Doctors diagnose nasal cancer with imaging tests such as X-rays, magnetic resonance images, and computed tomography scans; examinations of the inside the nose such as a nasoscopy or laryngoscopy; and biopsies.

A diagnosis of nasal cancer can be stressful for you and for your family and friends. There are several steps you can take to maintain control of your health and well-being.

Learn about nasal cancer in order to make decisions about your care. Write down questions to ask your doctor. Ask your health care team for information to help you better understand your disease.

Surround yourself with a support network. Close friends or family can help you with everyday tasks, such as getting you to appointments or treatment. If you have trouble asking for help, learn to be honest with yourself and accept help when you need it.

Seek out other people with cancer. Ask your health care team about cancer support groups in your community. Sometimes there are questions that can only be answered by other people with cancer. Support groups offer a chance to ask these questions and receive support from people who understand your situation.

Take time for yourself. Eat well, relax, and respect the limits that you may feel. Continue to work and engage in hobbies as you are able.

There are different types of treatment for patients with paranasal sinus and nasal cavity cancer.

Patients with paranasal sinus and nasal cavity cancer should have their treatment planned by a team of doctors with expertise in treating head and neck cancer.

Three types of standard treatment are used for treating nasal and paranasal cancers:

Surgery. Surgery to remove the cancer is a common treatment for nasal and paranasal cancers. A doctor may remove the cancer and some of the healthy tissue and bone around the cancer. If the cancer has spread, the doctor may remove lymph nodes and other tissues in the neck.

Radiation therapy. Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing.

Chemotherapy. Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Some of the chemotherapy drugs used to treat nasal and paranasal cancers include:

• carboplatin
• cisplatin
• 5-fluorouracil (5-FU)
• docetaxel (Taxotere)
• paclitaxel (Taxol)
• bleomycin (Blenoxane)
• cyclophosphamide (Cytoxan)
• vinblastine (Velban)
• methotrexate (Trexall)