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Nasal and sinus cancer affects the nasal cavity (the space behind your nose) and the sinuses (small air-filled cavities inside your nose, cheekbones and forehead). It’s a rare type of cancer that most often affects men aged over 40.
The most common types of nasal cancer are squamous cell cancer and adenocarcinoma. The former is classed as a type of skin cancer. An adenocarcinoma grows in the mucus producing cells and is a slow growing tumour. Much rarer are melanoma, sarcoma or malignant lymphoma.
The nose is not only the seat of the sense of smell but also cleans, moistens and warms inhaled air. Apart from the nasal cavity, we also recognise the sinuses: sinus frontalis, maxillaris, ethmoidalis and sphenoidalis.
During the early stages of nasal cancer, patients do not experience any discomfort. The onset of the illness is often a chronic sinusitis. Other early symptoms are discharge of puss – sometimes mixed with blood – a chronically blocked nose, a bad odour coming from the nose, face pain and swollen glands in the neck.
If the tumour has reached the sinuses, patients may experience:
The cause of nasal and sinus cancer is as yet unknown. There are, however, certain factors that may increase the risk of contracting the disease. Among those are:
When a GP suspects their patient may have nasal or sinus cancer, they will perform a physical examination, and when their suspicions seem to be confirmed, the patient will be referred to an ear-nose-throat specialist, who will perform a more in-depth examination, and possibly a blood test. In a later stage, imaging technologies may be applied in order to establish the precise location and stage of the cancer, such as ultrasound, CT scan, MRI scan, biopsy, PET-CT scan and X-ray.
The differentiation of the tumour is an important factor in establishing a prognosis and treatment. This can be determined on the basis of a biopsy. A biopsy involves the removal of a small bit of tissue that can be examined under a microscope. Differentiation determines the degree of mutation in the cancerous cells.
When nose cancer has been diagnosed, a team of specialists will come up with a treatment plan. In case of adenocarcinoma, surgery, radiation or chemoradiation are possible remedies. Chemoradiation is a combination of chemotherapy and radiation therapy. For patients with squamous cell cancer: see the respective chapter. In an advanced setting, targeted therapy with EGFR inhibitors can be given to eligible patients.
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