“Paranasal" means near the nose. The para sinuses are hollow, air-filled spaces in the bones around the nose. The sinuses are lined with cells that make mucus, which keeps the inside of the nose from drying out during breathing. There are several para sinuses named after the bones that surround them:
The nose opens into the nasal cavity, which is divided into two nasal passages. Air moves through these passages during breathing. The nasal cavity lies above the bone that forms the roof of the mouth (palate) and curves down at the back to join the throat. The area just inside the nostrils is called the nasal vestibule. A small area of special cells in the roof of each nasal passage sends signals to the brain to give the sense of smell.
Together the paranasal sinuses and the nasal cavity filter and warm the air, and make it moist before it goes into the lungs. The movement of air through the sinuses and other parts of the respiratory system help make sounds for talking.
Paranasal sinus and nasal cavity cancer is a type of head and neck cancer.
The most common type of paranasal sinus and nasal cavity cancer is squamous cell carcinoma. This type of cancer forms in the thin, flat cells lining the inside of the paranasal sinuses and the nasal cavity.
Other types of paranasal sinus and nasal cavity cancer include the following:
Being exposed to certain chemicals or dust in the workplace can increase the risk of paranasal sinus and nasal cavity cancer.
Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk. Risk factors for paranasal sinus and nasal cavity cancer include being exposed to certain workplace chemicals or dust, such as those found in the following jobs:
Signs of paranasal sinus and nasal cavity cancer include sinus problems and nosebleeds.
These and other signs and symptoms may be caused by paranasal sinus and nasal cavity cancer or by other conditions. There may be no signs or symptoms in the early stages. Signs and symptoms may appear as the tumor grows. Check with your doctor if you have any of the following:
Tests that examine the sinuses and nasal cavity are used to find and diagnose paranasal sinus and nasal cavity cancer.
The following tests and procedures may be used:
Prognosis (chance of recovery) depends on the following:
Paranasal sinus and nasal cavity cancers often have spread by the time they are diagnosed and are hard to cure. After treatment, a lifetime of frequent and careful follow-up is important because there is an increased risk of developing a second kind of cancer in the head or neck.
After paranasal sinus and nasal cavity cancer has been diagnosed, tests are done to find out if cancer cells have spread within the paranasal sinuses and nasal cavity or to other parts of the body.
The process used to find out if cancer has spread within the paranasal sinuses and nasal cavity or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if nasopharyngeal cancer spreads to the lung, the cancer cells in the lung are actually nasopharyngeal cancer cells. The disease is metastatic nasopharyngeal cancer, not lung cancer.
There is no standard staging system for cancer of the sphenoid and frontal sinuses.
The staging described below for the maxillary and ethmoid sinuses and the nasal cavity is only used for patients who have not had lymph nodes in the neck removed and checked for signs of cancer.
The following stages are used for maxillary sinus cancer:
Stage 0 (Carcinoma in Situ)
In stage 0, abnormal cells are found in the mucous membranes lining the maxillary sinus. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
In stage I, cancer has formed in the mucous membranes of the maxillary sinus.
In stage II, cancer has spread to bone around the maxillary sinus, including the roof of the mouth and the nose, but not to bone at the back of the maxillary sinus or the part of the sphenoid bone behind the upper jaw.Stage III
In stage III, cancer has spread to any of the following:
Cancer is found in the maxillary sinus and may have spread to any of the following:
Cancer has also spread to one lymph node on the same side of the neck as the cancer, and the lymph node is 3 centimeters or smaller.
Stage IV is the most advanced stage.
The following stages are used for nasal cavity and ethmoid sinus cancer:
Stage 0 (Carcinoma in Situ)
In stage 0, abnormal cells are found in the mucous membranes lining the nasal cavity or ethmoid sinus. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
In stage I, cancer has formed and is found in only one area of either the nasal cavity or the ethmoid sinus and may have spread into bone.
In stage II, cancer is found in two areas of either the nasal cavity or the ethmoid sinus that are near each other, or cancer has spread to an area next to the sinuses. Cancer may also have spread into bone.
Cancer is found in the nasal cavity or ethmoid sinus and may have spread to any of the following:
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.
Treatment will be overseen by a head and neck surgical oncologist, a doctor who specializes in treating people with cancer. The surgeon works with other doctors who are experts in treating patients with head and neck cancer and who specialize in certain areas of medicine and rehabilitation. Patients who have paranasal sinus and nasal cavity cancer may need special help adjusting to breathing problems or other side effects of the cancer and its treatment. If a large amount of tissue or bone around the paranasal sinuses or nasal cavity is taken out, plastic surgery may be done to repair or rebuild the area. The treatment team may include the following specialists:
Surgery is a common treatment for all stages of paranasal sinus and nasal cavity cancer. 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.
After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant 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. There are two types of radiation therapy:
The way the radiation therapy is given depends on the type and stage of the cancer being treated. External and internal radiation therapy are used to treat paranasal sinus and nasal cavity cancer.
External radiation therapy to the thyroid or the pituitary gland may change the way the thyroid gland works. The thyroid hormone levels in the blood may be tested before and after treatment.
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. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). Combination chemotherapy is treatment using more than one anticancer drug.
The way the chemotherapy is given depends on the type and stage of the cancer being treated.Printable PDF