Nasal and paranasal cancers are a rare set of cancers that affect the nasal cavity and the paranasal sinuses. The nasal cavity is the area located behind the nose, while the paranasal sinuses are the four air-filled cavities in your nose, cheekbones, and forehead. These types of cancer form as tumors in the nose and sinus cavity, and their symptoms are sometimes confused with other sinus problems such as a cold or allergies.
Cause of Nasal and Paranasal Sinus Cancers
Nose and sinus cancers, like many others, are believed to be caused by DNA damage in the cells. This damage creates abnormal cells as they continue to grow, multiply, and live beyond their expected lifespan. These abnormal cells then build up and accumulate into a tumor.
There are various factors that can contribute to the injury of the cells in the sinus and nose. These factors can include breathing in polluted air, contracting the human papillomavirus, being around second-hand smoke, and smoking. Working for an extended amount of time in areas where the air is filled with chemical fumes, flour, or dust has also been linked to sinus and nose cancers.
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Symptoms of Nasal and Paranasal Sinus Cancers
There may not be any obvious symptoms of nose or sinus cancer in the early stages. Those who exhibit early-onset symptoms may attribute them to allergies or the common cold due to their mildness. The difference is that these symptoms never clear up, and in some cases, only get worse.
Early Nasal and Paranasal Sinus Cancer Symptoms:
- Nosebleeds
- A stuffed nose that may only affect one nostril
- Difficulty breathing through the nose
- Loss of smell
- Excessive mucus draining down the back of the throat or out the nose
- Sinus pressure or blockage
- Headache
Later Stage Nasal and Paranasal Sinus Cancer Symptoms:
- Swollen glands in the neck
- Facial pain or swelling
- Numbness in the upper cheek, nose, or mouth
- A sudden change in eye pressure or vision
- Partial loss of vision
- A consistent watery eye, with or without bulging
- A growth in the mouth, nose, or on the face
- Ear pain or pressure
- Hearing loss
- Difficulty with opening the mouth
- Suddenly loose teeth
Diagnosis of Nasal and Paranasal Sinus Cancers
In order for a doctor to accurately diagnose nose and sinus cancers, an in-depth medical history will be obtained from the patient, and a physical exam will be done. This will help the doctor rule out other possible causes of the symptoms. If cancer is suspected, diagnostic and imaging tests may then be ordered to confirm the diagnosis.
Such diagnostic tests can include a panendoscopy, where a series of attached scopes examine the upper airway of the nose to the throat. A nasal endoscopy, where the nose is examined with a thin, long, flexible tube with a camera and light at the tip, is another less invasive test. There is also the chance for a biopsy, where a small sample of tissue is examined after being removed from the patient.
If the cancer is confirmed, imaging tests such as an MRI scan, a PET scan, or a CT scan can help doctors pinpoint the grade of the cancer and what stage it is in.
The Staging of Nasal and Paranasal Sinus Cancers
Once cancer is confirmed, doctors work to figure out what stage the cancerous tumor is in. Staging is a method utilized to find out how far the cancer has progressed and spread, if at all. It is in reference to how much cancer is in the body.
Staging is determined by three main pieces of information. This is where the tumor is located and how far it has gone into neighboring structures. Has the cancer expanded to the lymph nodes in the neck, and if so, what are their sizes and how many lymph nodes are affected. Finally, has the cancer spread to other parts of the body or metastasized yet? In most metastasized nose and sinus cancers, the spread is to the lungs. However, it is not unheard of for it to spread to the bones either.
Cancer staging for nose and sinus cancers are typically very intricate. They are divided into cancers that start in the nasal cavity and those that begin in the maxillary sinus. Stage I usually refers to an earlier caught cancer, as the cancer cells are only found on the top layer of cells lining the nasal or sinus cavity and have not spread. In stage II, the cancer will have reached other tissue in the nose or sinus area. Stage III is when the cancer has spread to outside areas, such as the eye socket, and could have spread to a lymph node. As the cancer progresses and spreads, it gets to stage IV. This stage is marked by spread to distant parts of the body. By stage IV, the cancer's spread will make it harder to treat.
Treatment Options for Nasal and Paranasal Sinus Cancers
The treatments available for patients with nose or sinus cancer depend on what stage they are in, how far the cancer has progressed around the body and the patient's overall health. Location of the tumor is also an important part, as some areas would be too difficult to get to by specific treatments.
Surgery is one option for treatment for nose and sinus cancers. There are two types of surgery typically performed for this type of cancer, which is open surgery and minimally invasive surgery. Open surgery requires doctors to make an incision in the mouth or nose in order to reach the nasal or sinus cavity. During this surgery, the doctor removes the cancerous tumor and any surrounding tissue that may have been affected. While minimally invasive surgery is when the location of the tumor makes it possible for the doctor to remove it through the nose with special tools. The tools are inserted into the patient's nose and a small camera that helps the doctor properly remove the whole tumor.
Radiation therapy is another treatment option. With radiation, doctors and radiographers use high powered X-rays to eliminate cancer cells. This treatment can be used on its own or combined with surgery.
The third option for nose and sinus cancer is chemotherapy. This is a drug treatment that targets cancer cells and eliminates them. Chemotherapy can be used along with radiation therapy, as well as before or after surgery.
Nasal and paranasal sinus cancers are a rare form of cancer that is thought to be caused by environmental irritants that damage the cells in the nose and sinuses. The symptoms of this cancer are similar to that of allergies or the common cold, leading many to refrain from visiting a doctor. Regular doctor visits and examinations can catch such cancers early if attended regularly.
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