Nasal and sinus cancer: symptoms, diagnosis and possible treatments

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According to NHS, nasal and sinus cancer is a rare cancer that affects the nasal cavity (the space behind your nose) and the sinuses (small air-filled cavities inside your nose, cheekbones and forehead).

Nasal and sinus cancer is different from cancer of the area where the nose and throat connect.

Symptoms of nasal and sinus cancer

The most common symptoms of nasal and sinus cancer are:

1. a blocked nose that does not go away and usually only affects 1 side

2. nosebleeds

3. a decreased sense of smell

4. mucus running from your nose, this can be bloody

5. mucus draining into the back of your nose and throat.

These symptoms can be similar to more common and less serious conditions, such as a cold or sinusitis.

At a later stage, symptoms can include:

1. pain or numbness in the face, particularly in the upper cheek, that does not go away

2. swollen glands in the neck

3. partial loss of vision or double vision

4. a bulging eye

5. a watering eye that does not go away

6. pain or pressure in 1 ear

7. a persistent lump or growth on your face, nose or roof of your mouth.

When to see a doctor

See a doctor if you notice any unusual or persistent symptoms.

It’s very unlikely they’ll be caused by nasal or sinus cancer, but it’s worth getting them checked out.

If a doctor thinks you might need some tests to find out what’s causing your symptoms, you’ll usually be referred to an ear, nose and throat (ENT) consultant at a hospital.

Diagnosing nasal and sinus cancer

Tests you may have to help diagnose nasal and sinus cancer include:

1. a nasal endoscopy (nasoendoscopy), where a long, thin, flexible tube with a camera and light at the end is inserted into your nose to examine the area; this can be uncomfortable, so before the procedure you’ll be asked whether you’d like anaesthetic sprayed on the back of your throat

2. a biopsy, where a small sample of tissue is removed and examined; this may be done during an endoscopy

3. a fine needle aspiration, where fluid and cells are taken from a lymph node using a needle to see if the cancer has spread.

If you’re diagnosed with nasal and sinus cancer, you may have a CT scan, MRI scan, PET scan or ultrasound scan to help stage and grade the cancer.

Risk groups for nasal and sinus cancer

Several factors are known to increase the risk of developing nasal and sinus cancer.

These include:

1. prolonged exposure to certain substances through your work, including wood dust, leather dust, cloth fibres, nickel, chromium and formaldehyde

2. smoking, the more you smoke, the higher your risk of developing several types of cancer, including nasal and sinus cancer

3. human papillomavirus (HPV), a group of viruses that affect the skin and moist membranes, such as the mouth and throat.

Treatments for nasal and sinus cancer

The treatment recommended for you will depend on several factors, including the stage at which the cancer was diagnosed, how far it’s spread, and your general level of health.

Treatment may include:

1. surgery to remove a tumour, this can be performed through open surgery or as keyhole surgery through the nose (endoscopic microsurgery)

2. radiotherapy, where high-energy radiation is used to kill the cancerous cells, shrink a tumour before surgery, or destroy small pieces of a tumour that may be left after surgery

3. chemotherapy, where medicine is used to help shrink or slow down the growth of a tumour, or reduce the risk of the cancer returning after surgery.

If you smoke, it’s important that you give up.

Smoking increases your risk of cancer returning and may cause you to have more side effects from treatment.

Your treatment will be organised by a head and neck cancer multidisciplinary team (MDT), who’ll discuss the treatment options with you. 

A combination of treatments will often be recommended.

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