Nasal Cavity and Sinus Cancer

The nasal cavity consists of the large open space behind the nose. The sinuses (also known as paranasal sinuses) are air-filled spaces that are connected to the nasal cavity. 

Symptoms of nasal cavity and sinus cancers may include: 

• Chronic nasal congestion or blockage (often only on one side of the nose)
• Nasal drainage (often only on one side of the nose)
• Nosebleeds (often only on one side of the nose)
• Pain around the eyes
• Loss of smell 

Various imaging tests, such as MRIs and CT scans may be used to diagnose nasal cavity and sinus cancer. A biopsy, or removal of a small piece of tissue, is also often needed. Our experienced pathologists, who specialize in head and neck cancers, will perform various lab tests to determine the type of cancer you have. 

The most common cancer that affects the nasal cavity and sinuses is squamous cell carcinoma, which form in the lining of the nose and sinuses. But a variety of other cancers can also form in these areas, including adenocarcinomas, olfactory neuroblastomas, neuroendocrine carcinomas and adenoid cystic carcinomas. Because treatment varies based on the type of cancer, it is important to get the diagnosis right. 

Once we know your diagnosis, our team of experts will discuss how to treat your cancer with the fewest side effects possible. By combining our expertise, we can better determine the best way to attack your cancer, taking into account your treatment preferences. 

Treatment for nasal cavity and sinus cancers can vary, depending on the location and type of cancer. Surgery is often the first step, followed by radiation and possibly chemotherapy or other medicines. However, every patient and every cancer is different. As a result, your individualized care plan may or may not include some or all of the following treatments: 

Surgery

When possible, we use a minimally invasive endoscopic approach to remove nasal cavity and sinus cancers. No incisions are used. Instead, our surgeons operate through the nose using tiny instruments. We use the latest equipment, including image-guided technologies, which help our surgeons complete the operation with the fewest and smallest cuts possible. As a result, our patients recover quickly with minimal side effects. 

At UChicago Medicine, two experienced surgeons team up for nasal cavity and sinus operations: a sinus surgeon and a neurosurgeon. This dual approach is important when operating in this area of the head. The nasal and sinus area is located close to the brain and sometimes these cancers extend into the skull base or parts of the brain. (When nasal cavity and sinus cancers involve the skull base, they are known as skull base tumors.)  

Our sinus surgeons are experienced in removing tumors from the nasal and sinus area while minimizing post-operative problems, such as sinus infections or mucus drainage. And our neurosurgeons are experts in using microsurgical techniques near and inside the brain to remove cancer completely and safely.  

Sometimes, after we remove the cancer and surrounding tissue, an opening is created between the nasal cavity and the brain. When this happens, we need to reconstruct that barrier using a small amount of tissue from inside the nose and/or tissue from the abdomen or thigh. This barrier is necessary to prevent infections such as meningitis, which can affect the brain. The removal of the tumor and any reconstruction is done during the same surgery. 

The team approach to surgery also proves beneficial after the operation. Both surgeons will be monitoring you and working together to optimize your postoperative recovery. We are currently conducting research, testing ways to improve and standardize postoperative care for nasal cavity and sinus cancer surgeries. Our goal is to improve quality of life for patients while reducing the amount of time you have to spend in the hospital.  

Radiation Therapy

Radiation therapy may be used to remove any remaining cancer cells after surgery, or to shrink tumors prior to surgery. This is performed in conjunction with our surgeons and radiation oncologists. Our goal is to target the radiation to the precise location of the cancer and to use the lowest dose possible. These approaches help reduce the toxicity of the treatment, reducing possible side effects. 

Chemotherapy and Other Drug Therapies

Some patients with nasal cavity and sinus cancers may also benefit from drug therapies: 

• Chemotherapy, or cancer-fighting drugs, may be recommended either alone or with radiation.
• Immunotherapies, such as checkpoint inhibitors, can help the body’s own immune system fight the cancer.
• Targeted drug therapies, such as monoclonal antibodies, block certain proteins in the body that help cancer cells grow.

UChicago Medicine offers more clinical trials of treatments for patients with head and neck cancer than any other hospital in the Chicago area.

Our nutritionists, speech pathologists and other rehabilitation team members are always available to help you with side effects from your cancer or cancer treatment. For instance, some patients with nasal cavity and sinus cancer develop swallowing problems during or after radiation. The speech pathologist will evaluate swallowing function and will provide individualized therapy to help promote recovery and optimal function and quality of life. 

In addition, our dedicated supportive oncology program provides a range of supportive care services to patients and their families, including mental health counseling, social work services and more.

If you smoke, it is important that you stop smoking during and after treatment for mouth cancer. UChicago Medicine’s No Smoker Left Behind program can provide you with the support you need to stop the habit.