In this section: Nasal and Sinus Cancer

NOSE CANCER 
treatment

ALSO KNOWN AS NASAL CANCER,
INCLUDES SINUS CANCER 

 

What do we mean by 'Nasal Cancer'? Nasal Cancer is a type of Head and Neck Cancer in the nose and nasal cavity. Sinus Cancer. If it's not the cancer type you're looking for, please explore the information about other types of Head and Neck Cancers.


 
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1. Treatment options for Nose Cancer

Following a diagnosis of Nose Cancer your cancer care team will discuss treatment options including the possibility of participating in a clinical trial that is suitable for you. This is also a good time to consider if you would like a second opinion.

The most suitable treatment for Nose Cancer depends on many things including:

  • type of nasal or para nasal cancer

  • size and location of the cancer

  • whether the cancer has spread

  • personal factors (e.g. age, general health and treatment history)

  • types of treatment available (and whether any clinical trials are available) 

  • ​your preferences for treatment. 

Nose Cancers are generally treated with surgery, radiation therapy, or a combination of both. Radiation therapy may be in combination with chemotherapy (adjuvant concurrent chemoradiation).

Surgery involves taking the cancer out of the nasal cavity and para nasal sinuses and for some people, the lymph glands in the neck. Some people may need extra treatment after surgery to reduce the risk of the cancer coming back.

This can be either radiation therapy alone (adjuvant radiation therapy) or radiation therapy in combination with chemotherapy (this is called adjuvant concurrent chemoradiation).


2. Surgery for Nose Cancer

There are a number of different operations that can be used to remove Nose Cancer. The operation used will depend on the size, the type nasal cancer and location of the tumour. 

Surgical procedures include:

ENDOSCOPIC SURGERY

This is when a telescope and surgical instruments are passed through the nose to get to the nasal cavity, paranasal sinuses, nasopharynx and sometimes into the brain without needing to cut through the skin on the outside.
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CRANIOFACIAL RESECTION

This involves removing the cancer using cuts (incisions) via the face and the skull. It is used for cancers that have grown inside, or approach the skull.
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ORBITAL EXENTERATION

This involves the removal of the eye or eye lid. It is used when the cancer has spread into the eye socket and cannot be treated any other way.
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NECK DISSECTION

This involves removing lymph nodes from the neck. It is used when the cancer has spread to the lymph nodes in the neck, or there is a risk of microscopic cancer in the lymph glands of the neck.
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RECONSTRUCTIVE SURGERY (SOFT TISSUE FREE FLAP

This may be considered if a large area of tissue is removed. Reconstructive surgery may involve taking tissue from another part of the body called a free flap repair. This operation may be carried out by a surgeon who specialises in reconstructive surgery, your head and neck surgeon or another surgeon.
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TRACHEOSTOMY

A tracheostomy is used to create an opening in the trachea (windpipe) after major head and neck surgery. A tube is inserted into the opening to help you breathe until normal breathing is possible.
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FEEDING TUBES

  • A gastrostomy tube (called a PEG tube) goes through the skin and the muscles of your abdominal wall into the stomach. Gastrostomy is recommended if feeding is needed for a medium to longer time (months or years).
  • A nasogastric tube goes through the nose down into the stomach. Nasogastric feeding is used for short time (days or weeks).
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3. Radiation Therapy for Nose Cancer

The most common radiation therapy approach for Nose Cancer is called external beam radiation. This type of radiation therapy applies radiation from outside the body.

Radiation therapy can be used in the following ways:

Definitive

This is the main treatment for nasal and para nasal sinus cancer. It is used without surgery to cure nasal and para nasal sinus cancers.

Definitive radiation therapy can also be given in combination with chemotherapy (called concurrent chemoradiation). The decision to give radiation therapy, alone or in combination with chemotherapy depends on the type of tumour, how big it is and how fit and strong you are. Typically radiation therapy is delivered one each week day (not on weekends) over 7 weeks.

Neo-adjuvant

This is when radiation therapy is given before surgery to help shrink large cancers so they are easier to remove during surgery. Sometimes chemotherapy is added to radiation therapy (chemoradiation) to make it more effective.

Adjuvant

This is when radiation therapy is given after surgery. It is used as an additional treatment to kill cancer cells that may not have been removed during surgery. This typically starts about 4 weeks after surgery to give you time to recover from the surgery. The radiation therapy usually lasts for about 6 weeks. Sometimes chemotherapy is added to the adjuvant radiation therapy (chemoradiation) to make it more effective.

The decision to give radiation therapy, either alone or in combination with chemotherapy, is based on the pathology results after surgery and how fit and strong you are to cope with the treatment. The aim is to lower the risk of the cancer coming back again in the nose, sinuses or neck, however not all patients need this.

Palliative

In cases where a cure is not possible, radiation therapy is used to relieve symptoms of advanced nasal and para nasal sinus cancer. Symptoms that may require palliative radiation therapy include pain, bleeding and pressure symptoms pressing on vital structures (e.g. visual disturbance and headaches).

4. Chemotherapy for Nose Cancer

Chemotherapy works by destroying or damaging cancer cells. For nasal and para nasal sinus cancers, it is usually given into a vein through a needle with a cannula (tube) attached.

There are a number of ways that chemotherapy may be used to treat Nose Cancer including:

Definitive

Sometimes chemotherapy is added to definitive radiation therapy (chemoradiation). This may be given once every 3 weeks or once a week throughout the duration of radiation therapy. This makes the radiation more effective at killing cancer cells but also leads to more side effects in most people.

Adjuvant

This is when chemotherapy is given after surgery and is usually combined with radiation therapy (called concurrent chemoradiation). This may be given once every 3 weeks or once a week throughout the duration of radiation therapy. This makes the radiation more effective at killing cancer cells but also leads to more side effects in most people. Unlike chemotherapy for many other cancers, most people do not lose their hair or have severe nausea and vomiting.

Neo-adjuvant

This is when chemotherapy is given before surgery or radiation therapy. It works to shrink large cancers so they are easier to remove during surgery or target with radiation therapy

Palliative

This is used when the cancer is incurable. The cancer may be too large or has spread too much to be removed by surgery. Palliative chemotherapy helps to slow the growth of cancer and reduce symptoms. It is important to remember that palliative chemotherapy is not as intense as other types and is much less likely to have significant side effects.

Before you start treatment, your medical oncologist will choose one or more chemotherapy medications that will be best to treat the type of cancer you have. 

The chemotherapy medications your doctor chooses may depend on: 
  • whether the treatment is curative or palliative

  • when it is used

  • your medical history.

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FURTHER INFORMATION
  1. Head and Neck Cancer Australia Resources 
  2. External Links to other Head and Neck Cancer Resources