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.
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.
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).
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.
Your doctor will explain details of the surgery, general risks and side effects of surgery. Ask your doctor if you have questions. They may recommend:
If you smoke, it is important that you consider stopping smoking before starting treatment to help reduce the risk of infection and help you recover after your treatment.
Treatment for nasal and para nasal sinus cancer may lead to a number of side effects. You may not experience all of the side effects. Speak with your doctor if you have any questions or concerns about treatment side effects.
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 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.
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.
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.
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).
You will meet with many members of the cancer care team, who will help you learn how to look after yourself through radiation therapy, recovery and long term follow-up. They will also talk to you about side effects and how to manage them. It may be helpful to write down questions as they come up, so you can ask anyone in your cancer care team when you see them.
You might need to have some of your teeth taken out, this will depend on the area being treated and the dose of radiation therapy. It is important to take out any broken or infected teeth before radiation therapy. Taking out unhealthy teeth after radiation therapy can cause problems with the jaw bone. Further information about removing teeth and what to expect before and after the operation is available here.
Your cancer and its treatment can make it hard to eat and drink. Your doctor will recommend you see a dietitian to maximise your nutrition during treatment as well as while you are recovering. Sometime feeding tubes may be recommended depending on the area being treated and the dose of radiation therapy. There are two common types of feeding tubes:
Gastrostomy tube (sometimes called a PEG tube): this type of tube is inserted through your abdominal wall into your stomach, with part of the tube staying outside the stomach. A syringe can be attached to the tube to give you food this way if needed. The tube is inserted using a camera through the mouth into the stomach (gastroscopy) or using a CT scanner to guide insertion directly through the skin. If a PEG tube is needed, your doctor will organise this before starting your radiation therapy
Nasogastric tube: this type of tube goes through the nose down into the stomach and is usually used for short periods (days or weeks). A nasogastric tube can be inserted at any time (before, during or after treatment).
There are many other aspects of supportive care that are available, ask your doctor if you have any specific needs.
The side-effects of radiation therapy start around two weeks into treatment and progress through treatment to peak in the last week or just after treatment ends. The side effects start to improve 2-3 weeks after the end of treatment.
the dose of radiation therapy
the area being treated
whether or not chemotherapy is added to the radiation.
tiredness
skin irritation in the treated area e.g. redness, dryness and itching, weeping skin, scaling or sometimes skin breakdown (sores)
nasal irritation, blockage and crusting
dry mouth and throat due to lack of saliva (called xerostomia)
altered taste, which is usally a loss of taste or sometimes an unpleasant taste in the mouth
pain on swallowing or difficulty with swallowing.
Most side effects are short lived and may go away within 4–6 weeks of finishing radiation therapy. Some side effects may last for months after you finish radiation therapy and some may be permanent.
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:
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.
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.
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
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.
whether the treatment is curative or palliative
when it is used
your medical history.
nausea and vomiting
more side effects of radiation, if you have chemotherapy at the same time as radiation
loss of feeling in the fingers and toes
some medications may cause kidney damage
hearing loss/thinning
ringing in the ears
rash
higher risk of infection (if the chemotherapy reduces the number of white cells in the blood).
Most of these side effects are short lived and may go away once you finish chemotherapy. . Some side effects can take months or years to improve or may be permanent
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