Treatment
Treatment for tumors of the nasal cavity and paranasal sinuses depends on the location, severity, and stage of the tumor. Surgery to remove the tumor and surrounding tissue is the ideal primary treatment; however, depending on the exact location and extent of the tumor, surgical treatments may differ.
Surgery
Surgery is the primary treatment for tumors of the nasal cavity and paranasal sinuses. Surgery depends on the location, size, and extent of the tumor. The doctor may be able to remove some tumors using an endoscope (a thin tube with a camera, light, and surgical tools on the end). Other tumors may require more extensive surgery that requires cutting through skin and bone to reach the tumor.
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Nasal Cavity
For tumors in the nasal cavity, the doctor will attempt to remove the tumor and a margin of surrounding tissue. The surgical technique may vary depending on the exact location of the tumor in the nasal cavity. The tumor may be reached by cutting through the skin of the nose and surrounding bones, or it may be reached through an incision under the upper lip. If the tumor is very advanced, the entire nose may need to be removed.
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Maxillary Sinus
For tumors in the maxillary sinuses, the primary treatment is a maxillectomy. In this procedure, an incision may be made along the side of the nose from eye to lip, or it may be made under the upper lip. The doctor may then remove bones in order to reach the tumor inside the sinus. The doctor will then remove the tumor and surrounding tissue in one piece. The doctor may also remove part of the eye socket, part of the roof of the mouth, some upper teeth, the cheek bone, and part of the nose.
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Ethmoid, sphenoid, and frontal sinuses
For tumors in these areas, the doctor may recommend a surgical procedure called a craniofacial resection. This procedure is basically the same as a maxillectomy, plus removal of the top part of the eye socket and the skull base.
Additional Treatments
The doctor may also recommend any of the following treatments:
Radiation therapy
Radiation therapy uses waves of high energy rays produced by a machine to destroy cancer cells. Radiation therapy may be the primary treatment for some smaller tumors. Radiation therapy may also be used as a palliative treatment in patients with advanced cancer in order to relieve symptoms. Most commonly, radiation therapy is given before and/or after surgery in order to shrink the tumor or reduce the risk of a recurrence. Patients with head and neck cancer should meet with an oncologic dentist before this treatment, as radiation can cause tooth decay and other side effects when administered to the head and neck region.
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Proton beam radiation therapy
Proton therapy is an advanced type of radiation therapy that uses “protons” rather than X-ray “photons” to deliver radiation to the tumor. In conventional radiotherapy, the photon beams can deposit radiation and damage healthy cells as they pass through the body. Proton therapy deposits most of the radiation directly at the tumor site, resulting in less damage to healthy tissue and fewer side-effects.
- Please see Understanding Proton Therapy to learn more.
Chemotherapy
Chemotherapy is the use of drugs to target rapidly growing cells in an effort to destroy cancer cells. Chemotherapy may be given before or after surgery, to shrink the tumor or reduce the chance of a recurrence. Chemotherapy may also be the primary treatment in patients whose cancer has metastasized, in order to shrink the tumor and relieve symptoms. Chemotherapy is often combined with radiation therapy in each of these instances.
Immunotherapy
Immunotherapy uses medications to help the body’s own immune system recognize and destroy cancer cells more effectively. It typically targets specific proteins in the immune system to boost its ability to fight cancer. It has different (sometimes less severe) side effects than chemotherapy. Immunotherapy is used to treat many kinds of cancer, but has not been well studied for treating most kinds of nasal cavity and paranasal sinus cancers due to their rarity.
Clinical Trials
Clinical trials allow patients to try a new treatment before it is available to the general public. In some cases, this may be a new drug that has not been used in humans before, or it may be a drug or drug combination that is not currently used for that specific type of cancer. Early phase clinical trials are often used to test side effects of a drug or drug combination, while later phase clinical trials are used to see how effective a new treatment might be for a certain type of cancer. Clinical trials allow doctors and researchers to improve the treatment of cancers with possibly more effective therapies. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation.
