Nasal cancer

Nasal and sinus cancer affects the nasal cavity (above the roof of your mouth) and the sinuses (small, air-filled cavities inside your nose, behind your cheekbones and forehead).

The area where the nose and throat connect is called the nasopharynx. A specific type of cancer, called nasopharyngeal cancer, affects this area.

Symptoms of nasal and sinus cancer

The most common symptoms of nasal and sinus cancer are similar to viral or bacterial infections, such as the common cold or sinusitis, and include:

a persistent blocked nose, which usually only affects one side – up to 90% of people with nasal or sinus cancer experience a blockage
nosebleeds (epistaxis)
a decreased sense of smell
mucus running from the nose or down the throat

Other symptoms often appear at a later stage, and include:

pain or numbness in the face, particularly the cheek or above the eye
enlarged lymph nodes in the neck
partial loss of vision or double vision
a bulging eye (proptosis)
severe headaches

When to see your GP

See your GP if you notice any unusual or persistent symptoms. It is unlikely to be nasal or sinus cancer, but the condition is easier to treat if diagnosed early.

If your GP feels a further opinion is needed, you will usually be referred to an ear, nose and throat (ENT) consultant in hospital.

If you are referred for further tests in hospital, they may include:

a nasal endoscopy – where a long, thin, flexible tube with a camera and a light source is inserted through your nose to examine the area
imaging studies – such as a chest X-ray, CT scan or MRI scan
a biopsy (taking a sample of tissue) to send for examination – this may be done during an endoscopy, or fine needle aspiration (FNA) may be used if there is a lump

Who is at risk?

Nasal and sinus cancer is rare in the UK, and only around 460 cases are diagnosed each year. However, several factors are known to increase the risk of developing the condition, including:

your gender – men are much more likely to develop nasal and sinus cancer than women
smoking – the more you smoke, the higher your risk of developing several types of cancer, including nasal and sinus cancer
having previously had radiotherapy to treat hereditary retinoblastoma (a rare type of eye cancer that affects children under five)
exposure to certain substances through work, including wood dust, leather dust, nickel, formaldehyde and cloth fibres
human papilloma virus (HPV) – a large group of viruses that affect the skin and moist membranes, such as the mouth and throat

The Health and Safety Executive (HSE) has produced a report on the risk of occupational nasal and sinus cancer in the UK (PDF, 2Mb).

Your risk may also be increased if you have a history of sinus or nose problems, or have previously had non-Hodgkins lymphoma (cancer of the lymphatic system).

Treating nasal and sinus cancer

Your treatment will be organised by a head and neck cancer multidisciplinary team (MDT) at the hospital. A keyworker will be assigned to you to act as support and a main contact point while you receive care. The cancer team will discuss treatment options with you.

The best treatment for nasal and sinus cancer depends on several factors, including the stage of your cancer and your general health.

Treatment usually includes a combination of:

surgery to remove a tumour – which can be performed using surgical incisions (open surgery) or as keyhole surgery through the nose (endoscopic microsurgery)
radiotherapy – using high-energy radiation to shrink a tumour before surgery or destroy small amounts of a tumour that may be left after surgery
chemotherapy – using medicine to help shrink a tumour before surgery or reduce the risk of the cancer returning after surgery
biological therapy – a newer type of medication known as monoclonal antibodies help to prevent cancer from spreading

Radiotherapy and chemotherapy can also be used to treat a tumour without surgery. In some cases, chemotherapy may be combined with radiotherapy.

Outlook

Overall, 35-60% of people with nasal and sinus cancer will live for at least five years after diagnosis. However, the outlook for nasal and sinus cancer can vary, depending on where the cancer is located and how far it has spread (the stage) before it is diagnosed and treated.

Nearly everyone who is diagnosed very early will live for at least five years afterwards. If the cancer is diagnosed at an advanced stage, only 20-30% of people will live for at least five years after diagnosis. However, this very much depends on the type of cancer, as well as individual factors.

Cancer of the nasal cavity generally has a better outlook than cancer of the sinuses.

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