Sinonasal cancer is a rare but aggressive type of cancer that develops in the nasal cavity or paranasal sinuses. The nasal cavity is the space behind the nose where air passes before reaching the lungs, and the paranasal sinuses are air-filled spaces surrounding the nasal cavity. Since early symptoms are often similar to those of benign conditions like sinus infections, sinonasal cancer is frequently diagnosed at an advanced stage.
Sinonasal cancer occurs when the cells lining the nasal cavity and sinuses undergo genetic mutations, causing them to grow uncontrollably and form a tumor. The tumor can invade nearby tissues, including the eyes, brain, and bones, and may spread to distant organs if not treated promptly.
Rare but aggressive – Sinonasal cancer is uncommon but has a high potential for spreading.
Difficult to diagnose early – Symptoms often mimic common sinus conditions.
Different cell types involved – Includes squamous cell carcinoma, adenocarcinoma, and rare types like olfactory neuroblastoma.
Occupational exposure risk – Linked to exposure to wood dust, leather dust, and other industrial toxins.
The exact cause of sinonasal cancer is unknown, but several risk factors contribute to its development.
Occupational exposure – Long-term exposure to wood dust, leather dust, and formaldehyde increases risk.
Smoking – Tobacco use significantly raises the risk of sinonasal cancer.
Human papillomavirus (HPV) – Certain HPV strains are associated with an increased risk.
Chronic sinus inflammation – Persistent sinus infections may contribute to cellular changes leading to cancer.
Radiation exposure – Previous radiation therapy to the head and neck area can increase susceptibility.
Genetic predisposition – A family history of head and neck cancers may increase risk.
Early symptoms of sinonasal cancer are often nonspecific, making early diagnosis difficult.
Nasal congestion – Persistent blockage in one nostril.
Nosebleeds – Frequent and unexplained bleeding.
Facial pain and swelling – Especially around the nose and eyes.
Vision problems – Blurred vision or double vision due to tumor growth.
Loss of smell – Partial or complete anosmia (loss of smell).
Ear pain and hearing loss – If the tumor affects the ear canal.
Persistent sinus infections – Recurrent infections not responding to antibiotics.
Lump or mass inside the nose – A noticeable growth that may cause discomfort.
Sinonasal cancer consists of different histological types, each requiring a specific treatment approach.
Squamous Cell Carcinoma (SCC) (Most Common)
Arises from the flat cells lining the nasal cavity and sinuses.
Accounts for 50-60% of sinonasal cancers.
Adenocarcinoma
Develops from glandular cells.
Strongly associated with wood dust exposure.
Olfactory Neuroblastoma (Esthesioneuroblastoma)
A rare tumor arising from the olfactory nerve.
May cause early loss of smell and nasal obstruction.
Sinonasal Undifferentiated Carcinoma (SNUC)
A highly aggressive cancer with a poor prognosis.
Often diagnosed at an advanced stage.
Melanoma
Originates from pigment-producing cells.
Less common but aggressive and prone to recurrence.
Sarcomas
Includes rhabdomyosarcoma and chondrosarcoma.
Arises from connective tissues like muscle, bone, and cartilage.
Early diagnosis improves treatment outcomes, but sinonasal cancer is often detected in advanced stages.
Physical examination – A doctor checks for visible abnormalities in the nasal cavity.
Nasal endoscopy – A thin, flexible tube with a camera is inserted into the nasal passages to examine abnormalities.
Imaging tests:
CT Scan – Provides detailed images of sinus structures and tumor location.
MRI Scan – Helps evaluate the extent of tumor spread.
PET Scan – Identifies distant metastases (spread to other organs).
Biopsy – A tissue sample is examined under a microscope to confirm cancer type.
Treatment depends on the cancer type, stage, and overall health of the patient.
Endoscopic surgery – Minimally invasive removal using a nasal endoscope.
Open surgery – Performed for larger tumors that invade surrounding tissues.
Maxillectomy – Removal of part or all of the upper jaw.
Craniofacial resection – Removal of tumors extending into the skull base.
Uses high-energy beams to destroy cancer cells.
Often used after surgery to eliminate remaining cancer cells.
Can be used as primary treatment for inoperable tumors.
Uses anti-cancer drugs to kill or shrink tumors.
Often combined with radiation therapy for advanced cases.
Can help control metastatic disease.
Focuses on specific molecules that promote cancer growth.
Drugs like cetuximab target specific proteins involved in cancer progression.
Stimulates the immune system to attack cancer cells.
Used in cases where other treatments are ineffective.
Survival rates depend on several factors, including the type, stage, and location of the tumor, as well as overall patient health.
Cancer stage – Early-stage cancers have better survival rates.
Tumor location – Some areas, like the ethmoid sinus, are harder to treat.
Histological type – Certain types, like SCC, have a better prognosis than SNUC.
Treatment response – Patients responding well to surgery and radiation have higher survival rates.
Localized disease (confined to the nasal cavity/sinus): 5-year survival rate of 60-70%.
Regional spread (lymph nodes involved): 5-year survival rate of 40-50%.
Distant metastases (spread to distant organs): 5-year survival rate below 20%.
While sinonasal cancer cannot always be prevented, certain lifestyle changes can reduce risk.
Avoid occupational hazards – Use protective masks if exposed to industrial dust.
Quit smoking – Reduces risk significantly.
Maintain nasal hygiene – Regularly clear nasal passages of irritants.
HPV vaccination – May lower risk associated with HPV-related sinonasal cancers.
Early screening – Regular check-ups for high-risk individuals.
Managing sinonasal cancer requires ongoing care and support.
Regular follow-ups – Essential for monitoring recurrence.
Nutritional support – A balanced diet promotes healing.
Pain management – Medications and therapies alleviate discomfort.
Speech and swallowing therapy – Helps with post-surgical recovery.
Psychological support – Counseling and support groups provide emotional help.