Nasal and sinus cancer

Nasal and sinus cancer are rare types of head and neck cancer that develop inside the nose or paranasal sinuses.

The space inside the nose is called the nasal cavity. This space warms, moistens and filters air as you breathe in. The bones around the nasal cavity have small hollow spaces in them. These spaces are called paranasal sinuses. The sinuses affect the sound and tone of your voice.

The exact causes of nasal and sinus cancer are not known but there are risk factors that can increase the chances of developing it.

Nasal and sinus cancer is more common in people who handle or breathe in certain chemicals or dust for many years because of their job. These include formaldehyde, wood dust and leather dust.

Smoking tobacco may also increase the risk of nasal and sinus cancer.

Some cases of nasal and sinus cancer may be linked to an infection called human papilloma virus (HPV). HPVs are a group of common infections that can affect areas such as the inside of the mouth, the throat, genital area or anus. Some types of high-risk HPV can increase the risk of certain cancers.

Most people have HPV at some time during their life. But most people with HPV do not develop nasal and sinus cancer.

As with other cancers, nasal and sinus cancer is not infectious and cannot be passed onto other people.

We have more information about the causes and risk factors of head and neck cancer.

The results of your tests help your doctors find out more about the size and position of the cancer and whether it has spread. This is called staging.

The grade of the cancer gives an idea how quickly it may develop.

Knowing the stage and grade of the cancer helps your doctors plan the best treatment for you.

The staging systems most often used for nasopharyngeal cancer are the TNM and number staging systems. The number staging system is less commonly used.

TNM staging system

TNM stands for tumour, node and metastases.

Tumour (T)

T describes the size of the tumour and whether it has grown into nearby tissues such as bones, muscles or nerves. It is numbered between 0 and 4 depending on the size and extent of the tumour.

• T0 means that there are no signs of a tumour, but there may be abnormal cells that are pre-cancerous.
  • Tis (carcinoma in situ) means the tumour is in the top layer of cells that line the inside of the nasal cavity and has not grown deeper.
• T1 nasal tumours are small and in one place in the nose and have not spread outside the nasal cavity.
• T2 nasal tumours have spread to parts of the surrounding tissue.
• T3 nasal tumours are larger and have spread further into the surrounding tissue.
• T4 nasal tumours have spread into nearby bones, nerves, tissue or areas of the skull. T4 is divided into T4a and T4b. T4a is less locally advanced than T4b.

Nodes (N)

N describes whether the cancer has spread to the [lymph nodes].

Metastases (M)

M describes whether the cancer has spread to another part of the body (called metastatic cancer).

We have more information about staging and grading of head and neck cancer.

Grading of nasal and sinus cancer

The grade describes how the cancer cells look under the microscope. This gives an idea of how quickly the cancer might grow or spread.

We have more information about grading of head and neck cancer.

After treatment, you will have regular follow-up appointments with your specialist doctor. These may continue for several years. You may also have regular follow-up appointments with your multidisciplinary team (MDT), including,a speech and language therapist (SLT), dietitian, restorative dentist and dental hygienist and sometimes a physiotherapist.

If you have any problems or notice new symptoms between appointments, let your doctor or nurse know as soon as possible.

Some treatment side effects may take a long time to improve after treatment finishes, or they may become permanent. These are called long-term effects. Other side effects can develop months or even years after treatment has finished. These are known as late effects. We have more information about long-term and long-term and late effects of head and neck cancer treatment.

Head and neck cancer and its treatment can sometimes have an effect on your sex life.

If you are worried about this, talk to your doctor or nurse. You can read about things that may help in our information on cancer and sex.

Some cancer treatments can also affect whether you can get pregnant or make someone pregnant. If you are worried about this, it is important to talk with your doctor before you start treatment.

We have more information about:

• fertility in women after treatment
• fertility in men after treatment.
• LGBTQ+ people and cancer treatment

Even if you already have a healthy lifestyle, you may choose to make some positive lifestyle changes during and after treatment. For example, if you smoke or drink alcohol, it is best to avoid smoking or reduce the amount of alcohol.

Eating well and keeping active can improve your health and well-being. It can also help your body recover. Your dietitian can help with any difficulties you might have with eating after treatment.

We understand that having treatment can be a difficult time for people. We're here to support you. If you want to talk, you can:

• Call the Macmillan Support Line on 0808 808 00 00.
• Chat to our specialists online.
• Visit our head and neck cancer forum to talk with people who have been affected by head and neck cancer, share your experience, and ask an expert your questions.

Further support and information is available through The Swallows. The Swallows is a national head and neck cancer support charity. It offers support to people affected by head and neck cancer, their carers, friends and relatives.