What Is Sinus Cancer?

Sinus cancer is a malignancy that develops in the open spaces behind your nose, called sinuses. It makes up about 3 to 5% of all head and neck cancers and can have long-lasting and devastating effects if not treated early.

Each year, about 2,000 people are diagnosed with nasal cavity or paranasal sinus cancer in the United States. Oftentimes sinus cancer goes unnoticed until symptoms develop, and when symptoms do occur, they often mimic common benign conditions like a cold or the flu. 

In this article, you will learn the signs and symptoms to be aware of if you suspect sinus cancer so that you can seek prompt treatment, as research has shown that early diagnosis and treatment better your chances of beating cancer.

Types of Sinus Cancer

Sinus cancers are classified according to the type of cells involved. There are many different types of sino-nasal cancers, including:

• Squamous cell carcinoma: Squamous cell carcinoma is the most common type of sinus cancer. It originates from surface layer cells of the head or neck. If the cancer is confined to the flat, top cell layer, it is called carcinoma in situ. If these cells continue to multiply, they can invade deeper into the tissues and become invasive squamous cell carcinoma.
• Adenoid cystic cell carcinoma: This rare cancer occurs in the secretory glands of the paranasal sinuses.
• Sinonasal undifferentiated carcinoma: When sinus cancer cells mutate to a degree that it is hard to identify which type of cells they are, it is called sinonasal undifferentiated carcinoma.
• Esthesioneuroblastoma: Also known as olfactory neuroblastoma, esthesioneuroblastoma is a rare malignant tumor that arises in the nasal cavity.
• Adenocarcinoma

Moreover, sinus cancer may occur in various locations around the face, such as:

• Maxillary sinus: The air-filled area of the cheekbones on either side of the nose that makeup part of the paranasal sinuses.
• Ethmoid sinus: Another part of the paranasal sinus system located along the upper nose and between the eyes. Cancer here is rare. 

Sinus Cancer Symptoms

Small sinus cancer growths usually cause no symptoms and are often found incidentally when your doctor is looking for something else. In most cases, sinus cancer is detected when you are experiencing one or several problems in the head and neck area of the body. Many symptoms, like nasal congestion and postnasal drip, can mimic a cold, allergies, or sinusitis, and are often ignored, but if any of the following symptoms persist or don’t get better with standard treatment, you should consult your healthcare provider. 

Signs and symptoms of sinus cancer often only occur on one side and include:

• Nasal congestion and stuffiness that doesn’t get better or even worsens
• Pain above or below the eyes
• Blockage of one side of the nose
• Frequent nosebleeds
• Mucus running from your nose
• Post-nasal drip (mucus draining into the back of your nose and throat)
• Problems with your sense of smell
• Numbness or pain in parts of the face
• Loosening or numbness of teeth
• A lump or mass on the face, palate (top of the mouth), or inside the nose
• Constant watery eyes
• Bulging of one eye
• Loss or change in vision
• Pain or pressure in one of the ears
• Hearing loss
• Headache
• Trouble opening the mouth
• Enlarged lymph nodes in the neck (seen or felt as lumps under the skin)

In the later stages, you may also experience:

• Pain or numbness in the face, particularly in the upper cheek
• Swollen glands in the neck
• Partial loss of vision or double vision
• A bulging or persistently watering eye
• Pain or pressure in one ear
• A persistent lump or growth on your face, nose, or roof of your mouth

Causes

Not all sinus cancers have known causes, but research suggests that some environmental factors, particularly heavy exposure to certain industrial chemicals, may increase the risk of developing sinus cancer. The following substances have been linked to higher rates of nasal and paranasal sinus cancer:

• Wood dust
• Leather dust
• Nickel compounds (a metal used to make stainless steel)
• Isopropyl alcohol production (often used in household products and in manufacturing processes)
• Radium 226 and 228 (radioactive metals, which can be found in old houses with cracks in the foundation, and at low levels in nature)

Other causes of sinus cancer include:

• Human papillomavirus (HPV) infection
• Cigarette smoke

Diagnosis

Although it's unlikely that your symptoms will be diagnosed as sinus cancer, it is important to get checked out by a healthcare professional if you are not improving. During your exam, you will be asked about your medical history, any problems you've been having, and possible risk factors such as where you work and what chemicals you work with. Your healthcare provider will perform a physical exam to look for signs of sinus cancer in the paranasal and nasal cavity, as well as check for other health problems that might explain your symptoms.

During your physical exam, your doctor will check for numbness, pain, swelling, and/or firmness in your face, while also looking for any changes in the symmetry of your eyes and face, loss of vision, and any other symptoms. Swollen lymph nodes or glands in the neck area are later sign of developing sinus cancer so your doctor or healthcare professional will also check those areas during your exam.

If your healthcare provider suspects sinus cancer, they will refer you to an otolaryngologist, a doctor who specializes in diseases of the ear, nose, and throat. More commonly referred to as ENTs, these specialists will perform an endoscopy, a procedure using a thin tube with a tiny light and a video camera on the end called an endoscope to look at the nose and nasal passages. During this procedure, your ENT may remove a small piece of abnormal tissue to further examine. They may also order imaging such as X-rays, CT scans, PET scans, bone scans, and MRIs to get a better idea of what’s going on.

Treatment

Your treatment options will depend on the stage at which your cancer was diagnosed, how far it's spread, and your general level of health. Usually, a combination of surgery, radiation, and chemotherapy will be needed to increase the efficacy of your treatment. 

Sinus cancer treatment options include:

• Surgery: Endoscopic or minimally invasive surgery through the nose is a tumor removal option for a small percentage of select patients. 
• Radiation: High-energy radiation is used to kill the cancerous cells, shrink a tumor before surgery, or destroy small pieces of a tumor that may be left after surgery.
• Chemotherapy: Medicine, which is injected intravenously or taken by mouth, works to kill cancer cells throughout the body. Adjuvant chemotherapy, or chemotherapy after surgery, may possibly help reduce the risk of cancer returning after surgery.

Prognosis 

Sinus cancer is usually diagnosed in older adults, age 55 and over. It also targets certain races and sexes more than others: White people are much more likely to develop sinus cancers than Black people, and men are about twice as likely as women to be diagnosed with sinus cancer.

Survival rates depend on the type of cancer and the stage of cancer at diagnosis. The SEER (Surveillance, Epidemiology, and End Results) database, maintained by the National Cancer Institute (NCI) found that the five-year survival of those with sinus cancer from 2010-2016 was 82% if the cancer was captured locally, 52% if it was found regionally, and 43% if it was found in a distant phase, underscoring the importance of early diagnosis and treatment. The sooner you get a diagnosis and start treatment, the better your chances of beating the cancer are likely to be.

Survival rates are calculated based on people with similar cancer types and stages of the disease. While survival rates can’t tell you how long you will live, they can give you insight into how successful treatment may be for you. 

A Word From Verywell

If you have chronic sinusitis or cold-like symptoms, don’t put off consulting your health care professional as the symptoms could be a sign of a more ominous condition. Early detection and treatment increases the likelihood of complete removal of the tumor and decreases the chances of the cancer returning.

A diagnosis of sinus cancer can be frightening, but take heart that if you do receive a diagnosis, your chances of survival are high. Your ENT will work with you to build a personalized treatment plan to manage your symptoms and optimize your chances of achieving complete remission.