Cancer arises when normal cells transform into tumour cells, it is the leading cause of death known worldwide, with nearly 10 million deaths in 2020. Sinus and nasal cancer also known as sinonasal cancer is rare cancer that affects the nasal cavity.
Sinus and nasal cancers are diseases that affect the nasal cavity, the space behind your nose causing cells in and around the nose to multiply and grow abnormally resulting in a tumour. The tumour can be found in two places; the space behind the nose where air passes to the lungs or the spaces around the nose that produces mucus. The sinuses are covered with cell lining that produces mucus to keep the inside of the nose dry when breathing.
Endoscopy of the sinuses is a procedure in which a very thin tube with a tiny light and a small video camera is at the end. This is inserted into your sinuses which helps the doctor to figure out the location of the tumour and its size. Its diagnosis usually requires a biopsy and the specimen is usually examined by a pathologist. Imaging is also a technique used to view your nasal cavity and sinuses like a CT scan and an MRI.
Staging is also an important part of the diagnosis process, with this the doctor can tell how advanced or how much cancer has spread to other parts of the body. This helps your doctor to determine the best treatment plan you need. Staging could range from stage I (earliest stage) to stage IV (most advanced stage);
- Stage I: At this stage, the tumour is contained either in the sinus or nasal cavity and has not spread.
- Stage II: The tumour has spread to areas near the sinuses. Cancer may have spread into the bone.
- Stage III: The tumour may have spread to the lymph node, the bone between the eyes, the maxillary sinus, and the bone of the sinuses.
- Stage IV: The tumour has spread deeper into the brain, eye socket, and possibly to more distant parts of the body and a larger presence in the lymph nodes.
Statistically, about 4 out of every 5 cases occur in people who are 55 years old or older. The most common type of nasal and sinus cancer is squamous cell cancer with sinonasal cancer being the 2nd most important cancer site or occupational attribution. The occupational attributable fraction for sinonasal cancer was estimated to be 20% in women and 43% for men registered in the United Kingdom. This explains why men are more likely to have sinus and nasal cancer than women. Sinus cancer happens most often in people from South Africa and Japan, it is rare in other groups.
Causes of sinus cancer
Even though the causes of each sinus and nasal cancer might be unknown, there are some factors or activities that increase the risk of nasal sinus cancer. Factors include:
- Smoking: There are membranes present in the nose and sinuses that are constantly producing mucus which protects the whole respiratory system. Tiny hair-like structures called cilia are also responsible for cleaning the lungs, nose, and sinuses from bacteria and airborne infections. Smoking causes the cilia to stop functioning and exposes the smoker to infection of the sinuses and lungs. When tobacco smoke is inhaled, toxic gases like ammonia and formaldehyde are released which causes the nose and sinuses to produce more mucus. The smoker is highly susceptible to allergies and colds, eventually inducing cell death and leading to cancer.
- Human papillomavirus (HPV): HPV is a common virus that can cause warts. A high risk of HPV infections that persist for many years can change the cells that may develop into cancer. According to research, about 30% of sinus and nasal cancer are linked to HPV, and type 16 is the most commonly linked with HPV.
- Gender: According to the American Cancer Society, men are twice as likely to develop sinus and nasal cancer as women. Several factors increase the risk of cancer in men like smoking, exposure to certain substances and heavy metals at work, alcohol, and so on.
- Acquired and inherited gene mutations: Although inherited gene changes are not believed to cause nasal and sinus cancer. Some people inherit DNA mutations from their parents which increases the chances of developing certain cancers. The protein contained in the gene controls many important functions like cell growth. When a mutation occurs, it changes the functions of protein which can cause healthy cells to become cancerous.
- Exposure to industrial chemicals: Frequent and prolonged exposure to certain toxic substances like cloth fibres, nickel, chromium, leather dust, radium, wood dust, and formaldehyde.
To help reduce the risk of getting nasal and sinus cancer, smoking should be avoided or exposure to second-hand smoke. Also, abide by the safety rules and follow them.
Symptoms of sinus cancer
Symptoms of sinus and nasal cancer are often missed because of the similarities with the symptoms of a cold or infection. In some cases, the cancer is detected accidentally while checking for other medical problems. The only way to be assertive is by seeing a medical doctor to prevent late detection. Symptoms include:
- Nosebleeds
- Fatigue
- Headache
- Bulging eyes
- Teeth become loose
- Unexplainable weight reduction
- Trouble opening the mouth
- Sinus blockage or pressure
- Changes in vision or eye pressure
- Enlarged lymph nodes in the neck
- Problem with the sense of smell
- A sore or lump inside the nose that does not heal
- Pain or Numbness in the face, teeth, and ears
- Nasal congestion and stuffiness that worsens
- Watery eyes with tears running down the cheeks
Do not ignore simple colds that have lasted up to 21 days or more, pay attention and make sure to take sufficient actions when it goes past 3 weeks. If you experience some of the symptoms in the list, then you might want to acknowledge it and see a doctor.
How is sinus cancer treated?
Treating sinus cancer can depend on some factors like the location of the tumour and size of the tumour that is within the sinus, type of cancer, stage of cancer, type of cancer, and overall health. Treatments include:
- Radiation therapy: This is usually given to shrink a tumour before surgery or to destroy remaining cancerous cells after surgery. In the period of post-surgery, radiation therapy starts several weeks after surgery to give your body enough time to heal. For those that can’t have surgery or do not want surgery, radiation therapy is used as the main treatment.
- Surgery: the tumour may be removed surgically through a procedure called endoscopic microsurgery as stated earlier. During this procedure, the cancer is removed through the nose with an endoscope. The surgery aims to preserve the face and function as possible, by removing as many tumours as possible. The surgery may involve a variety of specialists like neurosurgeons (brain surgeons), maxillofacial surgeons (specializes in the face, head, neck, and jaw), and an otorhinolaryngologist (specializes in the ear, nose, and throat) also known as ENT doctor.
- Chemotherapy: It is the use of chemical drugs used to destroy or kill cancer cells. This therapy is often used for cancers that returned after the first treatment. A combination of chemotherapy and radiation therapy referred to as chemo radiation is used to treat some types of sinus cancer.
- Other alternatives for the treatment of sinus cancer may include massage therapies, acupuncture, and yoga.
It is important to note that the above treatment may include some level of pain management. It is advisable to speak up to your doctor if you are in pain, so it can be managed.
Although undergoing cancer treatment can be exhausting and stressful, trust your doctor to help develop the best treatment plan for your situation. If you are treated for sinus and nasal cancer, frequently meet with your doctor to monitor your health status. If cancer returns, it is likely in the first few years after undergoing treatment.