Nasal and Sinus Cancer

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This blog is for informational purposes only and should not be taken as medical advice. Content is sourced from third parties, and we do not guarantee accuracy or accept any liability for its use. Always consult a qualified healthcare professional for medical guidance.

What is Nasal and Sinus Cancer?

Nasal and sinus cancer, also known as sinonasal cancer, is a rare malignancy that develops in the nasal cavity or paranasal sinuses (air-filled spaces around the nose, including maxillary, ethmoid, sphenoid, and frontal sinuses). It accounts for about 3-5% of head and neck cancers, with approximately 2,000 new US cases annually in 2025. The most common type is squamous cell carcinoma (50-60%), followed by adenocarcinoma, melanoma, and sarcomas. These cancers are often aggressive, invading nearby structures like the eyes, brain, or skull base, and are more common in men over 55. Early-stage tumors are confined to the sinus, while advanced stages spread to lymph nodes or distant sites like lungs.

Symptoms

Symptoms of nasal and sinus cancer often mimic common sinus issues, leading to delayed diagnosis. Common signs include persistent nasal congestion or blockage (unrelieved by blowing the nose), frequent nosebleeds, facial swelling or numbness, pain in the upper jaw or teeth, headaches, double vision or vision loss (from orbital involvement), ear pain or fullness, reduced sense of smell, chronic sinus infections, runny nose, nasal discharge (possibly bloody or foul-smelling), loose teeth, or a lump in the neck from lymph node spread. Advanced cases may cause bulging eyes (proptosis), facial deformity, or neurological symptoms if the tumor invades the brain. Symptoms typically worsen over months.

Causes

The primary causes involve chronic irritation and exposure to environmental carcinogens. Risk factors include occupational exposure to wood dust (e.g., carpenters, increasing adenocarcinoma risk 500-fold), leather dust, nickel, chromium, formaldehyde, or textiles; smoking or tobacco use (doubles risk); human papillomavirus (HPV, linked to 20-30% of cases); and chronic sinusitis or nasal polyps. Genetic mutations (e.g., TP53, EGFR) play a role, with higher incidence in men and certain ethnic groups (e.g., Asians for undifferentiated types). In 2025, research highlights how woodworking and industrial exposures remain significant, with HPV vaccination potentially reducing incidence.

Diagnosis

Diagnosis begins with a thorough history and physical exam, including endoscopy to visualize the nasal cavity and sinuses. Imaging includes CT scans for bony involvement, MRI for soft tissue and neural extension, and PET-CT for staging and metastasis detection. Biopsy (via endoscopy or fine-needle aspiration) confirms histology and grade. Additional tests like blood work or HPV testing guide subtype identification. In 2025, advanced techniques such as AI-enhanced imaging and molecular profiling (e.g., for PD-L1 expression) improve accuracy and predict response to immunotherapy.

Treatment

Treatment is multimodal and depends on stage, location, and histology. Surgery is the cornerstone for resectable tumors, using endoscopic sinus surgery for early cases or open craniofacial resection for advanced, often with reconstruction to preserve function and appearance. Radiation therapy (intensity-modulated or proton beam) follows surgery or is primary for unresectable tumors, reducing recurrence by 20-30%. Chemotherapy (cisplatin-based) is added for advanced or high-grade cases, with concurrent chemoradiation standard. Targeted therapies (e.g., EGFR inhibitors) and immunotherapy (pembrolizumab for PD-L1+) benefit select patients. Palliative care manages pain and symptoms. In 2025, minimally invasive robotic surgery and novel immunotherapies improve outcomes while reducing morbidity.

Future Outlook

In 2025, nasal and sinus cancer’s 5-year survival is 50-60% overall, 80% for localized disease, but 20-30% for advanced stages due to proximity to critical structures. Advances in immunotherapy and targeted therapies (e.g., for HPV-positive cases) have improved response rates to 40-50% in metastatic disease. Research focuses on biomarker-driven treatments, AI for early detection, and preventive measures like occupational safety. By 2030, these could raise overall survival to 70%, with emphasis on reducing recurrence through combination therapies and vaccination.

Sources

The information for nasal and sinus cancer is sourced from Johns Hopkins Medicine’s “Nasal Cancer/Sinus Cancer” for symptoms and overview; MD Anderson’s “What is Nose Cancer?” for causes and symptoms; Memorial Sloan Kettering’s “Nasal Cavity and Sinus Cancers” for treatment; Healthline’s “Sinus Cancer: Symptoms, Risk Factors, Treatment, and Outlook” for outlook; NHS’s “Nasal and sinus cancer” for symptoms and treatment; Rush’s “Nasal and Sinus Cancer Signs & Symptoms” for symptoms; City of Hope’s “Sinus Cancer: Causes, Symptoms & Treatments” for causes; NCI’s “Paranasal Sinus and Nasal Cavity Cancer Treatment” for treatment; Allegheny Health Network’s “Sinonasal Cancer Types, Symptoms, and Diagnosis” for diagnosis; Cleveland Clinic’s “Nasal & Paranasal Tumors: Symptoms, Causes & Treatment” for symptoms and treatment.