Paranasal Sinus Tumors

What are paranasal sinus tumors?

A paranasal sinus tumor is a cancer that has grown inside your sinuses. The sinuses are the open spaces and tunnels around and behind your nose. Cancer can start in the cells of the membranes, bones, or nerves that line the paranasal sinuses.

What causes paranasal sinus tumors?

Experts don’t know the exact cause of paranasal sinus tumors. But they have been linked to exposure to certain chemicals or dust in the workplace.

Who is at risk for paranasal sinus tumors?

A risk factor is anything that may increase your chance of having a disease. The exact cause of someone’s cancer may not be known. But risk factors can make it more likely for a person to have cancer. Some risk factors may not be in your control. But others may be things you can change.

Risk factors for paranasal tumors include:

• Exposure to industrial chemicals at work
• Human papillomavirus infection
• Exposure to wood, leather, flour, textile, nickel, or chromium dust
• Exposure to radium
• Smoking

Talk with your healthcare provider about your risk factors for paranasal sinus tumors and what you can do about them.

What are the symptoms of paranasal sinus tumors?

Early symptoms of paranasal sinus tumors can look like symptoms of colds or infections. Early symptoms include:

• Blockage of sinuses, or congestion that doesn't go away or gets worse
• Blockage of 1 side of your nose
• Changes in your voice or breathing
• Reduced or loss of sense of smell
• Headaches
• Numbness or pain in your face, eyes, ears, or teeth
• Teeth that become loose
• Pus draining from your nose or postnasal drip
• Frequent nosebleeds
• Growth on your face or the roof of your mouth (palate)
• Eyes that continuously water
• Bulging eye
• Loss of or change in vision
• Hearing loss
• Trouble opening your mouth

Most of the time, these are caused by other health problems. But it’s important to see a healthcare provider if you have these symptoms. Only a healthcare provider can tell if you have cancer.

How are paranasal sinus tumors diagnosed?

A healthcare provider will talk with you about your health history and do a physical exam. The physical exam will include looking at your eyes, ears, nose, mouth, face, neck, and throat. Any details you can give about your symptoms can help with the diagnosis. This includes details about pain, such as is it sharp, burning, dull, or achy, where it is, and when you have it.

Your provider might order an endoscopy of your sinuses. This is a procedure in which a thin, flexible tube with a tiny light and a video camera on the end is put into your sinuses. Looking inside your sinuses will help your provider figure out the location and size of the tumor.

Your provider might also order these tests:

• Blood tests
• Imaging tests of your skull, such as X-rays, CT scans, or MRI of the sinuses
• Imaging tests of your chest
• Biopsy. This is when a tiny piece of the tumor is taken out and tested in a lab for cancer.

After a diagnosis of paranasal sinus cancer, you’ll need to have more tests done. These help your healthcare providers learn more about the cancer. They’ll show how much and how far the cancer has spread (metastasized) in your body. A stage grouping is then assigned.

Staging

The stage of a cancer tells your provider how much cancer there is and how far it has spread in your body. The stage of a cancer is one of the most important things to know when deciding how to treat it.

Stage groupings can have a value of 0 to 4. They're written as Roman numerals 0, I, II, III, and IV. Stage 0 is also called carcinoma in situ. This is the earliest stage of cancer, when the cancer cells are only in the lining of the sinus where the cancer first started. Then, the higher the number, the more advanced the cancer is. Letters and numbers can be used after the Roman numeral to give more details.

Your healthcare provider will talk with you about what your cancer stage means for your treatment. Ask any questions or talk about your concerns.

How are paranasal sinus tumors treated?

The most common treatment for a paranasal sinus tumor is a combination of surgery and radiation therapy. The goal of surgery is to remove as much of the tumor as possible. If the cancer has spread to lymph nodes, they will also be removed. Surgery will be planned to preserve as much of your face and function as possible. Surgery can be complex and may involve a variety of specialists. These include healthcare providers who specialize in the ear, nose, and throat (ENTs or otolaryngologists), neurosurgeons, and maxillofacial surgeons.

Radiation therapy may be given before surgery to try to shrink the tumor so it's easier to remove. Or it may be given after surgery to destroy any remaining cancer cells. In this case, it will be started several weeks after your surgery to give your body time to heal. Radiation might also be the main treatment, such as if a person can’t have or does not want surgery.

Chemotherapy uses strong medicines to kill cancer cells. It's often used for cancers that might return or that have returned after treatment. You may be given a combination of chemo medicines. Or, you may get chemotherapy along with radiation, called chemoradiation.

Talk with your healthcare providers about your treatment choices. Make a list of questions. Think about the benefits and possible side effects of each choice. Discuss your concerns with your healthcare provider before making a decision.

Treatment will also include symptom management, such as nausea or pain management. Let your healthcare provider or nurse know if you are in pain or have any other symptoms. There are many ways to control, and even prevent, symptoms linked to cancer and cancer treatment.

What are possible complications of paranasal sinus tumors?

Paranasal sinus tumors and their treatment may lead to these complications:

• Scarring from surgery
• Long-term changes in vision, breathing, speech, chewing, or swallowing, caused by the tumor and/or surgery
• Changes in the way you look
• Nerve damage that can affect sensation in your face and movement in your face, shoulder, or arms
• Side effects from treatment, such as pain, nausea, trouble eating, mouth sores, loss of teeth, and changes in taste
• Cancer spreading to other parts of your body (metastasis)

People who are treated for paranasal sinus tumors should continue to meet regularly with their healthcare provider. If the cancer returns, it's most likely to do so in the first few years after treatment.

Coping with paranasal sinus tumors 

Many people feel worried, depressed, and stressed when dealing with cancer. Getting treatment for cancer can be hard on your mind and body. Keep talking with your healthcare team about any problems or concerns you have. Work together to ease the effect of cancer and its symptoms on your daily life.

Here are tips:

• Talk with your family or friends.
• Ask your healthcare team or social worker for help.
• Speak with a counselor.
• Talk with a spiritual advisor, such as a minister or rabbi.
• Ask your healthcare team about medicines for depression or anxiety.
• Keep socially active.
• Join a cancer support group online or in person.

Cancer treatment is also hard on the body. To help yourself stay healthier, try to:

• Eat a healthy diet, with as many protein foods as possible.
• Drink plenty of water, fruit juices, and other liquids.
• Keep physically active.
• Rest as much as needed.
• Talk with your healthcare team about ways to manage treatment side effects.
• Take your medicines as directed by your team.

When to call your healthcare provider

Your healthcare provider will talk with you about when to call. You may be told to call if you have any of these:

• New symptoms or symptoms that get worse
• Signs of an infection, such as a fever
• Side effects of treatment that affect your daily function or don’t get better with treatment

Ask your healthcare provider what signs to watch for and when to call. Know how to get help after office hours and on weekends and holidays.

Key points about paranasal sinus tumors

• A paranasal sinus tumor is a cancer that starts inside your sinuses. The sinuses are the open spaces behind your nose.
• Experts don’t know the exact cause of these tumors. But they have been linked to exposure to certain chemicals or dust in the workplace.
• Early symptoms of paranasal sinus tumors can look like symptoms of colds or infections.
• The most common treatment is a combination of surgery and radiation therapy.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new directions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when to report them.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.