Nasal and paranasal tumors

Overview

Nasal and paranasal tumors are growths that begin in and around the passageway within the nose. Nasal tumors begin in the main passageway within the nose, called the nasal cavity. Paranasal tumors begin in air-filled chambers around the nose, called the paranasal sinuses.

Some nasal and paranasal tumors aren't cancerous. These noncancerous tumors also are called benign tumors. They can grow to block the flow of air through the nose.

Other nasal and paranasal tumors are cancers. Cancerous tumors also are called malignant tumors. They can grow to invade and destroy healthy body tissue. In time, the cells can break away and spread to other parts of the body.

Several types of nasal and paranasal tumors exist. The type of tumor you have helps determine the best treatment for you.

Symptoms

Signs and symptoms of nasal and paranasal tumors can include:

• Difficulty breathing through the nose.
• Frequent headaches.
• Loss of the sense of smell.
• Nosebleeds.
• Discharge from the nose.
• Facial swelling or pain.
• Watery eyes.
• A sore on the roof of the mouth.
• Vision problems.
• A lump in the neck.
• Difficulty opening the mouth.

When to see a doctor

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.

Causes

Nasal and paranasal tumors happen when cells in the nasal cavity or chambers around the nose develop changes in their DNA. A cell's DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions also tell the cells to die at a set time. In tumor cells, the changes give different instructions. The changes tell the tumor cells to make many more cells quickly. Tumor cells can keep living when healthy cells would die. This causes too many cells.

Sometimes the changes in the DNA turn the cells into cancer cells. Cancer cells can invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.

Risk factors

Factors that may increase the risk of nasal and paranasal tumors include:

• Smoking tobacco increases the risk. This includes cigarettes, cigars and pipes.
• Being exposed to air pollution. Breathing in polluted air increases the risk of nasal and paranasal tumors.
• Being exposed to chemicals and irritants in the air at work. These may include wood dust, fumes from glue, rubbing alcohol and formaldehyde, and dust from flour, chromium and nickel.
• Being exposed to human papillomavirus, also called HPV. HPV is a common virus that's passed through sexual contact. For most people, it causes no problems and goes away on its own. For others, it causes changes in cells that can lead to many types of cancer.

Prevention

To reduce your risk of nasal and paranasal tumors, you can:

• Stop smoking. If you don't use tobacco, don't start. If you currently use tobacco of any kind, talk with a healthcare professional about strategies to help you quit.
• Protect yourself at work. Follow your workplace safety rules for protecting yourself from harmful fumes and irritants in the air, such as wearing a face mask.
• Ask about the HPV vaccine. Receiving a vaccination to prevent HPV infection may reduce your risk of HPV-related cancers. Ask your doctor or other healthcare professional whether an HPV vaccine is right for you.

Diagnosis

Tests and procedures used to diagnose nasal and paranasal tumors include:

Using a tiny camera to see inside the nasal cavity and sinuses

Nasal endoscopy is a procedure to look inside the nose. It uses a thin tube with a light and camera. The tube is inserted into your nose. The camera sends pictures to a computer for your healthcare team to look at. These pictures help your team look for any signs of a tumor.

Removing a tissue sample for testing

A biopsy is a procedure to collect a sample of tissue for testing. For nasal and paranasal tumors, the procedure involves taking a sample of cells from inside the nose or sinuses. Often a healthcare professional gets the sample during a nasal endoscopy. Special tools can go through the tube to take the cells. Another type of biopsy uses a thin needle that's inserted directly into the suspicious area to collect a sample of cells. The samples are sent to a lab to be tested. In the lab, tests can show whether the cells are cancerous.

Imaging tests

Imaging tests capture pictures of the inside of the body. The pictures can show the size and location of a tumor. Imaging tests used for nasal and paranasal tumors may include X-rays and scans such as CT, MRI and positron emission tomography, also called PET.

Your healthcare team may suggest more tests and procedures based on your condition.

Treatment

Most nasal and paranasal tumors are treated with surgery to remove the tumor. Treatment for nasal and paranasal tumors depends on where your tumor is located and what types of cells are involved. Your healthcare team will work with you to come up with a treatment plan that is best for your tumor.

Surgery

The goal of surgery for nasal and paranasal tumors is to remove all of the tumor. The surgeon might also remove some of the tissue around the tumor to make sure all the tumor cells are removed. Surgeons access nasal and paranasal tumors by:

• Making a cut in the nose or mouth to get to the tumor. An incision near your nose or in your mouth gives surgeons access to your nasal cavity or sinuses. The surgeon removes the tumor and any areas that may be affected, such as nearby bone.
• Putting tools through the nose. Sometimes, the surgeon can access the tumor using nasal endoscopy. The surgeon puts the endoscopy tube through the nose. Special tools go through the tube to cut out the tumor.

Nasal and paranasal tumors are located near important structures in your head. This includes as your brain, eyes and the nerves that control vision. Surgeons work to minimize damage to these areas.

Other treatments for nasal and paranasal cancers

Cancerous nasal and paranasal tumors might need other treatments to control the cancer cells. Options might include:

• Radiation therapy. Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from X-rays, protons or other sources. During radiation therapy, a machine directs beams of energy to specific points on the body to kill the cancer cells there.

  Radiation might be used after surgery to kill any cancer cells that remain. If surgery isn't an option, treatment might start with radiation therapy and chemotherapy at the same time. Surgery might not be an option if the cancer grows large or spreads.

• Chemotherapy. Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy may be used after surgery to kill any remaining cells. Sometimes chemotherapy is done at the same time as radiation therapy because it makes the radiation work better.
• Immunotherapy. Immunotherapy is a treatment with medicine that helps your body's immune system kill cancer cells. Your immune system fights off diseases by attacking germs and other cells that shouldn't be in your body. Cancer cells survive by hiding from the immune system. Immunotherapy helps the immune system cells find and kill the cancer cells. Immunotherapy might be used when the cancer spreads to other parts of the body and other treatments haven't helped.

Coping and support

People facing a serious illness often say they feel worried about the future. With time, you'll find ways to cope with your feelings. You may find comfort in these strategies:

• Ask questions about nasal and paranasal tumors. Write down questions you have about your tumor. Ask these questions at your next appointment. Also ask your healthcare team for reliable sources where you can get more information.

  Knowing more about your tumor and your treatment options may make you more comfortable when you make decisions about your care.

• Stay connected to friends and family. Friends and family can provide comfort and support. Your diagnosis can be stressful for friends and family too. Try to keep them involved in your life.

  Your friends and family will likely ask if there's anything they can do to help you. Think of tasks you might like help with, such as caring for your home if you have to stay in the hospital or just listening when you want to talk.

• Find someone to talk with. Find someone you can talk with who has experience helping people facing a life-threatening illness. Ask your healthcare team to suggest a counselor or medical social worker you can talk with. For support groups, contact the American Cancer Society or ask your healthcare team about local or online groups.

Preparing for an appointment

Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.

If you might have a nasal or paranasal tumor, you may be referred to a doctor who specializes in diseases that affect the ears, nose and throat, called an ENT specialist. This type of doctor also is called an otolaryngologist.

Because appointments can be brief, it's a good idea to be prepared. Here's some information to help you get ready.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet before a test.
• Write down symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Write down key personal information, including major stresses or recent life changes.
• Make a list of all medicines, vitamins or supplements you're taking and the doses.
• Take a family member or friend along. Sometimes it can be hard to remember all the information provided during an appointment. Someone who goes with you may remember something that you missed or forgot.
• Write down questions to ask your healthcare team.

Your time with your healthcare team is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For nasal and paranasal tumors, some basic questions to ask include:

• Do I have cancer?
• Where is my tumor?
• What other tests do I need?
• What are my treatment options?
• Is there one treatment that's best for my type of tumor?
• What are the potential side effects for each treatment?
• Should I seek a second opinion? Can you give me names of specialists you recommend?
• Am I eligible for clinical trials?
• Are there brochures or other printed material that I can take with me? What websites do you recommend?
• What will determine whether I should plan for a follow-up visit?

What to expect from your doctor

Be prepared to answer questions about your symptoms and your health, such as:

• When did you begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?