Head and neck cancers are rare, complex cancers and require specialized treatment. There are many types, including sinonasal and nasopharyngeal cancers, that can benefit from personalized care. Experts at the OSUCCC – James operate the region’s only dedicated Head and Neck Cancer Oncology Clinic. If you or a loved one has been diagnosed with sinonasal or nasopharyngeal cancer, we know you may have many questions. Our team will guide you through your entire experience to ensure you receive the individualized care you deserve.
What are sinonasal and nasopharyngeal cancers?
Sinonasal and nasopharyngeal cancers are a group of rare cancers that can affect your nose, sinuses and part of your throat. They’re often grouped together due to their proximity in the head, but they are different.
Sinonasal cancer
If cancer forms in the nasal cavity or paranasal sinuses, it’s referred to as sinonasal cancer. Sinonasal cancer is cancer that starts in the nasal cavity, which is the empty hollow area that sits behind your nose, and/or paranasal sinuses, which are also hollow and located in your skull.
The paranasal sinuses consist of the:
- Frontal sinuses: located above the nose, in the forehead
- Maxillary sinuses: these are in the cheekbones on both sides of your nose
- Ethmoid sinuses: situated about the top portion of the nose, between your eyes
- Sphenoid sinuses: located behind the nose, in the middle of your head
Sinonasal cancer can occur in any of the sinuses but most commonly occurs in the maxillary sinuses. Usually, these cancers are squamous cell carcinomas but can also be adenocarcinomas and some types of sarcomas.
The nasal cavity and paranasal sinuses help your body with several functions. The nasal cavity treats the air you breathe in with moisture and serves as a “filter” for this air. It also helps your sinuses drain mucus and assists with your sense of smell. Cancer in the nasal cavity or paranasal sinuses can interfere with these functions.
Sinonasal cancer is incredibly rare and only affects about one in 100,000 people. Most cases of sinonasal cancer are usually forms of advanced disease.
It’s important to note that there are many types of skull-base tumors and not all are cancerous. If you have any symptoms, it’s important to see your doctor.
Nasopharyngeal cancer
Nasopharyngeal cancer occurs in the nasopharynx, the top part of your throat behind your nose. It connects your nose to your throat. The nasopharynx moves air inward and outward as you breathe.
The nasopharynx is a part of the pharynx, which moves air into the lungs and moves food into the stomach. It’s in an intricate system that plays an important role with essential bodily functions. The pharynx is a tubular, hollow structure. It’s made up of the nasopharynx (top portion), the oropharynx (middle section) and hypopharynx (lower portion). Nasopharyngeal cancer occurs in the nasopharynx, but cancer can also occur in the oropharynx and hypopharynx.
Nasopharyngeal cancer usually forms in squamous cells, which are in the protective lining of the nasopharynx. Similarly to sinonasal cancer, only about one in 100,000 of all cancer diagnoses are nasopharyngeal cancer.
What causes sinonasal and nasopharyngeal cancers?
Researchers are unsure of the exact causes of sinonasal and nasopharyngeal cancer.
Sinonasal cancer occurs when abnormal cells grow out of control and form a tumor (mass) in the nasal cavity or paranasal sinuses (most commonly in the maxillary sinuses). Nasopharyngeal cancer occurs when a tumor forms in the tissues of nasopharynx.
Our bodies are made up of cells and these cells contain “instructions” called DNA that tells them how to replicate and grow. Usually, cells grow and reproduce at a normal rate. However, over time, DNA can change, causing cells to grow abnormally and develop into a tumor.
Cancer researchers are still unsure about why this happens in some people and not others. However, we do know that risk factors do play a role.
Sinonasal and nasopharyngeal cancer risk factors
Sinonasal and nasopharyngeal cancer have some risk factors associated with them. Risk factors are anything that can increase the likelihood of developing a condition. There are some factors you can influence and others you can’t.
Risk factors for sinonasal cancer include:
- Environmental and occupational exposure: Exposure to chemicals such as dust, radium, glue, nickel, arsenic and welding fumes
- HPV: Previous exposure to the human papillomavirus (HPV) can lead to cellular changes that can cause cancer
- Sex: Being a male assigned at birth
- Age: Those 50 years of age or older
- Tobacco use: Including a current use of tobacco or previous history of cigarette smoking
Risk factors for nasopharyngeal cancer include:
- Medical history: Previous infection with the Epstein Barr virus (EBV), human papillomavirus (HPV) or family history of nasopharyngeal cancer
- Dietary factors: Excessive alcohol use and diets high in salt cured foods
- Environmental exposure: Previous exposure to secondhand smoke
- Tobacco use: Current or previous history of tobacco use
- Ethnicity: Being of Asian, North African or Arctic descent
- Age: Being 50 years of age or older
It’s important to remember that just because you may have one or more risk factors for a condition doesn’t mean you’ll develop it. You should speak with your doctor if you’re at risk.
There are some preventive steps you can take to help reduce the likelihood, though, of developing sinonasal and nasopharyngeal cancer.
Reduce your exposure to environmental and occupational risks by wearing appropriate personal protective equipment (PPE) around certain chemicals.
If you smoke, talk to your doctor about quitting. Avoid being around others who smoke.
Limit the amount of alcohol you drink and preserved foods you eat.
Practice safer sex by reducing the number of partners you have and use protection to reduce (but not eliminate) the chances of contracting HPV.
Sinonasal and nasopharyngeal cancer symptoms
Sinonasal and nasopharyngeal cancers have symptoms that overlap with other conditions. It’s important to talk to your doctor if you’re not feeling well so they can rule out a cause.
Symptoms of sinonasal cancer may include:
- Sinus pain or pressure that doesn’t go away
- Unexplained headaches
- Nosebleeds
- Lump or bump in the nose that doesn’t go away
- Facial pain or numbness in the face
- Pain in or around the mouth
- Pain in or around the ear
Symptoms of nasopharyngeal cancer may include:
- Lump or bump in your neck
- Ear pain or ringing
- Difficulty hearing
- Nosebleeds
- Headaches
- Facial numbness or weakness
If you have any unusual symptoms that last longer than two weeks, talk to your doctor.
Sinonasal and nasopharyngeal cancer diagnosis
If you experience persistent symptoms, your doctor will want to rule out the cause.
First, your doctors will perform a physical exam of your head and neck. They will examine your mouth and nose and ask a series of questions. If your doctor thinks you might require further evaluation, they will order a series of tests as well. Some of these tests may include imaging tests or biopsies.
Imaging tests for sinonasal and nasopharyngeal cancers may include:
- Magnetic resonance imaging (MRI) scan
- Computed tomography (CT) scan
- Nasal endoscopy
- Laryngoscopy
If imaging tests indicate further evaluation is needed, your doctors may order a biopsy of the area of concern. A biopsy will help your doctors identify if cancer (or a noncancerous condition) is present. Your doctor will determine what type of biopsy you may need. Once a tissue sample is collected, a specially trained OSUCCC – James pathologist will look at the sample under a microscope and classify it accordingly. The results of the biopsy will be shared with your doctor and from there, a customized treatment plan will be made (if applicable to you).
Sinonasal & nasopharyngeal cancer treatment
Sinonasal and nasopharyngeal cancer is often treated with more than one approach. Your team of doctors will determine what the best treatments are for you.
Surgery
Surgery is almost always the first line of treatment for sinonasal cancers and not usually the first in nasopharyngeal cancer. At the OSUCCC – James, our team of experts help develop and train the latest in surgical techniques to treat head and neck cancers.
For sinonasal cancers, surgery may involve the removal of the tumor in the nose or sinus and some surrounding tissue. This ensures that all cancer cells are properly removed and nothing is left behind. Your surgeon may remove nearby lymph nodes to test and see if cancer has spread. Sinonasal cancer surgery is usually performed with an endoscope, which is a long flexible tube with a camera on the end. It’s less invasive than traditional open surgery and can reduce recovery time and minimize blood loss.
For nasopharyngeal cancers, surgery may be recommended if cancer has spread or not responded to other treatments first.
Radiation and chemotherapy may be recommended before or after surgery to help shrink a tumor so your surgeon can safely operate or to ensure cancer doesn’t return after removal.
Radiation therapy
Radiation therapy uses highly powered X-rays to specifically kill cancer cells while minimizing damage to surrounding tissue. Proton therapy, a different type of radiation therapy, may be recommended in some cases. It may be given before or after surgery or alone.
Chemotherapy
Chemotherapy uses anticancer drugs, which are injected into a vein (intravenously) or given in the form of a pill or capsule and swallowed, to help fight off cancerous cells. Doctors will determine the frequency and duration you may need to be on for chemotherapy treatment. Chemotherapy may also be given before or after surgery or in combination with other treatments.
Immunotherapy
Immunotherapy uses the body’s own immune system to fight off cancerous cells. There are different types of immunotherapies that may be recommended for you. Experts at the OSUCCC – James will determine the type that may work best in your case.
Clinical trials
The OSUCCC – James offers the latest in clinical trials for those who have been diagnosed with head and neck cancers like nasopharyngeal cancer or sinonasal cancers. At any time, we have over 500 open trials exploring the latest in groundbreaking potential treatment options. Your doctors will determine if you’re a candidate for a clinical trial.
To make an appointment, please call The James Line at 614-293-5066 or 800-293-5066.