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Paranasal Sinus and Nasal Cavity Cancer

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Paranasal Sinus and Nasal Cavity Cancer

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There are several paranasal sinus and nasal (nose) cancers. They get their names from the bones that surround them, including: 

  • The frontal sinuses in the lower forehead above the nose
  • The maxillary sinuses are the cheekbones on either side of the nose
  • The ethmoid sinuses beside the upper nose and between the eyes
  • The sphenoid sinuses behind the nose in the center of the skull

Squamous cell carcinoma is often diagnosed in the paranasal sinuses and nasal cavity.  Squamous cells are thin, flat cells inside the sinuses and nasal cavity. 

Other paranasal sinus and nasal cavity cancers include:

  • Melanoma: This cancer begins growing in melanocytes, which are cells that give your skin its natural color.
  • Sarcoma: Sarcomas are cancers that grow inside muscle or connective tissue.
  • Inverting papilloma: Benign tumors that form inside the nose. Very few inverting papillomas become cancer.
  • Midline granulomas: These cancers are in the tissues found in the middle of the face.

Why Choose Sylvester Comprehensive Cancer Center?

One of only 71 NCI-designated cancer centers in the United States. Sylvester is one of only two cancer centers in Florida that have been recognized by the National Cancer Institute. The team earned this distinction through its outstanding work conducting research in its laboratories, treating patients in its clinics and hospitals, and reaching out to medically underserved communities with innovative prevention strategies.

The Department of Otolaryngology ranks No. 9 in the nation according to U.S. News & World Report. The team has one of the largest academic head-neck cancer groups in the country at South Florida’s only NCI-designated cancer center, Sylvester Comprehensive Cancer Center. Surgeons lead a well-established multidisciplinary oncology team, incorporating innovative techniques such as oral cancer screening, robotic technology, microvascular reconstruction, sentinel node identification, and a specialized postoperative care unit for these complex procedures.

More board-certified head and neck surgical specialists than any other South Florida provider. Our team offers advanced, simplified surgery solutions. In the majority of cases requiring reconstruction, you have just one operation for cancer removal and any reconstructive surgery. Sylvester is one of the best places in the country for simultaneous head and neck cancer surgery and microvascular reconstruction.

Multidisciplinary care teams with nationally recognized expertise. Your care team is made up of experts in all aspects of your exact type of cancer. All of your physicians, nurses, and more collaborate to save lives.

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Treatments

At Sylvester Comprehensive Cancer Center, each cancer has a wide range of treatments that can be used alone or in combination to give the best outcome for your specific cancer, including standard therapies and novel therapies only available in clinical trials. That’s why careful diagnosis is so important.

Paranasal sinus and nasal cavity cancers are more challenging to treat than laryngeal cancers. Early symptoms are not typical. Most paranasal sinus and nasal cavity cancers get diagnosed at advanced stages. These tumors spread more often to the lymph nodes. Patients do not usually notice any growth in their neck. Because of this, treatment of the lymph nodes in the neck is often recommended.

Treatments for these cancers include:

  • Surgery

    Surgeons remove a tumor from the head and neck region and remove lymph nodes containing cancerous cells. Smaller tumors have less negative impact on your speech, swallowing and daily living. Types of surgery include:

    • Endoscopic Sinus Surgery: This newer approach keeps more healthy tissue intact than traditional surgery. Your surgeon will make a small incision in which to insert a thin, telescope-like tube into the nasal cavity or sinus. Endoscopic sinus surgery for non-cancerous sinusitis often leads to finding cancer. 

    • Maxillectomy: This surgery removes part or all of the hard palate, the bony roof of the mouth. Artificial prostheses or flaps of soft tissue can be used by your surgical team to fill gaps left by this operation.

    • Craniofacial Resection/Skull Base Surgery: This is an extensive surgery. Your surgeon will remove more tissue than a maxillectomy. A Sylvester neurosurgeon and head and neck surgeon often work together to ensure your best success.

  • Radiation Therapy

    Radiation therapy is often combined with surgery, either before or after the operation, or with chemotherapy, to treat many cases of paranasal sinus and nasal cavity cancers.

    • Intensity Modulated Radiation Therapy(IMRT): You benefit from Sylvester's experience as a leader in treating head and neck cancers with IMRT. This is an advanced form of external beam radiation therapy. Radiation specialists will shape radiation doses to the exact three-dimensional size of your tumor. The precise control and flexibility help to reduce the amount of radiation going to surrounding healthy tissue.

    • Internal Radiation Therapy:
      Brachytherapy is another name for this procedure. Tiny pellets, "seeds" or rods containing radioactive material get inserted inside or near the tumor. They deliver the radiation dose exactly where it needs to go. More radiation can be steered to the tumor than in external beam radiation therapy. This treatment requires several days of an inpatient stay.

    Chemotherapy

    The high level of experience of Sylvester’s medical oncology team allows our physicians to choose and deliver the most advanced chemotherapy approaches, often before they become available in the community. Your doctor may prescribe chemotherapy before or after surgery. He or she may combine chemotherapy with radiation therapy to try and avoid surgery. Chemotherapy drugs used for head and neck cancers do not usually make you lose your hair.

    Intravenous (infusion) chemotherapy is available at the Comprehensive Treatment Unit (CTU) at Sylvester's Miami location — a 12,000-square-foot unit that includes 33 recliners and 11 private rooms. If you prefer, you may have your infusion treatments at the Deerfield Beach, Plantation, Hollywood, Coral Springs, Coral Gables, and Kendall locations.

Tests

In addition to a complete medical history and physical examination, procedures for diagnosing head and neck cancers may include the following:

  • Endoscopic Ultrasound

    This exam uses a long, thin, flexible tube called an endoscope with a light at the end. It is put in through the nose so the doctor can get a close look at the inside of your nasal cavity, the back of your nose, throat, and voice box. A special tool on the endoscope is used by the doctor to remove samples of suspicious tissue.

  • Computed Tomography (CT or CAT Scan)

    In this test, an X-ray beam takes a series of pictures of the inside of your body from many angles. These images are then combined by a computer, giving a detailed 3-D picture of your body. The CT scan can be used to check the head and neck and is sometimes used to evaluate the chest, too.

  • Magnetic Resonance Imaging (MRI)

    This test uses magnets and radio waves to take detailed pictures of the inside of your body to look for cancer in the neck.

  • Biopsy

    A biopsy, taking a sample of the suspicious tissue, is the only sure way to know if you have cancer. The sample is checked by a pathologist who looks at the tissue under a microscope to check for cancer cells. The biopsy is removed from the primary tumor site in the head/neck area. If the suspicious area is a lump or lymph node on your neck, your doctor uses a very thin needle in a process called fine needle aspiration to see if there are cancer cells in your lymph node.

  • Nasoscopy

  • A procedure to look inside the nose for abnormal areas. A nasoscope is inserted into the nose. This is a thin, tube-like instrument with a light and a lens for viewing. A special tool on the nasoscope may be used to remove samples of tissue. The tissues samples are viewed under a microscope by a pathologist to check for signs of cancer.

  • Positron Emission Tomography (PET) Scan

    This test measures metabolic activity in your body tissue.   Radioactive material in small amounts is injected into a vein. The radioactive material is seen in the images as highlighted places where cancer cells could be growing. 

  • Chest X-ray or Chest CT Scan

    This X-ray helps us to see cancer cells that spread to your lungs. 

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