Treatments for ethmoid sinus cancer

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The following are treatment options for the stages of ethmoid sinus cancer. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Stages 1 and 2

Surgery is the main treatment for stages 1 and 2 ethmoid sinus cancer. The type of surgery usually done is endoscopic surgery. Endoscopic surgery uses a rigid tube with a light and lens on the end (called an endoscope) to remove tumours.

Radiation therapy is often used after surgery to lower the chance of the cancer coming back (recurring). It may be offered before surgery to help shrink tumours and make them easier to remove.

If the tumours are small, you may be offered radiation therapy as the main treatment instead of surgery.

Chemoradiation is a treatment that gives chemotherapy along with radiation therapy. The chemotherapy drug most often used is cisplatin. It may be given after surgery if there are cancer cells in the tissue around the removed tumour (called a positive surgical margin).

Stages 3 and 4

Surgery is the main treatment for stages 3 and 4 ethmoid sinus cancer. The type of surgery usually done is a craniofacial resection. A craniofacial resection removes the front part of the base of the skull, the ethmoid sinus, the frontal sinus and the wall of bone that divides the nasal cavity into right and left sides (called the nasal septum). Depending on the extent of the cancer, one of the eyes may need to be removed as well. Reconstructive surgery is usually done after the main surgery.

If cancer has spread to the lymph nodes in the neck (called cervical lymph nodes), these lymph nodes are also removed. This is called a neck dissection. Find out more about neck dissection.

Radiation therapy is often used after surgery to lower the chance of the cancer coming back. You may also have radiation therapy to the neck if cancer has spread to the lymph nodes there.

You may have radiation therapy before surgery to help shrink the tumour and make it easier to remove.

Radiation therapy may also be offered as the main treatment instead of surgery if the cancer can't be removed by surgery or you are unable to have or don't want surgery.

Radiation therapy can also be given to relieve pain or control symptoms (called palliative radiation therapy).

Chemoradiation may be offered after surgery to lower the chance of the cancer coming back. It may also be used to treat cancer that has spread to the lymph nodes in the neck.

You may have chemoradiation before surgery to help shrink the tumour and make it easier to remove.

Chemoradiation may also be offered as the main treatment instead of surgery if the cancer can't be removed by surgery or you are unable to have or don't want surgery.

Chemotherapy may be used to relieve pain or control symptoms (called palliative chemotherapy).

Recurrent

Recurrent ethmoid sinus cancer means that the cancer has come back after it has been treated. The following are treatment options for recurrent ethmoid sinus cancer.

Radiation therapy may be offered for recurrent ethmoid sinus cancer if you had surgery to treat the original tumour. It may be given as the main treatment or after more surgery.

In some cases, radiation therapy may also be given if you had radiation therapy to treat the original tumour.

Radiation therapy is often given if the cancer recurs in the lymph nodes in the neck. Radiation therapy is sometimes given with chemotherapy. The chemotherapy drug most often used is cisplatin.

Surgery may be offered for ethmoid sinus cancer that recurs after radiation therapy was used as the main treatment for the original tumour. It may also be offered if cancer comes back after surgery to remove the original tumour.

The type of surgery done depends on where the cancer comes back. You may be offered a maxillectomy. A maxillectomy is a surgery where the bone and mucosa of the maxillary sinus are removed. The eye may need to be removed as well. Other types of surgery you may be offered are craniofacial resection and neck dissection.

Chemotherapy may be offered if you can't have surgery or radiation therapy or if these treatments don't stop the growth of the cancer. Chemotherapy is sometimes given with radiation therapy.

If you can’t have or don’t want cancer treatment

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don't work anymore, they're not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can't have or don't want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.

Clinical trials

Talk to your doctor about clinical trials open to people with nasal cavity and paranasal sinus cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer.

Find out more about clinical trials.

Expert review and references

  • Shamir Chandarana, MD, MSc, FRCSC
  • Aaron Hansen, BSc, MBBS, FRACP
  • Michael P Hier, MDCM, FRCSC
  • Saul Frenkiel, MDCM, FRCS(C)
  • George Shenouda, PhD, MBBCh
  • American Cancer Society. Treating Nasal Cavity and Paranasal Sinus Cancers. 2021. https://www.cancer.org/.
  • Mendenhall WM, Dziegielewski PT, Pfister DG. Cancer of the head and neck. DeVita VT Jr., Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg's Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia, PA: Wolters Kluwer; 2019: 45:542–598.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers (Version 3.2021). 2021.
  • PDQ® Adult Treatment Editorial Board. Paranasal sinus and Nasal Cavity Cancer Treatment (PDQ®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2019. https://www.cancer.gov/.
  • Princess Margaret Cancer Centre. Princess Margaret Cancer Centre Clinical Practice Guidelines - Head and Neck, Nasal Cavity and Paranasal Sinus. 2015. https://www.uhn.ca/PrincessMargaret/Health_Professionals/Programs_Departments/Pages/clinical_practice_guidelines.aspx.

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