Treatments for maxillary sinus cancer

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The following are treatment options for the stages of maxillary 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 maxillary sinus cancer. The type of surgery done is a maxillectomy. A maxillectomy is a surgery where the bone and the soft tissue lining (the mucosa) of the maxillary sinus are removed. Reconstructive surgery is done either at the same time as the surgery to remove the cancer or at a later time.

Radiation therapy may be offered before or after surgery. Radiation therapy may be given after surgery if:

  • the tumour can't be completely removed
  • cancer cells are in the tissue around the removed tumour
  • cancer cells are around or near a nerve

In some cases, you may be offered radiation therapy instead of surgery as the main treatment if you can't have surgery because of other health conditions or if you choose not to have 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.

Stages 3 and 4A

Surgery is the main treatment for stages 3 and 4A maxillary sinus cancer. The type of surgery done is a maxillectomy.

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 may be offered before or after surgery.

Radiation therapy may be given before surgery:

  • if it is likely that cancer cells will be in the tissue around the tumour that will be removed
  • if the cancer has spread to the lymph nodes that can't be removed by surgery
  • to shrink the tumour and make it easier to remove by surgery

Radiation therapy may be given after surgery to help prevent the cancer from coming back (called recurrence). It may also be given after surgery if:

  • cancer cells are in the tissue around the removed tumour
  • cancer cells are around or near a nerve
  • cancer has spread to the lymph nodes in the neck

In some cases, you may be offered radiation therapy instead of surgery as the main treatment if you can't have surgery because of other health conditions or if you choose not to have surgery.

Chemoradiation may be given as a main treatment to treat a tumour in the maxillary sinus as well as cancer that has spread to the lymph nodes in the neck. It may also be given after surgery to prevent the cancer from coming back.

Stage 4B

Radiation therapy is a main treatment for stage 4B maxillary sinus cancer. It may be given to the main tumour in the maxillary sinus and to cancer that may have spread to the lymph nodes in the neck.

Chemoradiation may be given as a main treatment to treat the tumour in the maxillary sinus and to cancer cells that may have spread to the lymph nodes in the neck.

Surgery may be done before radiation therapy to remove as much of the tumour as possible (called debulking) or to help relieve a blockage in the sinus. Surgery is not often used to treat stage 4B maxillary sinus cancer.

Stage 4C

Chemotherapy is a main treatment for stage 4C maxillary sinus cancer. The chemotherapy drug most often used is cisplatin. It is also given to relieve pain or control symptoms (called palliative chemotherapy). It may be used alone or in combination with other chemotherapy drugs.

Radiation therapy is often given to relieve pain or control symptoms of stage 4C maxillary sinus cancer (called palliative radiation therapy).

Recurrent

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

Surgery may be offered to treat maxillary sinus cancer that has come back after radiation therapy or previous surgery.

Radiation therapy may be used if the first treatment used was surgery or to treat cancer that may have spread to the lymph nodes in the neck.

Chemotherapy may be used with or without radiation therapy to treat recurrences that are not controlled by surgery or radiation therapy. Chemotherapy may also be used to treat cancer that has come back in other organs or to relieve pain or control symptoms. The chemotherapy drug most often used is cisplatin.

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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