Treatments for nasal cavity cancer

The following are treatment options for the stages of nasal cavity 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 a main treatment for stages 1 and 2 nasal cavity cancer. Surgery is usually done if the tumour is on the wall that divides the nasal cavity (called the nasal septum). The type of surgery done depends on where the tumour is in the nasal cavity. The 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 another main treatment for stages 1 and 2 nasal cavity cancer. You may be offered radiation therapy if you can't have surgery because of other health concerns or if you choose not to have surgery.

Radiation therapy may also be given after surgery to lower the chance of the cancer coming back (recurring). It may be offered before surgery if it is likely that cancer cells will be in the tissue around the tumour that will be removed by surgery (called a positive surgical margin).

If the tumour is on the septum and is smaller than 1.5 cm, it may be treated with brachytherapy. Brachytherapy is a form of radiation therapy that places a radioactive material (called a radioactive isotope) directly into, or very close to, the tumour.

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 4

Surgery is the main treatment for stages 3 and 4 nasal cavity cancer. The type of surgery done depends on where the tumour is in the nasal cavity and whether or not it has grown into nearby bone. Reconstructive surgery is also done to help restore the form and function of the nose. Find out more about surgery for nasal cavity and paranasal sinus cancer.

If cancer has spread to the lymph nodes in the neck (called cervical lymph nodes), you will have surgery to remove them. This is called a neck dissection. Find out more about neck dissection.

Radiation therapy may be offered after surgery to destroy any cancer cells that may have been left behind. You may also have radiation therapy before surgery if it is likely that cancer cells will be in the tissue that will be removed by surgery.

In some cases, radiation therapy may be offered instead of surgery as the main treatment if the tumour is too hard to remove with surgery.

Radiation therapy may be given to treat cancer that has spread to the lymph nodes in the neck.

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

Chemoradiation may be given after surgery if there are cancer cells in the tissue around the removed tumour or if cancer has spread to the lymph nodes in the neck. The chemotherapy drug most often used is cisplatin.

Chemoradiation may also be offered as the main treatment instead of surgery if the cancer can't be removed by surgery, if the eye would need to be removed or if surgery would cause significant changes in your appearance.

Recurrent

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

Radiation therapy may be offered for recurrent nasal cavity 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 nasal cavity 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 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).

If cancer has spread to the lymph nodes in the neck, these lymph nodes are also removed.

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

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.