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Treatment decisions

Find out how your doctor decides which treatment you need and information about the types of treatment you might have.

Diagnosing your nasal cavity or paranasal sinus cancer early means it will be easier to control and possibly cure. You might have surgery, radiotherapy or chemotherapy or a combination of these. Surgery alone will cure some tumours, but others will respond better to radiotherapy.

Your doctor will plan your treatment according to:

  • the type of cancer you have
  • whether the cancer has spread (the stage)
  • what the cells look like under a microscope (the grade)
  • your general health

Surgery

Surgery is a common treatment for nasal cavity and paranasal sinus tumours. The type of operation you have will depend on the position of the cancer and its size.

For some very early stage cancers, it may be possible to remove the tumour under local or general anaesthetic using laser surgery. The surgeon uses a narrow, intense beam of light to cut out the cancer. The laser beam works like a surgical knife (scalpel).

For larger tumours you will need a bigger operation and a general anaesthetic.

Your surgeon will examine the area around the tumour. They might remove some of the lymph nodes from around the tumour. This is to try and get rid of any remaining cancer cells and lower the risk of the cancer coming back.

If the cancer has spread to lymph nodes in your neck, you might need to have all the nodes on one or both sides of your neck removed. You may hear your doctor call this operation a modified radical or radical neck dissection.

Radiotherapy

Radiotherapy on its own can treat some types of nasal cavity and paranasal sinus cancers that haven't spread. It will cure most people with small tumours of the nose (nasal cavity).

An advantage is that you don't have any tissue removed so it causes less of a change to your appearance.

If you are having an operation, your doctor may recommend that you have radiotherapy afterwards. This will get rid of any remaining cancer cells, which lowers the risk of the cancer coming back.

Chemotherapy

You might have chemotherapy for any of the following reasons:

  • Before or after surgery or radiotherapy
  • To treat some nasal cavity and paranasal sinus cancers that have spread to other parts of the body
  • If your cancer has come back after surgery and radiotherapy
  • During a course of radiotherapy (chemoradiation) for locally advanced cancer

Reports so far show that, for many people, giving chemotherapy at the same time as radiotherapy (called chemoradiation) can work better than radiotherapy on its own.

If your cancer has spread

If your cancer has already spread to another part of your body, surgery won't cure it. It might help to control the cancer for a time and reduce symptoms.

If your tumour is large and beginning to block your airway, your doctor might recommend surgery to remove all or part of the tumour. This will make your breathing easier.

Your doctor may also suggest:

  • surgery and radiotherapy together
  • radiotherapy alone
  • chemotherapy alone or with radiotherapy (chemoradiation)

Treatments that are still in development might be another option for you. This will mean taking part in a clinical trial. 

Palliative care

Your doctor is also likely to refer you to a palliative care team. This is a group of health care professionals who specialise in looking after people whose cancer isn't curable.

Some people assume that they are going to die very soon when their doctor suggests cancer is not curable. This is very often not the case. It doesn’t always mean that the doctors who have been caring for you up until now won’t go on being involved in your care.

Palliative care means helping to:

  • control any symptoms you have, such as pain, sickness or breathing problems
  • give treatment that can shrink the cancer and control symptoms
  • support you with both physical care and psychological care
  • plan to ensure the best possible care is arranged before going home from hospital

Deciding on treatment

Your specialist may advise that surgery is the best treatment for you because of the stage or position of your cancer. Or they might advise that it is better to have radiotherapy (with or without chemotherapy) because you may have fewer problems after treatment.

In some situations you may have a choice between types of treatment. Your doctor and specialist head and neck cancer nurse will be able to help you decide what is best for you.

You might want to get a second opinion before you have your treatment. This can give you more information and help you feel more confident about your treatment plan. Most doctors are happy to refer you to another specialist for a second opinion.

Getting a second opinion doesn't necessarily mean that the second doctor will take over your care. Your original specialist will usually still manage your treatment.

Information and help

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About Cancer generously supported by Dangoor Education since 2010.