Tests for nasal and paranasal sinus cancer
You will have tests to check for nasal and paranasal sinus cancer. You might not need all of these tests. It will depend on your individual situation.
Tests your GP might do
Most people start by seeing their GP. They can do some tests to help them decide whether you need a referral to a specialist. Your GP might:
- do a physical examination, feeling around your face and neck
- do blood tests
- arrange a chest x-ray
Tests your specialist might do
Depending on the results of your tests, your GP might refer you to a head and neck specialist.
Your specialist usually does more tests. This might include:
- a nasoendoscopy
- a biopsy
- a neck ultrasound
- a fine needle aspiration
- a CT scan
- an MRI scan
- a PET-CT scan
- tests for gene changes
Nasoendoscopy
A nasoendoscopy is part of a normal ear, nose and throat examination. It is a procedure to look at the inside and back of the nose. It can also be used to examine the:
- back of the tongue and throat
- voice box
Your doctor passes a thin rigid or flexible tube called a nasoendoscope through your nostril into your nose. The tube has a camera and a bright light at the end so they can check for any abnormal looking areas.
This can be uncomfortable but does not usually hurt. Your eyes might water, and you might feel like coughing.
Your doctor might ask if you would like a local anaesthetic sprayed in the nose 10 minutes beforehand to numb it.
If your specialist sees an abnormality in your nose, you will probably need to go into hospital for a day to have an endoscopic biopsy under a short general anaesthetic.
Biopsy
A biopsy means removing a sample of tissue and looking at it under a microscope. This is the only certain way to tell whether a growth or an abnormal area is a cancer or not. There are different ways of taking a biopsy from the lining of the nose.
The type you have will depend on the position of the abnormal area.
Biopsy of an abnormal area in the nostrils
If the abnormal area is close to the front of the nostrils you have the biopsy under a local anaesthetic. You may have the procedure in the outpatient clinic or as a day case under local or a short general anaesthetic.
Biopsy of the back of the nose
An abnormal area in the back of the nose is harder to reach. You usually have this test under a general anaesthetic in hospital as a day case.
You can't eat or drink for a few hours before an anaesthetic. Contact the hospital in advance if this is a problem for you, for example if you have diabetes.
Neck ultrasound
You have this scan to look at the lymph nodes in your neck.
Ultrasound scans use high frequency sound waves to create a picture of a part of the body. The ultrasound scanner has a microphone that gives off sound waves. The sound waves bounce off the organs inside your body, and are picked up again by the microphone. The microphone links to a computer. This turns the sound waves into a picture.
The sonographer puts a cold lubricating gel over the area. Then they put the ultrasound probe against your skin. You might feel a little pressure when the sonographer moves the probe over your neck. Tell them if it is uncomfortable. It shouldn’t hurt.
An ultrasound can take up to 45 minutes. The sonographer might ask you to move position a few times, so they can get the clearest pictures.
You might have the ultrasound at the same time as having a fine needle aspiration (FNA).
Fine needle aspiration
A fine needle aspiration (FNA) is a way of taking a sample of cells from a swollen lymph node in the neck. Your doctor uses a fine needle and syringe to take the cells. The samples can then be examined under a microscope. This test helps your doctor to see if cancer cells have spread to the lymph nodes.
You can have a local anaesthetic injection before the needle aspiration.
CT scan
CT (or CAT) scan stands for computed (axial) tomography. It is a test that uses x-rays and a computer to create detailed pictures of the inside of your body.
A CT scan helps your doctor to stage your cancer. Staging tells the doctor:
- where the cancer is
- how big it is
- whether it has spread
Knowing the stage helps your doctor decide which treatment you need.
You usually have a CT scan of your:
- head and neck
- chest
- abdomen
The head and neck CT will show the size of the cancer and any enlarged lymph nodes in the neck. A chest and abdominal CT may show other signs of cancer spread.
MRI scan
MRI stands for magnetic resonance imaging. It uses magnetism and radio waves to take pictures of the inside of the body.
An MRI scan helps your doctor to stage your cancer. Staging tells the doctor:
- where the cancer is
- how big it is
- whether it has spread
MRI shows soft tissues and not bone and separates the tumour from soft tissue and mucus.
PET-CT scan
A PET-CT scan combines a CT scan and a PET scan. It gives detailed information about your cancer.
The CT scan takes a series of x-rays from all around your body and puts them together to create a 3 dimensional (3D) picture.
The PET scan uses a mildly radioactive substance to show up areas of your body where cells are more active than normal.
A PET-CT scan can also show how well a cancer treatment is working.
Tests for gene changes
If you have a type of nasal and paranasal sinus cancer called melanoma, your doctor may send a sample of the melanoma for genetic testing. This is to look for changes (mutations) in genes including the BRAF gene. This genetic change makes the melanoma cells produce too much BRAF protein. This can make melanoma cells grow.
Treatment
The tests you have helps your doctor find out if you have nasal and paranasal sinus cancer and how far it has grown. This is the stage of the cancer.
This is important because doctors recommend your treatment according to the stage of the cancer.
Coping with nasal and paranasal sinus cancer
Coping with a diagnosis of nasal and paranasal sinus cancer can be difficult. There is help and support available to help you and your family.
