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Living with cancer

Changes in your sense of smell

Nasal and paranasal sinus cancer and its treatment can affect your sense of smell. But there are things you can do to help you cope.

How your sense of smell works

Our sense of smell is part of a chemical sensing system. Sensory cells called olfactory cells high up in the nose recognise smells. They connect directly to the brain. Our sense of smell is closely linked to the sense of taste. We recognise different flavours mainly through our sense of smell.

If the olfactory cells are damaged, telling the difference between some flavours such as coffee and oranges can be difficult.

Treatments that can change your sense of smell

Some types of surgery and radiotherapy to treat nasal cavity and paranasal sinus cancers damage the olfactory nerve cells. This can affect the sense of smell.

If you’ve had your nose packed after surgery, you won’t be able to smell anything. Once the pack is removed, it may improve.

It can take up to a few months or longer for your sense of smell to come back. If you had little or no sense of smell before your operation, losing your sense of smell might be permanent.

Radiotherapy to the nasal cavity or paranasal sinuses may also affect how well you can smell.

Read more about radiotherapy to the nasal cavity

Coping with changes to your sense of smell

We can take our sense of smell for granted. It often plays a big part in how we experience the world. It can also make us aware of dangers, such as smoke from a fire, leaking gas, or other chemicals.

Food, flowers and perfumes are only a few of many pleasant aromas we enjoy in life.

If cancer or its treatment changes how well you can smell, it can be more difficult to cope with than many people expect.

Loss of smell and taste can sometimes lead to loss of appetite and weight loss because eating is no longer as enjoyable.

You can vary textures within a meal or try spicy foods for a sensation on your tongue. This can help you to enjoy eating again.

Smell retraining can be possible if the organs that detect smells (the olfactory bulbs) have not been surgically removed. Ask your doctor if this would be helpful for your situation.

Read about tips to help with taste changes and loss of appetite

Safety issues

If you have lost your sense of smell it is important to be very safety conscious, especially when using ovens and fires.

Be sure that you have plenty of working smoke alarms throughout your home. Use electricity instead of gas. Always read the labels on bottles of chemicals that you use.

Many strong chemicals require that you use them outside or in a very well ventilated room.

Last reviewed: 23 Jan 2024

Next review due: 23 Jan 2027

Living with nasal and paranasal sinus cancer

There is support available during and after treatment to help you cope. This includes support from your clinical nurse specialist, cancer charities, community services, and family and friends.

What is nasal and paranasal sinus cancer?

Cancer can start in the lining of the space behind the nose (nasal cavity) or the nearby air cavities (paranasal sinuses) and sometimes spread to lymph nodes and rarely other parts of the body.

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.

Treatment for nasal and paranasal sinus cancer

Your treatment depends on several factors. These include what type of nasal and paranasal sinus cancer you have, how big it is, whether it has spread (the stage) and the grade. It also depends on your general health.

Radiotherapy for nasal and sinus cancer

Radiotherapy uses high energy x-rays to destroy cancer cells. You usually have a type of external radiotherapy called intensity modulated radiotherapy (IMRT).

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