The different stages of ethmoid sinus cancer and the treatment you might have.
What staging is
The stage of a cancer means how big it is and whether it has spread. It is important because the stage often decides the treatment. The tests and scans you have to diagnose cancer give some information about the stage. But your doctor may not be able to tell you the exact stage until you have surgery.
There are 5 number stages of ethmoid sinus cancer.
Stage 0 or carcinoma in situ (CIS)
If you have CIS or stage 0 cancer, you have a very early stage cancer. Some doctors prefer to call this pre cancer because there are cancer cells only in the skin like covering of your ethmoid sinus. This means the cancer cells are contained there and cannot spread.
As the cells cannot spread, this is not yet a true cancer. If the pre cancer is not treated, there is a high chance of this condition going on to develop into an invasive cancer.
If you have stage 1 cancer of the ethmoid sinus, it means the cancer is only in one part of the ethmoid sinus.
It may have grown into the bones of these structures. The cancer has not spread to the lymph nodes or other parts of the body.
If you have stage 2 cancer of the ethmoid sinus, it means the cancer has spread into more than one area of the ethmoid sinus, but not to a different sinus.
The cancer has not spread to the lymph nodes or other parts of the body.
Having stage 3 cancer of the ethmoid sinus can mean one of 2 things. Either:
- the cancer has begun to grow into the bones of the eye socket, the floor of the maxillary sinus (hard palate), or both. It has not spread to the lymph nodes or other organs
- the tumour is any size, except T4, and has spread to one lymph node on the same side of the neck. In this case the lymph node involved is no more than 3cm across
This means the cancer is advanced. All T4 tumours are considered to be stage 4 even if they have not spread to lymph nodes or other parts of the body. Stage 4 could mean one of 3 things:
- the tumour has grown into other nearby structures such as the eye, skin of nose or cheek, skull or the sphenoid or frontal sinuses
- the cancer is any size and has spread to more than one lymph node bigger than 3cm on the same side of the neck, or has spread to more than one lymph node of any size on one or both sides of the neck
- the cancer has spread to other parts of the body such as the lungs, liver or brain
Treatment by stage
Using surgery to treat ethmoid sinus cancer is sometimes difficult. This is because these sinuses are very close to your eye sockets and the base of your skull.
Operations tend to be more extensive than those for maxillary sinus cancer.
Stage 1 and 2
If you have a small stage 1 or 2 ethmoid sinus cancer, your doctor may be able to completely remove it with an operation called an ethmoidectomy.
You are more likely to have radiotherapy for these early stage cancers. This works just as well as surgery.
Stage 3 and 4
If you have stage 3 or 4 ethmoid sinus cancer, you will have a combination of craniofacial surgery and radiotherapy. You have the radiotherapy either before or after your surgery.