The nasal cavity includes the nostrils and the area behind the nose. Surgery in this area is very specialised and only a specialist surgeon can do it. They will try to remove the cancer and some surrounding tissue but will also try to change your appearance as little as possible.
How the surgeon decides on treatment
The amount of surgery you need depends on the position of the cancer in the nasal cavity.
The type of surgery also depends on the stage of your cancer. This means the size of the cancer and whether it has spread. Your doctor might not be able to tell you exactly what stage your cancer is until after surgery.
Removing the cancer
The surgeon removes the whole cancer and a border of normal tissue around it. Doctors call this operation a primary tumour resection or wide local excision. The aim is to remove all visible signs of the cancer and any tissue around it that could contain cancer cells.
The surgeon sends the tumour to the laboratory for examination under a microscope. This is to check that there is a border of healthy tissue with no cancer cells around the tumour. This is called a clear margin.
Sometimes the tumour is in the wall that separates the two sides of the nasal cavity (the nasal septum). In these situations, the surgeon might need to remove part or all of the nasal septum.
Removal of part or all of your nose
For cancers on the side of the nose, your surgeon can usually remove the affected part. Doctors call this operation a partial rhinectomy.
Your surgeon may need to remove all of your nose if the cancer has spread deep into your nose tissue.
In both cases, your surgeon will need to rebuild your nose. They use tissue taken from your face or another part of your body. This may need further operations. Or a prosthetic technician can make a new false nose for you. The false nose is called a prosthesis.
This type of surgery will change your appearance. This can be challenging at first, but there are people who can help you cope.
This type of surgery isn't suitable for everyone. It will depend very much on the type of tumour you have and what other options are available. You might have endoscopic surgery if you:
- have a small tumour
- have a larger tumour but are not fit enough for a big operation
Other types of surgery can cause damage to surrounding healthy tissue. Endoscopic surgery causes less damage. It involves putting a thin, flexible tube (an endoscope) up into the nose. The tube has a camera and light inside it.
The surgeon passes surgical instruments or a laser through the endoscope. They then remove the cancer. Once you have recovered from the surgery you usually have radiotherapy to the area.
Side effects of surgery
Depending on the position of your cancer and the type of operation you have, your surgery might change:
- your sense of smell
- your sense of taste
- how you speak
These changes may happen because your face and neck is swollen and sore after surgery. They will usually reduce or disappear once you start to heal. Swelling might also change how you look but this will usually get better too.
You might have some permanent changes in what you can do and the way you look.
Before you have the surgery, your doctor will discuss the likely side effects with you.
Removing lymph nodes in your neck
If tests have shown that the cancer has spread to lymph nodes in your neck, you will need to have the lymph nodes removed.