Nose cancer, also known as nasal cancer or paranasal sinus cancer, is an uncommon form of cancer that occurs in the nasal cavity and paranasal sinuses. These are hollow spaces in the bones around the nose and behind the facial area, which are responsible for producing mucus, reducing the weight of the skull, and influencing the tone of our voice. Due to its rarity and the complexity of the nasal and sinus structures, nose cancer can be challenging to diagnose and treat.
Types of Nose Cancer
Nose cancer can be classified based on the type of cells where the cancer begins. The main types include:
- Squamous Cell Carcinoma: The most common type, originating in the squamous cells that line the nasal cavity and sinuses.
- Adenocarcinoma: Arises from the glandular cells in the nasal cavity that produce mucus.
- Sarcoma: Begins in the bone, muscle, or cartilage tissues of the nasal cavity and sinuses.
- Melanoma: Originates in the pigment-producing cells of the nasal passages.
- Esthesioneuroblastoma: A rare type that starts in the olfactory nerves, which are responsible for the sense of smell.
Causes and Risk Factors
The exact cause of nose cancer is not fully understood, but several risk factors have been identified:
- Occupational Exposure: Exposure to certain chemicals or dust, particularly in industries like woodworking, leatherworking, and shoe manufacturing, has been linked to an increased risk.
- Tobacco Use: Smoking or chewing tobacco can raise the risk of nasal and sinus cancers.
- Human Papillomavirus (HPV): Some nasal and sinus cancers have been associated with HPV infection.
- Previous Radiation Therapy: Exposure to radiation in the head and neck area for other medical treatments can increase the risk.
Symptoms
Symptoms of nose cancer can often mimic those of more common conditions, such as sinus infections, making it difficult to diagnose early. Symptoms may include:
- Nasal Obstruction or Congestion: Persistent blockage in one side of the nose.
- Nosebleeds: Frequent and sometimes heavy bleeding from the nose.
- Reduced Sense of Smell: Partial or total loss of smell.
- Facial Pain or Swelling: Especially around the eyes or in the forehead area.
- Vision Changes: Double vision, reduced vision, or other eye problems.
- Headaches: Persistent pain that does not respond to usual headache remedies.
- Post-nasal Drip: Excessive mucus draining down the throat.
Diagnosis
Diagnosing nose cancer involves a combination of medical history, physical examination, and specialised tests, including:
- Nasal Endoscopy: A thin, flexible tube with a light and camera (endoscope) is inserted into the nose to examine the area.
- Imaging Tests: CT scans, MRIs, and PET scans can provide detailed images of the nasal cavity and sinuses.
- Biopsy: A small sample of tissue is retrieved from the suspicious area and examined under a microscope for cancer cells.
Treatment
Treatment for nose cancer depends on the type, stage, and location of the cancer, as well as the patient’s overall health. Options may include:
- Surgery: To remove the tumour and some surrounding healthy tissue. In more advanced cases, extensive surgery might be necessary, which can involve removing parts of the nasal cavity, sinuses, or even parts of the eye or brain.
- Radiation Therapy: High-energy rays are utilised to target and kill cancer cells. This can be an external beam radiation or internal radiation (brachytherapy).
- Chemotherapy: Uses drugs to kill cancer cells, often in combination with radiation therapy for advanced cases.
- Targeted Therapy: Focuses on specific genes, proteins, or the tissue environment that contributes to cancer growth and survival.
Prevention
While there is no guaranteed way to prevent nose cancer, certain lifestyle changes can help reduce the risk:
- Avoid Exposure to Harmful Substances: Use protective gear if you work in industries with high exposure to dust and chemicals.
- Quit Tobacco: Avoid smoking and chewing tobacco to reduce the risk of nasal and sinus cancers.
- Limit Alcohol Consumption: Excessive alcohol use can raise the risk of cancer.
- HPV Vaccination: Getting vaccinated against HPV might reduce the risk of cancers associated with the virus.
Conclusion
Nose cancer is a rare but serious condition that requires prompt and comprehensive treatment. Due to its nonspecific symptoms, early diagnosis can be challenging. Awareness of the risk factors and symptoms, combined with regular medical check-ups, especially for those at higher risk, can aid in early detection and improve treatment outcomes.
When should you see an ENT specialist in Singapore?
Please consult an ENT specialist if you are suffering from any ear, nose, or throat symptoms. It is also advisable to visit an ENT doctor if you experience persistent mouth breathing due to a chronic blocked nose or encounter snoring issues.
Dr Ker Liang sees adults and children for general ENT conditions and provides comprehensive management in a broad range of Ear, Nose, and Throat, as well as Head and Neck conditions. In particular, she has a special interest in treating throat and voice conditions, including persistent sore throat, voice issues, snoring, and Obstructive Sleep Apnoea (OSA).
Medical Teaching
Assistant Professor Ker Liang has a passion for teaching and is an Assistant Professor with NUS Yong Loo Lin School of Medicine (YLLSOM). As the NUS-NUH Otolaryngology Department Undergraduate Medical Director, Dr Ker Liang supervises the training of medical students from YLLSOM, NUS. She is actively involved
in the training of postgraduate junior doctors and residents in the Head and Neck Surgery department. She was conferred with an Undergraduate Teaching Award by the National University Health System in 2016 for her outstanding efforts as an Otolaryngology educator.
Medical Teaching
Assistant Professor Ker Liang has a passion for teaching and is an Assistant Professor with NUS Yong Loo Lin School of Medicine (YLLSOM). As the NUS-NUH Otolaryngology Department Undergraduate Medical Director, Dr Ker Liang supervises the training of medical students from YLLSOM, NUS. She is actively involved
in the training of postgraduate junior doctors and residents in the Head and Neck Surgery department. She was conferred with an Undergraduate Teaching Award by the National University Health System in 2016 for her outstanding efforts as an Otolaryngology educator.
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