Want more iVillage? Sign up for our
Newsletters
Paranasal Sinus and Nasal Cavity Cancer Treatment (PDQ®): Treatment - Patient Information [NCI]
After paranasal sinus and nasal cavity cancer has been diagnosed, tests are done to find out if cancer cells have spread within the paranasal sinuses and nasal cavity or to other parts of the body.
The process used to find out if cancer has spread within the paranasal sinuses and nasalcavity or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process:
- X-rays of the head, neck, and chest: An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
- Endoscopy: A procedure to look at organs and tissues inside the body to check for abnormal areas. An endoscope is inserted through an opening in the body, such as the nose or mouth. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of disease.
- CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
- MRI (magnetic resonance imaging) with gadolinium: A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body. Sometimes a substance called gadolinium is injected into a vein. The gadolinium collects around the cancer cells so they show up brighter in the picture. This procedure is also called nuclear magnetic resonance imaging (NMRI).
- Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones and is detected by a scanner.
There are three ways that cancer spreads in the body.
The three ways that cancer spreads in the body are:
- Through tissue. Cancer invades the surrounding normal tissue.
- Through the lymph system. Cancer invades the lymph system and travels through the lymph vessels to other places in the body.
- Through the blood. Cancer invades the veins and capillaries and travels through the blood to other places in the body.
When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.
There is no standard staging system for cancer of the sphenoid and frontal sinuses.
Pea, peanut, walnut, and lime show tumor sizes.
The following stages are used for maxillary sinus cancer:
Stage 0 (Carcinoma in Situ)
In stage 0, abnormalcells are found in the innermost lining of the maxillary sinus. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I
In stage I, cancer has formed in the mucous membranes of the maxillary sinus.
Stage II
In stage II, cancer has spread to bone around the maxillary sinus, including the roof of the mouth and the nose, but not to bone at the back of the maxillary sinus or the base of the skull.
Stage III
In stage III, cancer has spread to any of the following:
- Bone at the back of the maxillary sinus.
- Tissues under the skin.
- The eye socket.
- The base of the skull.
- The ethmoid sinuses.
or
Cancer has spread to one lymph node on the same side of the neck as the cancer and the lymph node is 3 centimeters or smaller. Cancer has also spread to any of the following:
- The lining of the maxillary sinus.
- Bones around the maxillary sinus, including the roof of the mouth and the nose.
- Tissues under the skin.
- The eye socket.
- The base of the skull.
- The ethmoid sinuses.
Stage IV
Stage IV is divided into stage IVA, IVB, and IVC.
Stage IVA
In stage IVA, cancer has spread either:
- to one lymph node on the same side of the neck as the cancer and the lymph node is larger than 3 centimeters but not larger than 6 centimeters; or
- to more than one lymph node on the same side of the neck as the original tumor and the lymph nodes are not larger than 6 centimeters; or
- to lymph nodes on the opposite side of the neck as the original tumor or on both sides of the neck, and the lymph nodes are not larger than 6 centimeters.
and cancer has spread to any of the following:
- The lining of the maxillary sinus.
- Bones around the maxillary sinus, including the roof of the mouth and the nose.
- Tissues under the skin.
- The eye socket.
- The base of the skull.
- The ethmoid sinuses.
or
Cancer has spread to any of the following:
- The front of the eye.
- The skin of the cheek.
- The base of the skull.
- Behind the jaw.
- The bone between the eyes.
- The sphenoid or frontal sinuses.
and cancer may also have spread to one or more lymph nodes 6 centimeters or smaller, anywhere in the neck.
Stage IVB
In stage IVB, cancer has spread to any of the following:
- The back of the eye.
- The brain.
- The middle parts of the skull.
- The nerves in the head that go to the brain.
- The upper part of the throat behind the nose.
- The base of the skull.
and cancer may be found in one or more lymph nodes of any size, anywhere in the neck.
or
Cancer is found in a lymph node larger than 6 centimeters. Cancer may also be found anywhere in or near the maxillary sinus.
Stage IVC
In stage IVC, cancer may be anywhere in or near the maxillary sinus, may have spread to lymph nodes, and has spread to organs far away from the maxillary sinus, such as the lungs.
The following stages are used for nasal cavity and ethmoid sinus cancer:
Stage 0 (Carcinoma in Situ)
In stage 0, abnormalcells are found in the innermost lining of the nasalcavity or ethmoid sinus. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.
Stage I
In stage I, cancer has formed and is found in only one area (of either the nasalcavity or the ethmoid sinus) and may have spread into bone.
Stage II
In stage II, cancer is found in two areas (of either the nasalcavity or the ethmoid sinus) that are near each other or has spread to an area next to the sinuses. Cancer may also have spread into bone.
Stage III
In stage III, cancer has spread to any of the following:
- The eye socket.
- The maxillary sinus.
- The roof of the mouth.
- The bone between the eyes.
or
Cancer has spread to one lymph node on the same side of the neck as the cancer and the lymph node is 3 centimeters or smaller. Cancer has also spread to any of the following:
- The nasalcavity.
- The ethmoid sinus.
- The eye socket.
- The maxillary sinus.
- The roof of the mouth.
- The bone between the eyes.
Stage IV
Stage IV is divided into stage IVA, IVB, and IVC.
Stage IVA
In stage IVA, cancer has spread either:
- to one lymph node on the same side of the neck as the cancer and the lymph node is larger than 3 centimeters but not larger than 6 centimeters; or
- to more than one lymph node on the same side of the neck as the original tumor and the lymph nodes are not larger than 6 centimeters; or
- to lymph nodes on the opposite side of the neck as the original tumor or on both sides of the neck, and the lymph nodes are not larger than 6 centimeters.
and cancer has spread to any of the following:
- The nasalcavity.
- The ethmoid sinus.
- The eye socket.
- The maxillary sinus.
- The roof of the mouth.
- The bone between the eyes.
or
Cancer has spread to any of the following:
- The front of the eye.
- The skin of the nose or cheek.
- Front parts of the skull.
- The base of the skull.
- The sphenoid or frontal sinuses.
and cancer may have spread to one or more lymph nodes 6 centimeters or smaller, anywhere in the neck.
Stage IVB
In stage IVB, cancer has spread to any of the following:
- The back of the eye.
- The brain.
- The middle parts of the skull.
- The nerves in the head that go to the brain.
- The upper part of the throat behind the nose.
- The base of the skull.
and cancer may be found in one or more lymph nodes of any size, anywhere in the neck.
or
Cancer is found in a lymph node larger than 6 centimeters. Cancer may also be found anywhere in or near the nasalcavity and ethmoid sinus.
Stage IVC
In stage IVC, cancer may be anywhere in or near the nasalcavity and ethmoid sinus, may have spread to lymph nodes, and has spread to organs far away from the nasal cavity and ethmoid sinus, such as the lungs.
PDQ is a comprehensive cancer database available on NCI's Web site.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health, the federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries are available in two versions. The health professional versions provide detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions provide current and accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are responsible for writing and maintaining the cancer information summaries. The summaries are reviewed regularly and changes are made as new information becomes available. The date on each summary ("Date Last Modified") indicates the time of the most recent change.
PDQ also contains information on clinical trials.
A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Listings of clinical trials are included in PDQ and are available online at NCI's Web site. Descriptions of the trials are available in health professional and patient versions. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
Last Revised: 2011-02-04
If you want to know more about cancer and how it is treated, or if you wish to know about clinical trials for your type of cancer, you can call the NCI's Cancer Information Service at 1-800-422-6237, toll free. A trained information specialist can talk with you and answer your questions.
© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
