Symptoms & Risk Factors of Cancer of Maxillary Sinus & Paranasal Sinuses
In the early stages of the disease, symptoms may be totally absent.
Another practical problem that makes an early detection difficult is
that, symptoms if present are not specific.
Blocked sinuses that do not clear
Headaches
Pain in the sinus areas on either sides of the nose
Runny nose
Nosebleeds
Lump or sore inside the nose that does not heal
Swelling on the face or roof of the mouth
Numbness of cheeks
Pain in the upper teeth
Loose teeth
Dentures that no longer fit well
Swelling or other difficulties with the eyes
A sinusitis, which is an infection of sinuses, may mimic these symptoms.
Risk Factors Of Maxillary Sinus Cancer
As mentioned earlier cancers of paranasal sinuses are not common, but if they arise the most common sites affected are the maxillary sinuses. These sinuses are normally lines by thin, flat cells called squamous cells. The abnormal division of these cells result in squamous cell carcinoma.
Risk Factors
A risk factor is something that increases the chance of acquiring a disease. It doesn’t however mean that there should be a risk factor for a person to catch the ailment.
The following conditions may predispose a person to increased risk of developing a maxillary sinus cancer.
Exposure to certain workplace chemicals or dust. The following jobs are the riskiest:
Work in Furniture-making.
Work in Sawmill.
Carpentry.
Shoemaking.
Metal-plating.
Flour mill or bakery work.
Being male.
Age more than 40 years.
Smoking; Tobacco use.
Chronic sinusitis.
A cancer can also arise even in the absence of the above mentioned factors.
Blocked sinuses that do not clear Headaches Pain in the sinus areas on either sides of the nose Runny nose Nosebleeds Lump or sore inside the nose that does not heal Swelling on the face or roof of the mouth Numbness of cheeks Pain in the upper teeth Loose teeth Dentures that no longer fit well Swelling or other difficulties with the eyesA sinusitis, which is an infection of sinuses, may mimic these symptoms.
Risk Factors Of Maxillary Sinus Cancer
As mentioned earlier cancers of paranasal sinuses are not common, but if they arise the most common sites affected are the maxillary sinuses. These sinuses are normally lines by thin, flat cells called squamous cells. The abnormal division of these cells result in squamous cell carcinoma.
Risk Factors
A risk factor is something that increases the chance of acquiring a disease. It doesn’t however mean that there should be a risk factor for a person to catch the ailment.
The following conditions may predispose a person to increased risk of developing a maxillary sinus cancer.
Exposure to certain workplace chemicals or dust. The following jobs are the riskiest: Work in Furniture-making. Work in Sawmill. Carpentry. Shoemaking. Metal-plating. Flour mill or bakery work. Being male. Age more than 40 years. Smoking; Tobacco use. Chronic sinusitis.A cancer can also arise even in the absence of the above mentioned factors.
Diagnosis of Cancer of Maxillary Sinus & Paranasal Sinuses
Early detection and initiation of treatment can improve survival
rates. The outcome depends on the ‘stage’ of the cancer. Staging is the
process of finding out the extent to which the cancer has spread. Apart
from the routine physical examination the following procedures are
carried out:
X-ray: This is a cost effective imaging modality and remains as one of the first investigations ordered for but it may not confirm the presence of cancer.
CT scan: In computed tomography (also called computerized tomography, or computerized axial tomography) a series of detailed pictures of areas inside the body are taken from different angles. This can accurately show the extent of the cancer
MRI scan: MRI stands for Nuclear Magnetic Resonance Imaging. This is a non invasive technique that doesn’t use ionizing radiations unlike a CT scan. Instead strong magnetic fields are used.
CT scan and MRI scans provide more detailed information than a plain radiograph.
Bone scan: A maxillary sinus cancer may lead to erosion of bones. These are checked for by performing a bone scan. A very small amount of radioactive material is injected into a vein. It travels through the bloodstream and collects in the bones and is detected by a scanner.
Endoscopy: Here an endoscope which is a thin, tube like instrument is inserted through the nose. It aids in visualising abnormal areas. It also lets removal of tissue samples for biopsy and further study.
X-ray: This is a cost effective imaging modality and remains as one of the first investigations ordered for but it may not confirm the presence of cancer.
CT scan: In computed tomography (also called computerized tomography, or computerized axial tomography) a series of detailed pictures of areas inside the body are taken from different angles. This can accurately show the extent of the cancer
MRI scan: MRI stands for Nuclear Magnetic Resonance Imaging. This is a non invasive technique that doesn’t use ionizing radiations unlike a CT scan. Instead strong magnetic fields are used.
CT scan and MRI scans provide more detailed information than a plain radiograph.
Bone scan: A maxillary sinus cancer may lead to erosion of bones. These are checked for by performing a bone scan. A very small amount of radioactive material is injected into a vein. It travels through the bloodstream and collects in the bones and is detected by a scanner.
Endoscopy: Here an endoscope which is a thin, tube like instrument is inserted through the nose. It aids in visualising abnormal areas. It also lets removal of tissue samples for biopsy and further study.
Spread (Metastasis) of Cancer of Maxillary Sinus & Paranasal Sinuses
Cancer cells never restrict themselves to an area; they may travel to far and distant places! This is termed metastasis.
This can be by different routes:
Tissue: The cancer starts to invade the adjacent normal tissue
Lymphatic system: Lymph vessels (these are tubes that carry lymph and white blood cells) to other parts of the body may serve as carriers of cancer cells.
Blood: Cancer cells invade veins, capillaries and reach different areas.
Organs like lungs may even become the destination for these cells. Hence the importance of chest x-rays. The term used for involvement of distant organs and tissues is ‘secondary tumour’. This happens in the advanced stages of a cancer.
This can be by different routes:
Tissue: The cancer starts to invade the adjacent normal tissue
Lymphatic system: Lymph vessels (these are tubes that carry lymph and white blood cells) to other parts of the body may serve as carriers of cancer cells.
Blood: Cancer cells invade veins, capillaries and reach different areas.
Organs like lungs may even become the destination for these cells. Hence the importance of chest x-rays. The term used for involvement of distant organs and tissues is ‘secondary tumour’. This happens in the advanced stages of a cancer.
Treatment Of Cancer Of Maxillary Sinus & Paranasal Sinuses
An early detection facilitates successful management of the cancer.
There are three types of standard treatment modality: Surgery, Radiation, and Chemotherapy.
Surgery
Here the cancer is removed in an operation. It is a common treatment for all the stages of a paranasal sinus cancer. A doctor removes the cancer and if required some of the nearby healthy tissues and bone are also taken out. If the cancer has spread, lymph nodes (rounded masses of tissues located along the lymph vessels) and other kinds of tissues in the neck may also be removed.
Even if all the cancer that can be seen at the time of the surgery are removed by the doctor, some patients may require further treatment in the form of chemotherapy or radiation therapy to kill any cancer cells that are left, this is called adjuvant therapy.
Radiation
Radiation therapy is a cancer treatment where high-energy x-rays or other types of radiation are used to kill cancer cells or prevent them from growing. There are two types of radiation therapy.
In External radiation therapy, a machine outside the body is used to send radiation toward the cancer. The total dose of radiation therapy is sometimes divided into several smaller, equal doses which are delivered over a period of time spanning over several days. In Internal radiation therapy, a radioactive substance is placed directly into or near the cancer. The type of radiation therapy used depends on the type and stage of the cancer being treated.
Chemotherapy
Here drugs are used to stop the growth of cancer cells, either by killing the cells or by preventing them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body, this is called systemic chemotherapy. In regional chemotherapy drugs are placed directly into an organ, or a body cavity. A combination of anti cancer drugs may be used.
There are three types of standard treatment modality: Surgery, Radiation, and Chemotherapy.
Surgery
Here the cancer is removed in an operation. It is a common treatment for all the stages of a paranasal sinus cancer. A doctor removes the cancer and if required some of the nearby healthy tissues and bone are also taken out. If the cancer has spread, lymph nodes (rounded masses of tissues located along the lymph vessels) and other kinds of tissues in the neck may also be removed.
Even if all the cancer that can be seen at the time of the surgery are removed by the doctor, some patients may require further treatment in the form of chemotherapy or radiation therapy to kill any cancer cells that are left, this is called adjuvant therapy.
Radiation
Radiation therapy is a cancer treatment where high-energy x-rays or other types of radiation are used to kill cancer cells or prevent them from growing. There are two types of radiation therapy.
In External radiation therapy, a machine outside the body is used to send radiation toward the cancer. The total dose of radiation therapy is sometimes divided into several smaller, equal doses which are delivered over a period of time spanning over several days. In Internal radiation therapy, a radioactive substance is placed directly into or near the cancer. The type of radiation therapy used depends on the type and stage of the cancer being treated.
Chemotherapy
Here drugs are used to stop the growth of cancer cells, either by killing the cells or by preventing them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body, this is called systemic chemotherapy. In regional chemotherapy drugs are placed directly into an organ, or a body cavity. A combination of anti cancer drugs may be used.
Prognosis, Follow-Up Prevention of Cancer of Maxillary Sinus & Paranasal Sinuses
Survival rates for patients with cancer of maxillary sinus average
about 40% over 5 years. The more advanced the disease is, the worse is
the outcome or the prognosis. Early-stage tumours may have a cure rate of up to 80%. Patients treated with radiation have a survival rate of less than 20%.
In spite of a complete treatment there are chances that the cancer might recur.
If the patients experience difficulty with nutrition intake or pain control during radiation therapy, it necessitates periodic examinations by the head and neck surgeon.
Checkups with a radiation oncologist and a dentist are also required.
In addition yearly liver function tests, chest x-rays, periodic CT scans and MRI scans are mandatory depending upon the conditions of the patient. If the patient has received radiation to the lower neck thyroid function tests will be required for a year.
Prevention- It is not possible to completely prevent these cancers. However, the avoidance of risk factors (mentioned above) may help to an extent. But it is important to know that even in the absence of these causative factors, a person may acquire a maxillary sinus cancer. However cessation of smoking and tobacco abuse can certainly help.
In spite of a complete treatment there are chances that the cancer might recur.
If the patients experience difficulty with nutrition intake or pain control during radiation therapy, it necessitates periodic examinations by the head and neck surgeon.
Checkups with a radiation oncologist and a dentist are also required.
In addition yearly liver function tests, chest x-rays, periodic CT scans and MRI scans are mandatory depending upon the conditions of the patient. If the patient has received radiation to the lower neck thyroid function tests will be required for a year.
Prevention- It is not possible to completely prevent these cancers. However, the avoidance of risk factors (mentioned above) may help to an extent. But it is important to know that even in the absence of these causative factors, a person may acquire a maxillary sinus cancer. However cessation of smoking and tobacco abuse can certainly help.