What is cancer of the paranasal sinus and nasal cavity?

Cancer of the paranasal sinus and nasal cavity is a disease in which cancer (malignant) cells are found in the tissues of the paranasal sinuses or nasal cavity. The paranasal sinuses are small hollow spaces around the nose. The sinuses are lined with cells that make mucus, which keeps the nose from drying out; the sinuses are also a space through which the voice can echo to make sounds when a person talks or sings. The nasal cavity is the passageway just behind the nose through which air passes on the way to the throat during breathing. The area inside the nose is called the nasal vestibule.
There are several paranasal sinuses, including the frontal sinuses above the nose, the maxillary sinuses in the upper part of either side of the upper jawbone, the ethmoid sinuses just behind either side of the upper nose, and the sphenoid sinus behind the ethmoid sinus in the center of the skull. Cancer of the paranasal sinus and nasal cavity most commonly starts in the cells that line the oropharynx. Much less often, cancer of the paranasal sinus and nasal cavity starts in the color-making cells called melanocytes, and is called a melanoma. If the cancer starts in the muscle or connecting tissue, it is called a sarcoma. Another type of cancer that can occur here, but grows more slowly, is called an inverting papilloma. Cancers called midline granulomas may also occur in the paranasal sinuses or nasal cavity, and they cause the tissue around them to break down.
A doctor should be seen for any of the following problems:
* Blocked sinuses that do not clear.
* A sinus infection.* Nosebleeds.
* A lump or sore that doesn’t heal inside the nose.
* Frequent headaches or sinus pain.
* Swelling or other trouble with the eyes.
* Pain in the upper teeth.
* Dentures that no longer fit well.
If there are symptoms, a doctor will examine the nose using a mirror and lights. The doctor may order a CT scan (a special x-ray that uses a computer) or an MRI scan (an x-ray-like procedure that uses magnetic energy) to make a picture of the inside of parts of the body. A special instrument (called a rhinoscope or a nasoscope) may be put into the nose to see inside. If tissue that is not normal is found, the doctor will need to cut out a small piece and look at it under the microscope to see if there are any cancer cells. This is called a biopsy.
Sometimes the doctor will need to cut into the sinus to do a biopsy. The chance of recovery (prognosis) depends on where the cancer is in the sinuses, whether the cancer is just in the area where it started or has spread to other tissues (the stage), and the patient’s general state of health.

What is Cancer?

The name for diseases in which the body's cells become abnormal and divide without control. Cancer cells may invade nearby tissues. And they may spread through the bloodstream and lymphatic system to other parts of the body.

How is Cancer formed?

Cancer cells are formed from normal cells due to a modification / mutation of DNA and/or RNA. These modifications / mutations can occur spontaneously (II Law of Thermodynamics - increase of entropy) or they may be induced by other factors such as: nuclear radiation, electromagnetic radiation (microwaves, X-rays, Gamma-rays, Ultraviolet-rays, etc.), viruses, bacteria and fungi, parasites (due to tissue inflamation/irritation), heat, chemicals in the air, water and food, mechanical cell-level injury, free radicals, evolution and ageing of DNA and RNA, etc. All these can produce mutations that may start cancer. Cancer can be called therefore "Entropic Disease" since it is associated with the increase of entropy of the organism to the point where the organism cannot correct this itself.
External intervention is required to allow the organism to return to an stable entropic state.Cancer cells are formed continuously in the organism (it is estimated that there are about 10,000 cancer cells at any given time in a healthy person). The question is why some of these result in macroscopic-level cancers and some don't. First, not all damaged cells can multiply and many of them die quickly. Those which have the potential to divide and form cancer are effectively destroyed by the various mechanisms available to the immune system.
This process takes place continuously. Therefore cancer develops if the immune system is not working properly and/or the amount of cells produced is too great for the immune system to eliminate.
The rate of DNA and RNA mutations can be too high under some conditions such as: unhealthy environment (due to radiation, chemicals, etc.), poor diet (unhealthy cell environment), people with genetic predispositions to mutations and people of advanced age (above 80).

Signs and Symptoms

The symptoms can vary depending on which sinuses are affected.
The most common symptoms include:
* blocked sinuses which do not clear
* pain behind the nose or in the upper teeth
* swelling around the eyes.
Other symptoms may include:
* numbness of the cheek, upper lip, upper teeth or side of the nose
* persistent nosebleeds* headaches
* speech changes
* double vision.
These symptoms may occur due to conditions other than cancer, and most people with these symptoms will not have paranasal sinus cancer. However, like most cancers, paranasal sinus cancer is most likely to be cured when diagnosed at an early stage.Therefore, any of the above symptoms should be reported to your GP if they do not improve over a few days.

How it is Diagnosed

Your GP will examine you and arrange for any further tests that may be necessary. You will need to be referred to a hospital specialist for these tests, and for expert advice and treatment. The doctor at the hospital will take your full medical history, carry out a physical examination, and take blood samples to check your general health. The following tests are commonly used to make a firm diagnosis:
X-rays These may be taken to show the size and position of the cancer.
CT (computerised tomography) scan This is a sophisticated type of x-ray that builds up a detailed three-dimensional picture of the inside of the body. The scan is painless but takes about 10 minutes. It may be used to find the exact site of the cancer, or to check for any spread of the cancer. Most people who have a CT scan are given a drink or injection that enables particular areas to be seen more clearly. Before having the injection or drink, it is important to tell the person doing this test if you are allergic to iodine or have asthma.
MRI (magnetic resonance imaging) scan This scan uses magnetism instead of x-rays to form a series of cross-sectional pictures of the inside of the body. During the scan, you will be asked to lie on the couch inside a metal cylinder. You will usually be given an injection of a liquid that enables the pictures to be seen more clearly. The test can take up to an hour and is completely painless. If you don't like enclosed spaces you may find the machine claustrophobic. The machine is also quite noisy, but you will be given earplugs or headphones to wear.
Nasopharyngoscopy In this procedure a fine tube with a light at the end (nasendoscope) is guided through the nose into the sinus area. If an abnormal area is seen, a small piece of tissue will be taken to examine under a microscope for cancer cells (biopsy). This may be carried out under a local or general anaesthetic. This test can be uncomfortable and you may be given an anaesthetic spray beforehand to numb your nose and throat. You will then be asked not to eat or drink anything for about an hour afterwards, until your throat has lost the numb feeling.

Types of Treatment

What treatment is best for you? Which methods have proven to be most effective? Here you can find answers to your questions, plus learn about what to ask your physician, what's new in research, and what you can expect after treatment is over. Treatment Options Learn about the most common forms of treatment and how they're used to fight cancer.
Surgery Find out when surgery is necessary and what techniques are used.Radiation Therapy Principles In depth guide to see how radiation therapy works and what you can expect before, during, and after treatment. Understanding Radiation Therapy A Guide for Patients and Families Answers to your questions about radiation therapy and managing side effects.
Chemotherapy What It Is, How It Helps Basics of how chemotherapy works to treat cancer. Chemotherapy Principles In depth guide to see how chemotherapy works and what you can expect before, during, and after treatment. Understanding Chemotherapy A Guide for Patients and Families Answers to your questions about chemotherapy and managing side effects.
Oral Chemotherapy What You Need to Know General information on taking chemotherapy as a liquid, tablet, or capsule.
Immunotherapy Find out how this treatment uses your body's own defense system to fight cancer.
Off-Label Drug Use explains under what circumstances a patient might receive an investigational new drug outside a clinical trial.

Alternative therapies

Aromatherapy is the use of fragrant substances, called essential oils, distilled from plants to alter mood or improve health. These highly concentrated aromatic substances are either inhaled or applied during massage. Approximately 40 essential oils are commonly used in aromatherapy; among the most popular are lavender, rosemary, eucalyptus, chamomile, marjoram, jasmine, peppermint, lemon, ylang ylang, and geranium.
Art therapy is used to help people manage physical and emotional problems by using creative activities to express emotions. It provides a way for people to come to terms with emotional conflicts, increase self-awareness, and express unspoken and often unconscious concerns about their illness and their lives. "Expressive arts therapy" or "creative arts therapy" may also include dance and movement, drama, poetry, photo therapy and others, as well as the more traditional art methods.
Ayurveda is an ancient Indian system of medicine. It has an integrated approach to the prevention and treatment of illness and tries to maintain or re-establish the harmony between the mind, body, and forces of nature. It combines a number of approaches, such as changes in lifestyle, herbal remedies, exercise, and meditation to strengthen and purify the body and mind and increase spiritual awareness.
Feng shui is the ancient Chinese philosophy and art of placing objects, ornaments, furniture, rooms, buildings, and even towns in position so they promote the beneficial flow of vital energy or life force called qi (or chi). The words feng shui literally mean wind and water.
Yoga is a form of non-aerobic exercise that involves a program of precise posture, breathing exercises, and meditation. In ancient Sanskrit, the word yoga means "union."
Meditation is a mind-body process that uses concentration or reflection to relax the body and calm the mind. It has been defined as the intentional self-regulation of attention, a mental focus on a particular aspect of one's inner or outer experience. One commonly practiced type is Transcendental Meditation, which involves repeating a word or phrase (mantra), either silently or aloud. Another is mindfulness meditation, in which a person observes sensations, perceptions, and thoughts without judgment as they arise. There are other types of meditation that focus attention by walking or visualizing. Meditations that focus on words or images and do not strive for a state of thoughtless awareness are sometimes called quasi-meditative.
Tai chi is an ancient Chinese martial art that is part of Qigong (see Qigong). It is a mind-body, self-healing system that uses movement, meditation, and breathing to improve health and well being.
Qigong is a Chinese system designed to enhance the natural flow of vital energy called qi (or ch'i, pronounced "chee" or "kee") in the body. The process of working toward a regulated, smooth flow of qi is called "gong" (pronounced "kung").
Native American healing is a broad term that includes healing beliefs and practices of hundreds of indigenous tribes of North America. It combines religion, spirituality, herbal medicine, and rituals that are used to treat people with medical and emotional conditions. There are many tribal differences, so it is not surprising that healing rituals and beliefs vary a great deal. The most sacred traditions are still kept secret, passed along from one healer to the next. Because of these factors, information on healing practices is general and somewhat limited.
Breathwork is a general term used to describe a variety of conscious breathing techniques that are used in many relaxation exercises and spiritual healing methods. There are many types of breathwork and facilitators. Focused, deep breathing exercises, such as exaggerating the way you naturally inhale and exhale, is said to promote relaxation, awareness, and emotional release. Since shallow breathing is considered to be a way to avoid feeling one's emotions and an indicator of stress, the goal in breathwork is usually to take long, deep breaths. These breaths are said to be "cleansing" in that they free the body and mind from restrictions, and release toxins that work against a healthy state.
Dance therapy is the therapeutic use of movement to improve the mental and physical well being of a person. It focuses on the connection between the mind and body to promote health and healing. Dance therapy can be considered an expressive therapy.

New Research in Cancer Treatment

Genetically engineered bacteria and virusesSome new promising research uses genetically engineered bacteria and viruses to infect and destroy cancer cells. This could be useful when cancer is already advanced and there are large masses of cancer cells. The potential drawback of these methods is the generation of large amounts of toxins from dying cancer cells, which in turn can suppress the immune system or even kill the patient. Also bacteria and viruses very often mutate which in turn can lead to infection and attack on healthy, non-cancerous cells.
Anti-cancer vaccines Anti-cancer vaccines or even custom-made anti-cancer vaccines for a particular patient and cancer type are also a very promising line of research. By providing fragments of cancer cells to the immune system, one can potentially get the immune system response to destroy live cancer cells. Cancer markers Another promising line of research is related to chemical substances which could be used to mark cancer cells. This in turn will allow easier recognition of these cells by the immune system.
Cancer growth retarders / inhibitors This line of research is related to the use of chemical substances which could retard / inhibit the growth of cancer cells. An interesting research topics are the substances blocking activity of telomerase, the enzyme responsible for the management/elongation of telomeres. Telomerase is found in high concentrations in 80% of tumors and allows tumor cells to gain "immortality" by removing restrictions on the number of cell divisions. This enzyme may also be useful in extending the lifespan of healthy cells and in turn extend the lifespan of the organism (cancer cells and their growth may hold much valuable information about fountain of youth and immortality).All the above mentioned methods show some promise. However these methods by themselves do not provide reliable cancer treatment. It is possible that some of them in conjunction with the non-traditional treatment of cancer (listed below) will become the standard cancer treatment, in the 21st or 22nd century.

What are the Risk Factors for Nasal Cavity and Panasal Sinus Cancers?

A risk factor is anything that increases a person's chance of getting a disease such as cancer. Different cancers have different risk factors. For example, unprotected exposure to strong sunlight is a risk factor for skin cancer, and smoking is a risk factor for cancers of the lung, larynx, mouth, throat, esophagus, kidneys, bladder, and several other organs.
Although researchers have found several risk factors that make a person more likely to develop nasal cavity and paranasal sinus cancer, many people with these cancers have no known risk factors. Even if a patient has one or more risk factors, it is difficult to know whether that factor actually caused the cancer.
Occupational exposures: Scientists have found many occupational risk factors that make a person more likely to develop nasal cavity and paranasal sinus cancer. Most of these risk factors are associated with substances in the work environment that are inhaled. These include occupational exposure to dusts from wood, textiles, and leather and even perhaps flour. Other substances linked to this type of cancer are glues, formaldehyde, solvents used in furniture and shoe production, nickel and chromium dust, mustard gas, isopropyl ("rubbing") alcohol, and radium. Some have also suggested that air pollution in heavily polluted cities such as Mexico City may also be a risk factor. None of these risk factors is completely certain because these cancers are so uncommon.
Smoking: Smoking is a major risk factor for nasal cavity cancer.Family history: Most people with nasal cavity and paranasal sinus cancer do not have any relatives with this disease. Family history does not seem to be a risk factor for these cancers.

"World Cancer Report" by Who

WHO (World Health Organization, division of UN) estimates that only 4% of all cancers are inherited /genetic and that the majority of cancers are preventable ("World Cancer Report", IARC Press, Lyon 2003). According to this report, various cancers are strongly linked to lifestyle and the environment.It lists many of these factors and carcinogens. Cancer world maps shown in the report illustrate that the majority of cancers are in developed countries which indicates again a strong link between cancer, lifestyle, diet and environment. This statistical data is very consistent with the cancer model outlined in this paper."World Cancer Report" by WHO