Chemotherapy for Nasal Cavity and Paranasal Sinus Cancers
Chemotherapy (chemo) uses anti-cancer drugs that are given into a vein or by mouth. These drugs enter the bloodstream and reach all areas of the body, making this treatment useful for cancer that has spread metastasized (spread) to organs beyond the nasal cavity and paranasal sinuses.
Chemo may be used in different situations for nasal cavity and paranasal sinus cancers:
- Before surgery (often along with radiation therapy) to try to shrink the tumor and make surgery easier. This is called neoadjuvant chemotherapy.
- After surgery (often along with radiation therapy) to help lower the chance the cancer will come back later. This is called adjuvant chemotherapy.
- As the main treatment (often along with radiation therapy) for cancers that are too large or have spread too far to be completely removed with surgery.
Chemo for nasal cavity and paranasal sinus cancers may include a combination of several anti-cancer drugs. Nasal and paranasal sinus cancers are rare, so there aren’t many studies to help doctors decide the best way to treat them. Often, doctors treat them with the same drugs that are used for other, more common, cancers of the head and neck.
The most common types of nasal cavity and paranasal sinus cancers, squamous cell carcinoma, adenocarcinoma, and adenoid cystic carcinoma, can be grouped together as carcinomas. Some of the chemo drugs used to treat carcinomas include:
- 5-fluorouracil (5-FU)
- Docetaxel (Taxotere®)
- Paclitaxel (Taxol®)
- Cyclophosphamide (Cytoxan®)
Chemo drugs may be used alone, but more often they are used in combination with one another. The drugs used depend on several factors, including the extent of the cancer, the person’s overall health, and whether chemo is combined with radiation therapy. Cisplatin (sometimes combined with 5-FU) is the drug most often given with radiation. Some studies have shown that giving docetaxel with these 2 drugs may work even better.
New chemo drugs and combination treatments are also being studied. Some doctors give the drugs directly into arteries leading to the tumor. This concentrates the chemotherapy into the area that needs it to try to reduce side effects.
Different chemo drugs are used for sarcomas and melanomas. Information about chemotherapy for sarcomas may be found in our document Sarcoma: Adult Soft Tissue Cancer. Drug therapy for melanoma is covered in our document Melanoma Skin Cancer.
Side effects of chemotherapy
Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be affected by chemo, which can lead to side effects. Side effects depend on the specific drugs used, their dose, and the length of treatment. Common temporary side effects of chemo include:
- Nausea and vomiting
- Loss of appetite
- Loss of hair
- Mouth sores
- Low blood counts
Chemo often affects the blood-forming cells of the bone marrow, this can lead to:
- Increased chance of infection (from a shortage of white blood cells)
- Bleeding or bruising after minor cuts or injuries (from a shortage of blood platelets)
- Fatigue (from low red blood cell counts)
If the blood counts get too low, treatment may need to be delayed for a time so that they return to a safe level.
Most side effects improve once treatment is stopped. Hair will grow back after treatment ends, though it may look different. There are remedies for many of the temporary side effects of chemotherapy. For example, there are very good drugs to prevent or reduce nausea and vomiting.
Some side effects continue long after treatment is stopped. For example, cisplatin can cause nerve damage (neuropathy), which can lead to numbness in the hands and feet or hearing loss. These symptoms usually improve after the drug is stopped, but may not go away completely.
If your doctor plans treatment with chemo you should be sure to discuss which drugs will be used and the possible side effects. Once chemo is started, let your health care team know if you have side effects, so they can be treated.
Last Medical Review: April 22, 2014 Last Revised: August 8, 2016
- Surgery for Nasal Cavity and Paranasal Sinus Cancers
- Radiation Therapy for Nasal Cavity and Paranasal Sinus Cancers
- Chemotherapy for Nasal Cavity and Paranasal Sinus Cancers
- Targeted Therapy for Nasal Cavity and Paranasal Sinus Cancers
- Palliative Treatment for Nasal Cavity and Paranasal Sinus Cancers
- Treatment Options by Type, Location, and Stage of Nasal Cavity and Paranasal Sinus Cancer