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Treating Nasal Cavity and Paranasal Sinus Cancers

If you’ve been diagnosed with nasal cavity or paranasal sinus cancer, your cancer care team will discuss your treatment options with you. It’s important to weigh the benefits of each treatment option against the possible risks and side effects.

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Who treats nasal cavity and paranasal sinus cancers?
How are nasal cavity and paranasal sinus cancers treated?
Treatment of nasal cavity and paranasal sinus cancers, by type and stage
Making treatment decisions
Social and emotional health during treatment
Help getting through cancer treatment
Choosing to stop treatment or choosing no treatment at all

Who treats nasal cavity and paranasal sinus cancers?

Based on your treatment options, you will likely have different kinds of doctors on your treatment team. These doctors might include:

An otolaryngologist: a doctor (surgeon) who specializes in treating diseases of the head and neck, also known as an ear, nose, and throat doctor (ENT doctor) or a head and neck surgeon.
A neurosurgeon: a doctor who specializes in surgery on the brain and other parts of the nervous system.
A radiation oncologist: a doctor who treats cancer with radiation therapy.
A medical oncologist: a doctor who treats cancer with medicines such as chemotherapy, immunotherapy, or targeted therapy.
A plastic surgeon (reconstructive surgeon): a doctor who specializes in reconstructing or repairing parts of the body.
A dentist or oral and maxillofacial surgeon: a dentist or surgeon who treats diseases and defects of the face, jaw, mouth, and neck.

Many other specialists might be involved in your care as well, including physician assistants (PAs), nurse practitioners (NPs), nurses, nutrition specialists, social workers, and other health professionals.

Your situation might be discussed at a multidisciplinary meeting, often referred to as a tumor board. In this meeting, your medical information is reviewed by doctors and other professionals from different specialties who, as a group, recommend a treatment plan for you.

Nasal cavity and paranasal sinus cancers aren’t common and can be challenging to treat, so it’s important that your cancer care team is experienced in treating them.

Treatment of cancers in the nasal cavity and sinuses can affect how you eat, look, and breathe. Your cancer care team will work with you to limit changes to your body and help you adjust to the changes while using the best treatments available.

How are nasal cavity and paranasal sinus cancers treated?

Depending on the type and stage of the cancer and your overall health and preferences, different treatment options might be used, alone or in combination.

Treatment of nasal cavity and paranasal sinus cancers, by type and stage

Treatment of nasal cavity or paranasal sinus cancer is based mainly on:

Where the cancer started
Its stage
The type of cancer
Your overall health and personal preferences

Because these cancers are rare and complex, treatment plans are typically created for each person. Care is usually provided by a team of specialists, such as head and neck surgeons (ENT doctors), radiation oncologists, and medical oncologists.

Many experts recommend considering a clinical trial whenever possible since new treatments are still being studied.

Treatment options for nasal cavity cancers

These cancers are limited to the nasal cavity and nearby structures and might have spread to lymph nodes in the neck, but they haven’t spread to other parts of the body.

Surgery is often the main treatment. Radiation therapy is commonly given after surgery to lower the risk of the cancer returning. For some small tumors, surgery or radiation alone might be enough.

In some people, radiation with chemotherapy (chemoradiation) might be an option instead of surgery. Sometimes chemotherapy alone is given first, known as induction chemotherapy. If the tumor shrinks enough, radiation therapy or surgery might be options afterward.

Lymph nodes in the neck might be treated with surgery or radiation if there is a risk the cancer has spread there.

These cancers have spread to other parts of the body.

The main goal of treatment is usually to slow the cancer, relieve symptoms, and maintain a person’s quality of life. Treatments that reach all areas of the body are likely to be the main options. These might include:

Chemotherapy
Targeted therapy
Immunotherapy
Some combination of these

Radiation therapy might also be given to specific areas causing symptoms.

Treatment options for paranasal sinus cancers

The paranasal sinuses include the maxillary, ethmoid, frontal, and sphenoid sinuses. Treatment depends on which sinus is affected and how far the cancer has grown.

These cancers are limited to the sinus and nearby structures and might have spread to lymph nodes in the neck, but they haven’t spread to other parts of the body.

Surgery is often the first treatment, sometimes using endoscopic techniques. Radiation therapy is commonly given after surgery.

Chemotherapy might be added for more aggressive tumors or those with higher-risk features to lower the risk of the cancer returning.

For more advanced tumors, radiation with chemotherapy (chemoradiation) or chemotherapy alone (known as induction chemotherapy) might be given first. Surgery or radiation therapy might be options afterward.

Lymph nodes in the neck might be treated with surgery or radiation if there is a risk the cancer has spread there.

For sphenoid sinus cancers, which are deep in the skull, surgery is less likely to be an option, so radiation therapy is usually used first. Chemotherapy, targeted therapy, and/or immunotherapy might be options as well.

These cancers have spread to other parts of the body.

Chemotherapy
Targeted therapy
Immunotherapy
Some combination of these

Radiation therapy might also be given to specific areas causing symptoms.

Treatment options for less common types of nasal cavity or paranasal sinus cancers

Some cancers behave differently and might need different treatment approaches.

These cancers tend to grow and spread more quickly than most other nasal cavity or paranasal sinus cancers. Different treatment approaches might be options, depending on the extent of the cancer.

Surgery might be used if it’s thought that all of the tumor can be removed. It is usually followed by radiation therapy alone or with chemotherapy (chemoradiation).

Sometimes chemotherapy might be used first (induction chemotherapy). It can be followed by either surgery, possibly with radiation therapy, or chemoradiation.

Surgery is usually the first treatment if possible. Radiation therapy is often added.

Immunotherapy or targeted therapy might be used for more advanced disease, similar to treatment for skin melanoma.

Surgery is usually the main treatment. Radiation and/or chemotherapy might also be used. For more information about the treatment of sarcomas, see Rhabdomyosarcoma or Soft Tissue Sarcoma.

Treatment options for recurrent nasal cavity or paranasal sinus cancer

Cancer recurrence is when it comes back after treatment. Recurrence can be:

Local (in or near the same place the cancer first started)
Regional (in nearby lymph nodes)
Distant (spread to distant organs such as the lungs)

Treatment options for recurrent cancer depend on the location and type of cancer, what treatments were used before, and a person’s health and preferences. Options might include:

Surgery
Radiation therapy
Chemotherapy, targeted therapy, and/or immunotherapy
Taking part in a clinical trial of a newer treatment

For recurrent or metastatic disease, treatment might not always be able to cure the cancer. The goals often shift to stopping or slowing the growth of the cancer, relieving symptoms, and maintaining your quality of life. Talking with your doctor about the goals of treatment can help you weigh the benefits and side effects of each option.

Making treatment decisions

It’s important to discuss all your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs.

Take your time and think about all your options. It’s also very important to ask questions if you’re not sure about something.

Questions to ask before treatment for nasal cavity or paranasal sinus cancer

Understanding the diagnosis and choosing a treatment plan

What are my treatment options?
What do you recommend and why?
If surgery is part of my treatment, what kind are you recommending? Will I need reconstructive surgery afterward? What options for reconstruction do I have?
Are there treatment options that would allow me to keep my nose intact?
Will surgery make it harder for me to eat, talk, smell, or see?
How much experience do you have treating this type of cancer?
What would the goal of the treatment be?
What are the chances the cancer will come back with these treatment plans?
How quickly do we need to decide on treatment?
Should I get a second opinion? Can you recommend a doctor or cancer center?

What to expect during treatment

What should I do to be ready for treatment?
How long will treatment last? What will it be like? Where will it be done?
Do I need to change what I eat during treatment?
How might treatment affect my daily activities? Can I still work full time?
Can I exercise during treatment? If so, what kind should I do, and how often?
Are there any limits on what I can do?
How will we know if the treatment is working?
What will we do if the treatment doesn’t work or if the cancer recurs?

Side effects and long-term effects

What risks or side effects are there to the treatments you suggest?
Are there things I can do to reduce these side effects?
Is there anything I can do to help manage side effects?
What symptoms or side effects should I tell you about right away?
How can I reach someone on the team on nights, holidays, or weekends?

Support and resources

What if I have transportation problems getting to and from treatment?
Can you suggest a mental health professional I can see if I start to feel overwhelmed, depressed, or distressed?
Who can I talk to if I need social support during treatment?

Other things to consider

Quitting smoking: If you smoke, it is very important to try to quit before any treatment for nasal cavity or paranasal sinus cancer. Smoking can affect your treatment, leading to issues such as a worse response to radiation therapy, poor wound healing after surgery, and less tolerance of chemotherapy. Smoking after treatment can also increase the chance of getting another new cancer. Quitting smoking for good, before treatment starts, if possible, is the best way to improve your chances of survival. It is never too late to quit. For help, see How To Quit Using Tobacco.

Seeking a second opinion: If time allows, consider getting a second opinion. This can give you more information and help you feel more confident about the treatment plan you choose. If you seek a second opinion with a NET specialist, it is often possible for that specialist to work closely with your community oncologist.

Clinical trials: Clinical trials study new treatments and might offer access to promising options not widely available. They are also how doctors learn better ways to treat cancer. Ask your doctor about clinical trials you might qualify for.

Integrative (holistic) methods: You might hear about herbs, diets, acupuncture, massage, or other ways to relieve your symptoms or treat your cancer. Integrative methods are used with standard care, while alternative ones replace it. Some of these might help with symptoms, but many aren’t proven to work and could even be harmful. Talk with your care team first to make sure anything you are considering is safe and won’t interfere with treatment.

It’s normal to have some anxiety or other emotions during and after cancer treatment. But feeling overly worried, depressed, or angry can affect your health. It can get in the way of relationships, work, and other aspects of life.

With support from other people, including family, friends, mental health professionals, and other survivors, many people who have gone through cancer can thrive despite the challenges they’ve had to face.

Help getting through cancer treatment

People with cancer need support and information, no matter what stage of illness they might be in.

Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life.

Different types of programs and support services might be helpful, and they can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.

The American Cancer Society also has programs and services – including rides to treatment, lodging, and more – to help you get through treatment. Contact the ACS cancer helpline for more information.

Contact the ACS cancer helpline to get answers and information

Find free or low-cost resources from ACS and other organizations.

Choosing to stop treatment or choosing no treatment at all

For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life.

Choosing not to treat your cancer

Some people, especially if the cancer is advanced, might not want to be treated at all. There are many reasons you might decide not to get cancer treatment, but it’s important to talk to your doctors as you make that decision. Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms.

Hospice care

People who have advanced cancer and who are expected to live less than 6 months might want to consider hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with your doctor or a member of your supportive care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families.

The treatment information given here is not official policy of the American Cancer Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor. Your doctor might have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask your cancer care team any questions you might have about your treatment options.

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References

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Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).

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Last Revised: February 27, 2026

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