Nasal cavity and sinus cancer develop when healthy cells in the nasal cavity or paranasal sinuses undergo genetic mutations, causing them to grow uncontrollably. These abnormal cells form tumours, which can invade nearby tissues and, in advanced cases, spread to other parts of the body through the lymphatic system or bloodstream.
Nasal Cavity & Sinus Cancer Treatment in Singapore
Nasal cavity and sinus cancer is a form of cancer that arises in the nasal cavity or the paranasal sinuses.
This condition can disrupt breathing, diminish the sense of smell, and affect facial function. Early detection at the clinic and appropriate treatment are necessary for improving patient outcomes and maintaining quality of life.
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
How Nasal Cavity and Sinus Cancer Develop
Symptoms of Nasal Cavity and Sinus Cancer
Recognising the symptoms of nasal cavity and sinus cancer early can significantly influence treatment outcomes. Common symptoms include:
- Nasal Obstruction or Congestion: Persistent blockage in one or both nostrils that fails to improve with standard treatments.
- Nosebleeds: Frequent or unusual bleeding from the nose without any apparent cause or injury.
- Facial Pain or Pressure: Continuous or recurring discomfort in the face, especially around the cheeks or between the eyes.
- Lump in the Nose or Face: A noticeable growth or swelling in the nasal cavity, on the face, or in the neck area.
- Reduced Sense of Smell: A significant decrease or complete loss of the ability to detect odours.
- Unexplained Vision Changes: Blurred, double vision, or other visual disturbances caused by tumour proximity to the eyes.
- Unexplained Weight Loss: Gradual and unintentional weight loss due to reduced appetite or cancer-related metabolic effects.
Causes and Risk Factors
The development of nasal cavity and sinus cancer is influenced by a combination of environmental, lifestyle, and genetic factors. These include:
Tobacco Use: Smoking is a risk factor for nasal cavity and sinus cancer, as it introduces harmful chemicals that damage nasal tissues over time.
Occupational Exposure: Frequent exposure to wood dust, nickel, chromium, or other industrial chemicals raises cancer risk. Proper protective equipment can reduce these risks.
Human Papillomavirus (HPV) Infection: Certain HPV strains are linked to cancer of the nasal cavity and sinuses, particularly in younger individuals.
Chronic Sinusitis: Prolonged inflammation of the nasal cavity and sinuses may increase the likelihood of cellular changes that lead to cancer.
Family History: A genetic predisposition to nasal cancers can elevate risk, especially in individuals with close relatives who have had related cancers.
Types of Nasal Cavity and Sinus Cancer
Nasal cavity and sinus cancer is classified according to its origin, which influences symptoms, progression, and treatment options.
Nasal Cavity Cancer
Nasal cavity cancer begins in the hollow space inside the nose. Symptoms often include persistent nasal obstruction, frequent nosebleeds, and difficulty breathing. Advanced cases may spread to nearby tissues.
Paranasal Sinus Cancer
Paranasal sinus cancer originates in the sinuses surrounding the nasal cavity and is further categorised based on specific sinus involvement.
- Maxillary Sinus Cancer: Forms in the largest sinuses, located in the cheeks. It can cause facial swelling, chronic facial pain, tooth pain, or loose teeth.
- Ethmoid Sinus Cancer: Develops in the sinuses between the eyes. Symptoms may include nasal congestion, pressure around the eyes, and vision problems such as blurriness or double vision.
- Sphenoid and Frontal Sinus Cancer: These rare types arise in the deeper sinuses at the base of the skull or forehead. Symptoms may include persistent headaches, neurological changes, or pressure behind the eyes.
Diagnostic Methods
- Physical Examination: A thorough examination of the nasal cavity and sinuses is conducted using specialised tools, such as a nasal endoscope, to detect visible abnormalities. This helps assess the size and location of the tumour and identify any signs of tissue damage or swelling.
- Imaging Studies: CT scans provide detailed images of the nasal and sinus structures, highlighting the extent of tumour growth and potential spread. MRI scans offer superior visualisation of soft tissues, while PET scans detect active cancer cells throughout the body.
- Biopsy: A tissue sample is collected from the affected area to confirm the presence and type of cancer through microscopic analysis. This step is required for determining the most effective treatment plan.
- Endoscopy: A flexible, camera-equipped endoscope is inserted into the nasal passages to closely examine internal structures for signs of cancer. This minimally invasive procedure provides a clearer view of hard-to-reach areas in the nasal cavity and sinuses.
Treatment Options
Treatment is tailored to the cancer stage, location, and patient-specific factors, and it frequently involves a combination of methods.
Non-Surgical Treatment
- Radiation Therapy: High-energy beams are directed at the tumour, destroying cancer cells while causing minimal damage to healthy tissues. It is commonly used for localised tumours or as an adjunct to surgery to reduce recurrence risk.
- Chemotherapy: Anti-cancer drugs are delivered orally or intravenously to eliminate cancer cells throughout the body. It is often used for advanced-stage cancer, in combination with radiation, or when surgery is not an option.
- Targeted Therapy: This approach uses drugs that specifically target molecular changes in cancer cells, reducing the impact on healthy tissues. It is often combined with other treatments for advanced or recurrent cancer.
Surgical Treatment
- Endoscopic Surgery: This is a minimally invasive surgery performed through the nose with a nasal endoscope to remove small or early-stage tumours. This method avoids external incisions and generally leads to quicker recovery. It is most effective for tumours that are well-contained and accessible.
- Open Surgery: This approach is used for larger or more complex tumours that cannot be fully removed endoscopically. It may involve an external incision and removal of affected tissue or bone, followed by reconstructive efforts if needed. Recovery times can be longer compared to minimally invasive methods.
- Reconstructive Surgery: Performed after tumour removal to restore the appearance and function of the affected areas, such as the nose or facial structures. Techniques include tissue grafts or prosthetic implants, depending on the extent of tissue loss. Rehabilitation is often required by ENT doctor to improve breathing post-surgery.
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Prevention and Management
Preventing nasal cavity and sinus cancer involves reducing exposure to known risk factors. Quitting smoking significantly lowers the risk, while occupational exposure to substances such as wood dust and nickel should be minimised with protective equipment and proper ventilation. HPV vaccination can help reduce virus-related cancer risks. Regular monitoring of chronic sinusitis may prevent complications. Post-treatment care includes imaging, endoscopic evaluations, and rehabilitation to manage breathing or swallowing issues.
For Singaporeans & Singapore Permanent Residents
Medisave & Insurance Shield Plan approved
Your ENT procedure may be eligible for Medisave claims, with the claimable amount varying based on the procedure’s complexity. For additional options, including the use of your insurance or Integrated Shield Plan, reach out to our friendly clinic staff today for assistance.
Frequently Asked Questions (FAQ)
Can second-hand smoke increase the risk of nasal cavity and sinus cancer?
Yes, prolonged exposure to second-hand smoke can raise the risk of developing cancer in the nasal cavity and nearby respiratory structures. The harmful chemicals in smoke can damage nasal tissues over time, contributing to cellular changes that may lead to cancer.
Can sinus infections mimic the symptoms of nasal cavity and sinus cancer?
Yes, chronic sinus infections can cause similar symptoms, such as persistent nasal obstruction, facial pain, or pressure. These overlapping symptoms can sometimes delay a proper diagnosis, making it necessary to seek medical evaluation if symptoms persist despite treatment.
What are the chances of a complete recovery from nasal cavity and sinus cancer?
The likelihood of recovery depends on factors such as the stage at diagnosis, the tumour location, and the treatment approach. Early-stage cancers have higher success rates with treatment, while advanced cases may require more complex interventions and ongoing management.
Dr Gan Eng Cern
MBBS
MRCS (Edin)
mmed (orl)
FAMS
With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.
Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.
- 2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
- 2016 – Best Educator Award (Eastern Health Alliance)
- 2016 – “Wow” Award (Patient Compliment)
- 2014 – Eastern Health Alliance Caring Award – Silver
- 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
- 2012 – Human Manpower Development Award (Ministry of Health, Singapore)
- 2007 – Singhealth Best Doctor Award
Qualifications
- MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
- MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
- MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
- FAMS – Fellow of the Academy of Medicine Singapore
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A Specialist Clinic for Sinus, Snoring & ENT
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Mount Elizabeth Novena Hospital
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