Treatments for recurrent ethmoid sinus cancer
The following are treatment options for recurrent ethmoid sinus cancer. Most tumours in the nasal cavity or paranasal sinuses recur in the same area as the original tumour (called a local recurrence). As a result, your treatment options will depend on the treatments that you were first given.
Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. You may be offered one or more of the following treatments.
External beam radiation therapy may be offered for recurrent ethmoid sinus cancer if you had surgery to treat the original tumour. It may be given as the main treatment or after more surgery.
In some cases, radiation therapy may also be given if you had radiation therapy to treat the original tumour. The healthcare team will look at your previous dose of radiation, the exact area where the radiation was given and how long it’s been since you had radiation therapy to see if you are able to have more radiation.
Radiation therapy is often given if the cancer recurs in the lymph nodes in the neck (called the cervical lymph nodes). Radiation therapy is sometimes given with chemotherapy (called chemoradiation) or targeted therapy.
Surgery may be offered for ethmoid sinus cancer that recurs after radiation therapy was used as the main treatment for the original tumour. It may also be offered if cancer comes back after surgery to remove the original tumour.
The type of surgery done depends on where the cancer comes back.
Maxillectomy removes part or all of the upper jaw bone (called the maxilla) on the same side of the face as the tumour.
Craniofacial resection removes the front part of the base of the skull, the ethmoid sinus, the frontal sinus and the wall of bone that divides the nasal cavity into right and left sides (called the nasal septum). This surgery is used for cancer that has spread to the base of the skull (the area where the brain sits).
Palliative surgery is used to relieve pain and ease symptoms by removing part of the tumour blocking the sinus.
Neck dissection removes lymph nodes in the neck (called cervical lymph nodes). This surgery is done when cancer recurs in these lymph nodes. Learn more about neck dissection.
You may be offered chemotherapy for recurrent ethmoid sinus cancer. It is sometimes used:
- if you can’t have surgery or radiation therapy
- if surgery or radiation therapy doesn’t stop or slow the growth of the cancer
- to relieve pain and ease symptoms (called palliative chemotherapy)
Chemotherapy is sometimes given with radiation therapy (called chemoradiation).
Targeted therapy may be offered for recurrent ethmoid sinus cancer. Cetuximab (Erbitux) is the targeted therapy drug most often used. Targeted therapy is sometimes given along with radiation therapy, chemotherapy or both.
Targeted therapy may be given as a main treatment if you can’t have surgery or radiation therapy. It may also be given to relieve pain and ease symptoms (called palliative targeted therapy).
If you can’t have or don’t want cancer treatment
You may want to consider a type of care to make you feel better rather than treat the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.
Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.
You may be asked if you want to join a clinical trial for nasal cavity and paranasal sinus cancer. Find out more about clinical trials.
I’m extremely grateful to the Canadian Cancer Society for funding my research with an Innovation Grant.
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