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Nasal cavity and paranasal sinus cancer

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Treatments for stage IV ethmoid sinus cancer

The following are treatment options for stage IV ethmoid sinus cancer. 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.

Surgery

Surgery is a main treatment for stage IV ethmoid sinus cancer. The type of surgery done will depend on the size of the tumour, how far the tumour has grown into nearby bone and if cancer has spread to lymph nodes in the neck.

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).

Surgery to remove the orbit is done if cancer has spread to the bone surrounding the eye (called the orbit). Doctors remove the part of the orbit that contains cancer.

Surgery to remove the eye may be done if cancer has grown into the eye, the muscles of the eye or the fat around the eye.

Neck dissection removes lymph nodes in the neck (called cervical lymph nodes). This surgery may be done if cancer has spread to these lymph nodes. Learn more about neck dissection.

Radiation therapy

External beam radiation therapy is usually given after surgery to help prevent the cancer from coming back (recurring). It may also be offered before surgery if it is likely that cancer cells will be on the cut surface of the tissue removed by surgery or if the cancer has spread to lymph nodes that can’t be removed by surgery.

External beam radiation therapy may be offered as the main treatment instead of surgery.

Palliative radiation therapy may also be used to relieve pain or control symptoms.

Chemoradiation

Chemoradiation is treatment that gives chemotherapy during the same time period as radiation therapy. The chemotherapy drug used is usually cisplatin (Platinol AQ).

Chemoradiation may be used as the main treatment if the tumour can’t be removed by surgery.

Chemoradiation may be offered after surgery if cancer cells are found on the cut surface of the tissue removed (called a positive surgical margin). It may also be offered before surgery if it is likely that cancer cells will be on the cut surface of the tissue removed by surgery (called a positive surgical margin) or if the cancer has spread to lymph nodes that can’t be removed by surgery.

Chemotherapy

Chemotherapy may be offered for stage IV ethmoid sinus cancer. It is given to relieve pain or control symptoms (called palliative chemotherapy).

Targeted therapy

Targeted therapy may be offered for stage IV ethmoid sinus cancer. Cetuximab (Erbitux) is the drug most often used. Targeted therapy is usually given with radiation 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.

Clinical trials

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.

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