The following are treatment options for recurrent maxillary 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 maxillary sinus cancer if you had surgery to treat the original tumour. It may be given as the main treatment or after more surgery. Radiation therapy may also be given to the lymph nodes in the neck (called the cervical lymph nodes).
Radiation therapy is sometimes given with chemotherapy (called chemoradiation) or targeted therapy.
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.
Surgery may be offered for maxillary 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 was used to remove the original tumour.
The type of surgery done depends on where the cancer comes back and what treatments were used for the original cancer.
Total, or radical, maxillectomy removes the maxilla on one side of the face, including part of the hard palate and floor of the orbit (eye socket) above the tumour. This surgery is only done if cancer recurs after radiation therapy was used as the main treatment for the original 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). It is used for cancer that recurs in these lymph nodes. Learn more about neck dissection.
You may be offered chemotherapy for recurrent maxillary sinus cancer. It is sometimes used:
Chemotherapy is sometimes given with radiation therapy (called chemoradiation).
Targeted therapy is sometimes used to treat recurrent maxillary sinus cancer. It may be given along with radiation therapy or chemotherapy. Cetuximab (Erbitux) is the targeted therapy drug most often used for recurrent maxillary sinus cancer.
Targeted therapy that is used to relieve pain and ease symptoms is called palliative targeted therapy.
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.
The Canadian Cancer Society is actively lobbying the federal government to establish a national caregivers strategy to ensure there is more financial support for this important group of people.