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The following are treatment options for recurrent nasal cavity 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 nasal cavity cancer if the original tumour was treated with surgery. It may be given as the main treatment, or it may be given after more surgery. Radiation therapy is often given to the lymph nodes in the neck (called cervical lymph nodes) as well as to the recurrent tumour.
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 sometimes given with chemotherapy (called chemoradiation) or targeted therapy.
Surgery may be offered for nasal cavity cancer that recurs after radiation therapy was used as the main treatment for the original tumour. It may also be offered if the cancer comes back after surgery to remove the original tumour.
The type of surgery done depends on where the cancer comes back.
Medial maxillectomy removes the part of the upper jaw (called the maxilla) closest to the nose, including the side wall of the nose.
Partial or infrastructure maxillectomy removes part of the maxilla. An infrastructure maxillectomy also removes part of the hard palate and the side wall of the nose.
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.
Craniofacial resection removes the front part of the base of the skull, the nasal cavity, 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 has recurred in these lymph nodes. Learn more about neck dissection.
Chemotherapy may be given as a main treatment for recurrent nasal cavity cancer if you can’t have surgery or radiation therapy. When chemotherapy is given to relieve pain and ease symptoms, it’s called palliative chemotherapy.
Sometimes chemotherapy is given with radiation therapy (called chemoradiation) for recurrent nasal cavity cancer.
Targeted therapy may be offered for recurrent nasal cavity cancer. Cetuximab (Erbitux) is the targeted therapy drug most often used. Targeted therapy is sometimes given with radiation therapy.
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).
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.