Nasal cavity and paranasal sinus cancer

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Treatments for stage 4 maxillary sinus cancer

The treatments offered for stage 4 maxillary sinus cancer depend on if the cancer is stage 4A, 4B or 4C. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

Treatments for stage 4A maxillary sinus cancer

You may be offered one or more of the following treatments for stage 4A maxillary sinus cancer.

Surgery

Surgery is the main treatment for stage 4A maxillary sinus cancer. The type of surgery done depends on whether or not the tumour has grown into nearby tissues and which tissues it has grown into.

Total, or radical, maxillectomy removes the upper jaw (called the maxilla) on one side of the face, including part of the hard palate and the floor of the orbit (also called the eye socket) above the tumour.

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). It is done if cancer has spread to these lymph nodes. Learn more about neck dissection.

Radiation therapy

Sometimes external beam radiation therapy is offered before surgery for stage 4A maxillary sinus cancer. External beam radiation therapy is given if it is likely that cancer cells will be on the cut surface of the tissue removed by surgery (called a positive surgical margin). It may also be given if the cancer has spread to lymph nodes that can’t be removed by surgery.

External beam radiation therapy may be given after surgery to help prevent the cancer from coming back (called recurrence). It may be given to the main tumour in the maxillary sinus and to the neck. Radiation therapy is given to the neck to destroy any cancer cells that may have spread to the lymph nodes there (called cervical lymph nodes).

In some cases, you may be offered radiation therapy as the main treatment for stage 4A maxillary sinus cancer if you can’t have surgery.

Chemoradiation

Chemoradiation may be used for stage 4A maxillary sinus cancer. This treatment gives chemotherapy during the same time period as radiation therapy. The chemotherapy drug used in chemoradiation is usually cisplatin (Platinol AQ).

Chemoradiation may be given as a main treatment for a tumour in the maxillary sinus. It is also used to destroy any cancer cells that may have spread to the lymph nodes in the neck (called cervical lymph nodes).

Targeted therapy

Targeted therapy may be offered after surgery for stage 4A maxillary sinus cancer to destroy any cancer cells that may have been left behind. Cetuximab (Erbitux) is the drug most often used. Targeted therapy is often given with radiation therapy.

Treatments for stage 4B maxillary sinus cancer

The following are treatment options for stage 4B maxillary sinus cancer.

Radiation therapy

External beam radiation therapy is a main treatment for stage 4B maxillary sinus cancer. It may be given to the main tumour in the maxillary sinus and to the neck. Radiation therapy is used to destroy any cancer cells that may have spread to lymph nodes in the neck (called cervical lymph nodes).

Chemoradiation

Chemoradiation is a main treatment for stage 4B maxillary sinus cancer. The chemotherapy drug used is usually cisplatin (Platinol AQ).

Chemoradiation may be given as a main treatment to treat the tumour in the maxillary sinus. It is also used to destroy any cancer cells that may have spread to the lymph nodes in the neck (called cervical lymph nodes).

Targeted therapy

Targeted therapy may be used along with radiation therapy for stage 4B maxillary sinus cancer. Cetuximab (Erbitux) is the drug most often used.

Surgery

You may have surgery before radiation therapy to remove as much of the tumour as possible (called debulking) or to help relieve a blockage in the sinus. Surgery is not often used to treat stage 4B maxillary sinus cancer.

Treatments for stage 4C maxillary sinus cancer

The following are treatment options for stage 4C maxillary sinus cancer.

Chemotherapy

Chemotherapy is a main treatment for stage 4C maxillary sinus cancer. It is given to relieve pain or control symptoms (called palliative chemotherapy).

Targeted therapy

Targeted therapy may be used to treat stage 4C maxillary sinus cancer. It is given to relieve pain or control symptoms (called palliative therapy). Cetuximab (Erbitux) is the drug most often used. It is most often given in combination with chemotherapy.

Radiation therapy

Radiation therapy is often given to relieve pain or control the symptoms of stage 4C maxillary sinus cancer (called palliative 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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