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Treatments for stage 4 nasal cavity cancer
The following are treatment options for stage 4 nasal cavity 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 is a main treatment for stage 4 nasal cavity cancer. The type of surgery done depends on where the tumour is in the nasal cavity, if it has grown into nearby bone and if cancer has spread to the lymph nodes in the neck or other parts of the body.
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).
Surgery to remove the orbit is done if cancer has spread to the bone around the eye (called the orbit). Doctors remove the part of the orbit that has cancer.
Neck dissection removes lymph nodes in the neck (called cervical lymph nodes). It may be done if cancer has spread to these lymph nodes. Learn more about neck dissection.
When surgery is the main treatment, you may be offered external beam radiation therapy after surgery to destroy any cancer cells that may have been left behind. External beam radiation therapy 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.
In some cases, external beam radiation therapy may be offered instead of surgery as the main treatment. This may be an option if the tumour is too hard to remove with surgery.
You may be given radiation therapy to treat cancer that has spread to lymph nodes in the neck (called cervical lymph nodes).
Chemoradiation may be used for stage 4 nasal cavity cancer. This treatment gives chemotherapy during the same time period as radiation therapy. The chemotherapy drug used is usually cisplatin (Platinol AQ).
Chemoradiation may be offered after surgery:
- if cancer cells are on or near the cut surface of the tissue removed by surgery (called positive surgical margins)
- to destroy any cancer cells that may have spread to the lymph nodes in the neck (called cervical lymph nodes)
- if cancer cells have grown outside of a lymph node into the surrounding tissues
Chemoradiation may be offered as the main treatment instead of surgery. This may be an option if you:
- can’t have surgery because the tumour is too difficult to remove
- have other health concerns
- choose not to have surgery
Chemotherapy may be offered for stage 4 nasal cavity cancer. It is given to relieve pain or control symptoms (called palliative chemotherapy).
Targeted therapy may be offered for stage 4 nasal cavity cancer. Cetuximab (Erbitux) is the type of targeted therapy most often used for nasal cavity cancer. It is usually given with radiation therapy.
Targeted therapy may be offered instead of surgery or radiation therapy if:
- you can’t have surgery because the tumour is too difficult to remove
- you can’t have radiation therapy because the tumour is too difficult to treat with radiation therapy
- you have other health concerns
- you choose not to have surgery or 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.
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.