Ear, Nose, Throat, Head and Neck Surgery Specialist
Prof. Dr. Murat Topdağ

Born in Malatya in 1978, Murat Topdağ completed his primary and secondary education, then attended high school in Istanbul. He graduated from the English program of Cerrahpaşa Tıp Fakültesi. Performing his surgeries at Acıbadem Altunizade Hospital, Prof. Dr. Murat Topdağ is married and has two children.

Resume Treatments

Resume Treatments

What Is Sinus Cancer?

Sinus cancer is a disease that occurs in the nasal cavity and paranasal sinuses. These cavities are air-filled spaces located behind the nose, in the cheekbones, and in the forehead area. This type of cancer is different from cancers located at the junction of the nose and throat. Sinus cancer refers to the development of cancerous cells in these specific areas. This rare type of cancer manifests itself in various forms:

• Squamous cell carcinoma
• Adenocarcinoma
• Adenoid cystic carcinoma
• Esthesioneuroblastoma (olfactory neuroblastoma)
• Sinonasal undifferentiated carcinoma

Each originates from different cell types, and the behavior of the cancer varies according to the cell type. Due to the localized area, sinus cancer can be challenging to diagnose and treat. The treatment process is determined by the type and stage of the cancer. Early diagnosis is critical for an effective treatment plan. Hence, recognizing the symptoms of this disease and intervening early is of great importance.

What Are the Possible Causes of Nasal and Paranasal Sinus Cancer?

Nasal and paranasal sinus cancer can result from various factors. One of the most common causes of this type of cancer is exposure to industrial chemicals.

In particular, when these chemicals enter the body through the respiratory tract, they can damage sinus tissues and increase the risk of cancer. In addition, human papillomavirus (HPV) infections are also linked to this type of cancer. HPV can lead to abnormalities, particularly on mucosal surfaces, that may cause cancer.

1. Working in the wood, leather, flour, or textile industries
2. Contact with heavy metals such as nickel or chromium
3. Exposure to radioactive substances such as radium

These factors can also lead to sinus cancer. Smoking is another well-known cause of sinus cancer. The harmful substances in cigarette smoke irritate the nose and sinus tissues, potentially leading to cancer over time. Therefore, being aware of these risk factors and avoiding them whenever possible is an important step in preventing the disease.

Diagnostic Methods for Nasal and Paranasal Sinus Cancer

The diagnosis of nasal and paranasal sinus cancer requires a complex and careful process. The first step is usually an endoscopic examination, in which a thin tube equipped with a light and camera is inserted into the sinuses.

In this way, the internal structure of the sinuses can be examined in detail. This method provides crucial information about the location and size of the tumor. Additional tests are required to confirm the diagnosis:

1. Blood tests to assess overall health.
2. X-ray, CT, or MRI imaging to evaluate the structural features of the skull.
3. Chest imaging to determine whether the disease has spread to other areas.
4. A biopsy may be necessary to obtain a tissue sample for a definitive diagnosis.

All these tests are crucial for determining the stage of the disease and deciding on appropriate treatment methods. Each test contributes to accurately identifying the cancer and preparing the most effective treatment plan.

Sinus Cancer Stages

Stage 0:

• Known as carcinoma in situ (CIS). In this stage, the tumor does not show invasive properties and has not spread to surrounding tissues.

Sinus Cancer Stage I:

• IA: The tumor is 2 cm or smaller in diameter and has not spread to lymph nodes or distant organs.
• IB: The tumor can grow up to 4 cm in diameter and/or may advance into nearby bony structures.

Sinus Cancer Stage II:

• IIA: In this sub-stage, the tumor exceeds the maximum size of Stage I, but still has not spread to lymph nodes or other organs.
• IIB: The tumor may be of any size and may show limited spread to one or two lymph nodes in the neck.

Sinus Cancer Stage III:

• IIIA: The tumor has extended into nearby tissues such as the facial skin, eyes, or brain.
• IIIB: The tumor has spread to lymph nodes on both sides of the neck or to lymph nodes larger than 6 cm.
• IIIC: The tumor has spread both to nearby tissues and to large lymph nodes on both sides of the neck.

Sinus Cancer Stage IV (Final Stage):

• This stage represents the most advanced form of sinus cancer, and the cancer has spread to distant parts of the body. Common sites include the lungs, bones, and liver.

Advancements in the Treatment of Nasal and Paranasal Sinus Cancer

Surgical intervention is considered one of the most effective methods in treating nasal and paranasal sinus cancers. Surgically removing benign tumors can be an ideal solution for patients. The size and location of the tumor determine the type of surgical procedure. For malignant tumors, a more extensive surgical approach is usually required. After these operations, radiation therapy (radiotherapy) plays a critical role. In some cases, chemotherapy may be administered in addition to radiotherapy.

Surgical Methods:

1. In benign tumors and early-stage malignant tumors, an endoscopic method is preferred.
2. While traditional surgical approaches involve incisions in the mouth, scalp, forehead, or facial area, endoscopic surgery is performed through the nasal cavities.
3. Endoscopic surgery does not leave an externally visible incision scar.

Endoscopic surgery allows patients to recover faster and offers more satisfying cosmetic results. Side effects of the operation are generally milder compared to conventional methods, and the risk of complications is lower. These developments increase patient satisfaction and make the treatment process more comfortable. Therefore, in the treatment of nasal and paranasal sinus cancer, technological advances and innovative surgical techniques offer promising alternatives for patients. These treatments are an important step in combating cancer and improving patients’ quality of life.

Recovery Process After Surgery

After the operation, the patient opens their eyes in the recovery room. Here, they receive meticulous nursing care until they are fully recovered. They remain there until returning to the ward, after which the doctor conducts regular check-ups. Specialist nurses may also visit. If the patient’s condition is more serious, they may stay in the intensive care unit or the high-dependency unit.

Patients in poor general condition or those who have undergone a complicated operation are closely monitored in these units. Nurses will discuss the visitor policy with family members. Usually, within a few days, the patient returns to the regular ward. After surgery, the patient may have various tubes and drains. These tubes may include:

• An IV line for fluid and medication,
• A thin tube to drain stomach contents,
• Drains that allow fluid to exit the wound,
• A urinary catheter for collecting urine.

These tubes play an important role in the recovery process. Pain management is an integral part of recovery. The patient may use a pain control pump to self-administer medication when needed. Regular use of painkillers speeds up recovery. Wound care is supported by dressing changes or applying antibiotic ointment.

Stitches or clips can remain for up to ten days and are monitored throughout the healing process. In cases requiring a skin graft or flap, two different wound sites are formed. The surgical site and the donor site are assessed regularly. A prosthesis may be necessary for surgeries performed on the jaw area.

Nasal packing helps control bleeding and is typically removed after a few days. Communication aids are provided for patients experiencing speech difficulties. In the early days, with the help of a physiotherapist, the patient begins to move around gradually. Nurses assist with drains and other medical equipment so that the patient can sit upright in a chair. All these steps help the patient recover more comfortably and quickly.

Recommended Dietary and Lifestyle Changes for Post-Operative Patients

The following dietary and lifestyle changes are recommended to support recovery after sinus cancer surgery:

Diet:

• Drink plenty of water and keep the mucous membranes moist.
• In the initial days, opt for soft foods such as mashed potatoes and yogurt.
• As the healing process progresses, include nutritious foods like fruits and vegetables.
• Reduce your intake of processed foods, sugary drinks, caffeine, and alcohol.

Lifestyle:

• It is recommended that patients rest sufficiently and avoid strenuous activities.
• Using a humidifier in the bedroom can be beneficial for the sinuses.
• Perform nasal rinses if advised by the doctor.
• Stay away from smoke, dust, and other environmental pollutants.

Additionally, it is crucial for individuals who have undergone sinus cancer surgery to attend regular doctor’s appointments to monitor the recovery process and detect any potential issues early. These guidelines can help manage side effects and improve overall health. The first few weeks following surgery are especially critical in terms of recovery. Any dietary and lifestyle adjustments made during this period can have a decisive impact on long-term health outcomes.

F.A.Q.

Where Does Sinus Cancer Spread?

Sinus cancer initially develops in the sinuses and nasal cavity. However, if it is malignant, it may spread to other parts of the body. This spread usually occurs through the lymphatic system and the bloodstream.

Firstly, cancer cells can spread to nearby tissues and organs. They also tend to spread to lymph nodes. This means cancer can reach more distant parts of the body, particularly the:

• Lungs
• Brain
• Bones

The spread depends on the stage and type of cancer. The tendency of malignant sinus tumors to spread underscores the importance of early diagnosis and treatment. Therefore, it is vital to seek medical attention immediately if sinus cancer symptoms are noticed.

Is Sinus Cancer Fatal?

Sinus cancer is a serious health concern for the patient. First of all, the 5-year survival rate for this disease is high, around 86%, which is promising. However, it is also true that the fight against the disease is not easy.

• There is a 30% risk of recurrence in the same area,
• And a 25% risk of distant spread.

These factors can significantly affect the course of the disease. Treatment methods such as surgery and radiotherapy play an important role. When radiotherapy is applied alongside surgical intervention, treatment success can increase.

A determining factor in the progression of the disease is whether there is distant spread at the time of diagnosis. This has a direct impact on the lethality of sinus cancer. Therefore, early diagnosis and effective treatment methods are crucial in overcoming the disease.

Which Department/Doctor Should I Visit for Sinus Cancer?

Sinus cancer is a serious health issue that manifests with certain symptoms. In such a situation, patients should first consult the Ear, Nose, and Throat (ENT) department for accurate diagnosis and treatment. ENT specialists thoroughly examine individuals suspected of having sinus cancer and conduct the necessary tests.

They may also refer patients to the Oncology department, depending on the situation. Oncology specialists determine a treatment plan based on the stage and type of cancer. The treatment process generally involves the following steps:

• Surgical intervention
• Radiotherapy
• Chemotherapy

Both departments play a critical role in the diagnosis and treatment of sinus cancer. It is extremely important for patients to consult these specialists without delay when noticing any symptoms. This enables early diagnosis and more effective treatment of the cancer.

Is Sinus Cancer Genetic or Contagious?

Sinus cancer is not considered a genetic disease. However, certain genetic factors can increase the risk. For example, individuals with a family history of cancer may have a slightly higher risk. Moreover, sinus cancer is not a disease that spreads from one person to another.

Therefore, it cannot be described as contagious. Understanding that cancer is not contagious is important. This helps reduce fears stemming from misinformation about the disease. Risk factors include smoking and exposure to certain chemicals.

• Genetic factors may increase the risk but are not a definitive cause.
• A family history of cancer slightly raises the risk.
• It is not contagious and therefore cannot be passed from person to person.

Consequently, sinus cancer is not viewed as a genetic or contagious disease. Knowing the risk factors and taking necessary precautions are of great importance.

What Happens If Sinus Cancer Is Not Treated?

If sinus cancer is left untreated, the consequences can be very serious for the patient. First, cancer cells multiply uncontrollably. Then, this increases the risk of spreading to nearby tissues and organs. Notably, there is a high chance of spreading to vital organs such as the brain and eyes. This spread can lead to permanent damage and dysfunction in the body.

Additionally, as the cancer progresses, treatment options become limited and the chances of successful treatment decrease. Therefore, early diagnosis and prompt treatment are crucial in the fight against sinus cancer. Untreated sinus cancer can significantly reduce the patient’s quality of life and shorten life expectancy. Thus, it is extremely important to seek medical help immediately if symptoms are noticed.

Does Sinus Cancer Go Away on Its Own?

Sinus cancer does not resolve on its own. These types of cancers continue to grow over time and require treatment. Sinus cancer is a type of tumor that generally starts in the sinus cavities.

If not diagnosed early, it can spread quickly. Therefore, early intervention is essential. Treatment methods include surgery, radiotherapy, and chemotherapy. Each patient’s treatment plan is tailored according to the type and stage of the cancer.

The treatment process can be long and challenging. However, with early diagnosis and appropriate treatment, it is possible to overcome the disease. Therefore, it is crucial to consult a doctor without delay when signs of sinus cancer appear.

How Is Sinus Cancer Surgery Performed?

In the past, sinus cancer surgeries typically required large incisions. These incisions were made inside the mouth, on the scalp, or in the facial area. Nowadays, things have changed considerably. For benign sinus and nasal tumors, as well as early-detected malignant tumors, endoscopic methods are preferred. This method involves a less invasive procedure for the patient.

In addition, endoscopic surgery speeds up the recovery process and reduces the risk of postoperative complications. Patients can return to their normal lives more quickly after surgery. Endoscopic methods allow the surgeon a better view of the surgical field. Hence, it becomes easier to completely remove the tumor while preserving healthy tissue.

Is There a Chance of Survival in Stage 4 Sinus Cancer?

The five-year survival rate for fourth-stage paranasal sinus cancer is generally around 52%. This rate may vary depending on how the disease progresses and the treatments applied. The treatment process is shaped by the patient’s overall health condition and the extent of cancer spread.

Looking at images or photographs of people with sinus cancer to diagnose yourself can be misleading, so you should consult your doctor if you suspect anything.