Nasal and sinus cancer is a rare type of cancer that develops in the space behind your nose or in the hollow spaces around it. Although uncommon, this cancer can cause symptoms that may seem like everyday sinus problems, making it important to recognize when something more serious might be happening.

What Is Nasal Sinus Cancer?

Nasal sinus cancer starts in the cells of the nasal cavity, which is the hollow space behind your nose, or in the paranasal sinuses, which are air-filled chambers located in the bones around your nose. These structures are part of your respiratory system and play important roles in breathing, filtering air, and giving your voice its unique sound.^[1][4]

The nasal cavity is made up of the nostrils and the passageway just behind them. It filters, warms, and moistens the air you breathe in, and also helps you smell. The paranasal sinuses include several different chambers named after the bones they’re surrounded by. These include the frontal sinuses in your forehead above your nose, the maxillary sinuses in your cheekbones, the ethmoid sinuses between your eyes, and the sphenoid sinuses behind your nose in the center of your skull.^[5][7]

Sometimes cells in the nasal cavity and paranasal sinuses change and no longer grow or behave normally. These changes can lead to non-cancerous growths such as nasal polyps. But in some cases, the changes cause cancer to develop. A cancerous tumor is a group of cancer cells that can grow into nearby tissue, destroy it, and spread to other parts of the body.^[4]

The most common type of nasal and sinus cancer is squamous cell carcinoma, which develops in the thin, flat cells that line the inside of the nasal cavity and sinuses. This type accounts for about seventy to eighty percent of cases. Sometimes cancer starts in the gland cells of the nose or sinuses, called adenocarcinoma. Other less common types include melanomas (which start in cells that give skin its color), sarcomas (which begin in muscle or connective tissue), and rare forms such as esthesioneuroblastoma and sinonasal undifferentiated carcinoma.^[4][5][7]

How Common Is Nasal Sinus Cancer?

Nasal and sinus cancer is rare. Most people will never encounter this condition, but when it does occur, it presents serious challenges. The cancer often grows within the bony spaces of the sinuses and may not cause symptoms until it has grown large enough to push into nearby structures. Because the tumors can develop without obvious signs for some time, many people are diagnosed when the disease has already advanced.^[1][6]

Cancers of the maxillary sinus, located in the cheekbones, are the most common among the paranasal sinus cancers. Tumors of the ethmoid sinuses, nasal cavity, and nasal vestibule occur less frequently, while cancers of the sphenoid and frontal sinuses are rare. Because nasal and sinus cancers often present with advanced disease at diagnosis, cure rates are generally poor, typically at fifty percent or less.^[11]

What Causes Nasal Sinus Cancer?

While the exact cause of nasal and sinus cancer is not always clear, certain exposures and conditions can trigger the changes in cells that lead to cancer. Understanding these causes helps identify who might be at higher risk and what preventive measures might be helpful.^[5]

Workplace exposures appear to play a significant role in the development of nasal and sinus cancer. Research shows that exposure to certain industrial chemicals or dust in the workplace can increase the risk of developing this cancer. People who work with wood dust, leather dust, nickel compounds, chromium, and other chemicals used in manufacturing may face higher risks over time. These exposures can damage the cells lining the nasal passages and sinuses, eventually leading to cancerous changes.^[5][7][11]

Another factor linked to nasal and sinus cancer is infection with human papillomavirus (HPV). Research has shown that a subgroup of these cancers is associated with HPV infection. Interestingly, patients whose tumors are HPV-positive may have a better outlook than those whose tumors are HPV-negative.^[11]

Risk Factors for Nasal Sinus Cancer

Certain groups of people, behaviors, and habits can increase the risk of developing nasal and sinus cancer. Knowing these risk factors can help people make informed decisions about their work environments and lifestyle choices.^[5]

Smoking is a significant risk factor for nasal and paranasal sinus cancer. Tobacco smoke contains many harmful chemicals that can damage the cells in the nasal passages and sinuses over time. People who smoke face an increased risk not only of nasal and sinus cancer but also of many other types of cancer throughout the body.^[6]

Occupational exposures remain one of the strongest risk factors. Workers in certain industries face higher risks due to breathing in harmful substances over many years. These industries include woodworking, furniture making, leather processing, textile manufacturing, and metalworking. The risk increases with longer exposure times and higher concentrations of these substances in the workplace environment.^[5][7]

Having had previous head and neck cancer also increases the risk of developing nasal and sinus cancer. People who have been treated for other cancers in the head and neck region should maintain regular follow-up appointments because their risk of developing new primary cancers in this area is considerably increased.^[11]

Symptoms of Nasal Sinus Cancer

The symptoms of nasal and sinus cancer can be frustrating because they often resemble common, harmless conditions like sinus infections or allergies. This similarity can lead to delays in diagnosis, as both patients and doctors may initially treat symptoms as routine sinus problems.^[1][6]

One of the most common symptoms is persistent nasal congestion or blockage, often affecting only one side of the nose. Unlike temporary stuffiness from a cold or allergy, this blockage doesn’t improve with time or typical treatments. People may also experience unusual nasal drainage from one nostril that continues over weeks or months.^[5][7]

Nosebleeds, particularly those that occur repeatedly and only on one side, can be a warning sign. While occasional nosebleeds are common and usually harmless, frequent bleeding from one nostril deserves medical attention. Sinus pain or pressure that doesn’t respond to normal sinus treatments may also signal something more serious.^[5][7]

As the cancer grows, it can cause additional symptoms by pressing on nearby structures. Pain around the eyes, changes in vision, or swelling of the face may occur. Some people notice a loss of their sense of smell or develop a lump or growth in the nose or on the face. Headaches, particularly those that are persistent and don’t respond to usual pain medications, can also be a symptom.^[6]

Because these cancers often remain asymptomatic until they have grown large enough to affect surrounding structures, people should not ignore symptoms that persist or worsen over time. While most of these symptoms have innocent explanations, any that last more than a few weeks should be evaluated by a healthcare professional.^[1][11]

Prevention of Nasal Sinus Cancer

While it’s not possible to prevent all cases of nasal and sinus cancer, certain measures can help reduce the risk. These steps focus on avoiding known risk factors and maintaining overall health.^[6]

Quitting smoking is one of the most important steps anyone can take to reduce their cancer risk. For people who work with potentially harmful substances, smoking cessation becomes even more critical. Smoking not only increases the risk of developing cancer but can also make treatment less effective and cause more side effects if cancer does develop.^[15]

Workers in high-risk industries should take advantage of all available protective equipment. Wearing proper masks or respirators, ensuring adequate ventilation in work areas, and following safety protocols can significantly reduce exposure to harmful dusts and chemicals. Employers should provide appropriate protective gear and maintain safe working conditions.^[5][7]

For people who have been treated for cancer in the head and neck region, maintaining regular follow-up appointments is crucial. Since the risk of developing a second primary cancer is high, consistent monitoring allows for early detection if new cancers develop. Early detection typically means more treatment options and better outcomes.^[11]

How Nasal Sinus Cancer Changes the Body

Understanding what happens in the body when nasal and sinus cancer develops can help explain why certain symptoms occur and why treatment approaches work the way they do. This knowledge can also help patients feel more prepared and less anxious about their diagnosis.^[5]

Cancer begins when cells in the nasal cavity or paranasal sinuses undergo changes that cause them to grow and multiply in an uncontrolled way. Normal cells have built-in controls that regulate when they divide and when they die. Cancer cells lose these controls and continue to divide, forming a mass of abnormal cells that we call a tumor.^[4]

The sinuses are enclosed spaces surrounded by bone. When a tumor grows within these confined areas, it has limited room to expand. As it grows larger, the tumor begins to press against the bony walls. Eventually, the cancer cells can erode through bone and invade adjacent structures. This invasion can affect the eyes, brain, nerves, and blood vessels in the area, leading to the various symptoms people experience.^[11]

Unlike many other cancers, nasal and sinus cancers don’t frequently spread to lymph nodes in the early stages. The lymphatic drainage from the maxillary sinus and other sinuses does connect to lymph nodes in the neck, but spread to these nodes is relatively infrequent. However, when the cancer does spread, it most commonly goes to the submandibular nodes, parotid nodes, and nodes along the jugular vein.^[11]

When nasal and sinus cancers spread beyond the original site, they can form distant metastases. These are found in twenty to forty percent of patients who don’t respond to initial treatment. However, most deaths from nasal and sinus cancer occur because of local problems rather than distant spread. The cancer may extend into vital areas of the skull or recur rapidly in the same location after treatment.^[11]