Manipal Hospitals, one of India's largest healthcare networks, opens 250-bed super specialty hospital in Baner, Pune

The nose is part of the respiratory system, which allows air enter in to our body. During breathing it filters the dirt and allergens out of air and provides smell of smell. The nostrils opens into the space behind called the nasal cavity. The nasal cavity warms and moistens the air we breathe and helps to filter out smell particles and harmful bacteria.

The para sinuses are hollow, air-filled spaces in the bones around the nose. "Paranasal" means near the nose. The sinuses are lined with a layer that make mucus, which keeps the inside of the nose from drying out during breathing.

Paranasal and nasal cavity cancers occurs from the malignant transformation of the tissues lining the nasal and paranasal cavities.

CAUSES

• Smoking
• Sniffing of tobacco
• Wood dust
• Petrochemical products
• Long standing nasal Polyps

TYPES OF NASAL AND PARANASAL CAVITY CANCERS

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

Tumors of the paranasal sinus and nasal cavity are rare compared to others. Nasal tumours are an assorted group of tumours and have substantial management issues due to their close proximity to the orbit and intracranial cavity.

SYMPTOMS

Other signs and symptoms of nasal and paranasal tumors can include

• Nasal block
• Difficulty in breathing.
• Loss of sense of smell.
• Nasal bleed.
• Discharge from the nose.
• Facial swelling and pain.
• Watery and red eyes.
• A sore or lesion on the roof of mouth.

DIAGNOSIS

Tests and procedures employed to diagnose nasal and paranasal tumors are as follows:

• Nasal Endoscopy: During a nasal endoscopy, a thin tube with a light and camera at the end is inserted into the nose. The camera transmits pictures to a monitor that the doctor uses to look for anything unusual.
• Biopsy: Based on the observations for any abnormalities during a nasal endoscopy, special tools are used to collect tissue samples. The samples are then tested.
• CT / MRI: Imaging tests to create pictures of nasal cavity and sinuses to know the extent of the disease.
• PET Scan:  It’s a functions scan used to image whole body to know the  spread of cancer.
• Additional tests and procedures will be conducted based on one’s condition and the spread of cancer.

TREATMENT

Subject to the stage of the cancer and general health condition , different treatment options may be used alone or in a combination.

Surgery -  During the operation, a surgical oncologist will remove the tumor and some surrounding healthy tissue, called a margin, it need along with some part of bone also. . Surgery is frequently used to a tumor in the paranasal sinus or nasal cavity.

Radiation Therapy : . Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells delivered by radiation machine called LINAC. .For the cancers that cannot be removed with surgery alone, radiation might be added or be the main treatment.

Chemoradiotherapy : Chemotherapy drugs is given along with radiation therapy for effective treatment of tumors.

Radiation therapy is most often used in combination with surgery also. It is given either before, to decrease the size of tumor or after the operation, to prevent re occurrence of the cancer . Radiation therapy may also be given along with chemotherapy.

PREVENTION

There are some things people can do to lower their risk.

• Avoid smoking or use of tobacco products.
• Avoid Exposure to chemicals and dust at work place - Not all nasal cavity and paranasal sinus cancers can be prevented, but the danger of developing these cancers can be greatly decreased by limiting exposure to certain substances in the workplace, especialy wood dust , petrochemical products. Luckily, awareness of the probable danger from these exposures has increased and workplace safety actions to help protect people have improved. Risk of tumors can be reduced greatly, if not prevented, by avoiding things that can cause cancer.
• Maintaining a healthy lifestyle – exercise and nutrition habits both help in keeping good overall health while also removing substantial cancer perils.

 Dr. Ramakrishna Reddy, Senior Consultant – Surgical Oncologist, HCG MNR Cancer Centre, Ongole