How Sinus Cancer Is Diagnosed

Early sinus cancer symptoms are usually subtle and often go unnoticed because they mimic other benign (not harmful) conditions like allergies, the common cold, and postnasal drip. Therefore, the majority of tumors are diagnosed at an advanced stage, requiring invasive surgery.

Sinus cancer is rarely diagnosed or suspected before the onset of symptoms, but sometimes it is found on imaging when looking for other conditions. More commonly, it is diagnosed after someone presents with unilateral (one-sided) and continuous nasal sinus symptoms or damage to facial bones that is confirmed on imaging.

Sinus cancer may be suspected in people with risk factors such as smoking, exposure to industrial substances like wood dust or radon, or a history of premalignant lesions like inverted papillomas, growths found in the mucus linings of the nose or sinuses. Still, a definitive diagnosis is often based on a biopsy. This involves removing tissue for a closer examination.

Man describing symptoms

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Self-Examination

Unlike breast cancer, which can be detected early with a self-examination, there are no self-exams to detect early nasal and paranasal cancers. There also are no screening tests that can detect sinus cancer early. Sinus cancer is relatively rare, so major cancer organizations like the American Cancer Society do not offer recommendations for routine screening for these cancers. 

More research needs to be done to develop a screening tool that can help save lives worldwide. The relatively low number of sinus cancer diagnoses and deaths in the United States may not reflect the world’s disease burden.

Also, rare diseases like sinus cancer are difficult to diagnose and not all medical personnel are trained to identify this uncommon disease or provide access to everyone. This means there may be many more people living with the disease that haven’t been properly identified.

Physical Examination

If sinus cancer is suspected, your doctor will first perform a physical examination, looking carefully for any obvious skin changes or deformities. The doctor will look for changes in the symmetry of your eyes and face (both sides should be about the same), vision changes, and any other noticeable signs.

During the physical exam, your doctor also will carefully check your head and neck area, including the nose and sinuses, for numbness, pain, swelling, and firmness in your face and the lymph nodes in your neck. The doctor will also feel for any lumps on your neck, lips, gums, and cheeks and inspect your nose, mouth, throat, and tongue for abnormalities, often using a light and a mirror for a clearer view.

If your primary care doctor suspects sinus cancer, you will be recommended to an otolaryngologist, a doctor who specializes in diseases of the ear, nose, and throat. These specialists are more commonly referred to as ENTs. They often use an endoscope, a thin tube with a tiny light and a video camera on the end, to look into the nose and nasal passages. This procedure is called an endoscopy. 

Labs and Tests

During the endoscopy, your doctor may remove a small piece of abnormal tissue to further examine it. The abnormal tissue from your biopsy will be sent to a lab, where it will be checked for signs of cancer. Molecular testing can identify specific genes, proteins, and other factors unique to the tumor.

Cancer can severely impact your blood cell levels, so your doctor may also order a urine test and blood tests, such as a complete blood cell count (CBC), to examine the number of red blood cells, platelets, and the number and type of white blood cells in your body. These markers can indicate whether your immune system is working to fight off cancer.

Imaging

After your doctor orders labs and performs an endoscopy, the doctor may order the following imaging tests:

  • X-rays, CT (computed tomography) scans, or MRI (magnetic resonance imaging) scans of the sinuses
  • Imaging tests of your chest to look for local metastasis (spreading of the cancer to nearby tissue)
  • PET (positron emission tomography) scans or bone scans to look for distant metastasis (spreading of the cancer to areas away from the initial site) 

Differential Diagnosis

Sinus cancer mimics many noncancerous conditions such as:

  • Postnasal drip (mucus running down the back of the throat)
  • Kilian's polyp (a benign polyp mainly found in children and young adults)
  • Sinus aspergillosis (a fungal disease)
  • Seasonal allergies
  • Common cold
  • Sinusitis
  • Ossifying fibroma (benign bone lesions)
  • Infection

Although long-standing unilateral nasal sinus symptoms and chronic exposure to harmful chemicals can raise your suspicion of sinus cancer, a biopsy will be needed to confirm the diagnosis. 

A Word From Verywell

After receiving a diagnosis of sinus cancer, it's natural to feel worried, depressed, and stressed. Getting treatment for sinus cancer can be hard on your mind and body. Talking to your family and healthcare team about any problems or concerns you have can ease the effects that cancer and its symptoms have on your daily life.

Remember that you do not have to go through this journey alone and that advances in healthcare mean there are more avenues for providers to not only detect sinus cancer earlier on, but also provide proper treatment that can lead to better quality of life.

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3 Sources
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