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NASAL CANCER created by KIRAN K. KARETHA

Detailed presentation on nasal cancer covering types, risk factors, staging, clinical signs, diagnostic methods, and management including surgery, radiation, chemotherapy, targeted therapy, immunotherapy, and palliative care.

Health & Medicine◦
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NASAL CANCER • Presented by • MS. KIRAN K. KARETHA • M.SC (N), MSN (CCN)
INTRODUCTION • Nasal cancer includes cancers originating in the nasal cavity and the paranasal sinuses (maxillary, ethmoid, frontal, and sphenoid sinuses). • Approximately 70–80% of sinonasal cancers arise in the maxillary sinus, while cancers of the nasal cavity commonly involve the lateral wall or nasal septum. • Because the early symptoms resemble common conditions such as sinusitis or allergic rhinitis, diagnosis is often delayed.
DEFINITION •Nasal cavity cancer is a malignant tumor that arises from the tissues lining the nasal cavity or the paranasal sinuses.
TYPES • A. According to Site • 1. Nasal Cavity Cancer • Arises from the lining of the nasal cavity. • Commonly affects the lateral wall or nasal septum. • Usually presents earlier because symptoms appear sooner.
CONTI.. • 2. Paranasal Sinus Cancer • Originates from one of the paranasal sinuses. • Maxillary sinus cancer (most common) • Ethmoid sinus cancer • Frontal sinus cancer (rare) • Sphenoid sinus cancer (very rare)
CONTI.. • According to histological types • 1. Squamous Cell Carcinoma (SCC) – Most Common • It is the most common type, accounting for approximately 60–70% of nasal cavity and paranasal sinus cancers. • It develops from the squamous epithelial cells lining the nasal cavity and paranasal sinuses. • It usually occurs in adults over 50 years of age and is more common in males.
• 2. Adenocarcinoma • Adenocarcinoma arises from the mucus-producing glandular cells of the nasal cavity or paranasal sinuses. • It is the second most common sinonasal malignancy. • It is strongly associated with long-term exposure to hardwood dust and leather dust, especially in carpenters and furniture workers. • It most commonly affects the ethmoid sinus.
CONTI.. •3. Adenoid Cystic Carcinoma (ACC) •Adenoid cystic carcinoma originates from the minor salivary glands present in the nasal cavity and paranasal sinuses. •It is a slow-growing but highly invasive tumor.
CONTI.. •5. Olfactory Neuroblastoma •This rare tumor arises from the olfactory neuroepithelium located in the roof of the nasal cavity. •It can occur in both young adults and older individuals.
CONTI.. •6. Mucosal Melanoma •Mucosal melanoma develops from the melanocytes present in the nasal mucosa. •It is a rare but highly aggressive form of nasal cancer.
RISK FACTORS • Occupational exposure (wood dust, leather dust, nickel, chromium, formaldehyde) • Tobacco smoking • Alcohol consumption • Increasing age (>50 years) • Male gender • Chronic nasal or sinus inflammation
CONTI.. • Previous radiation exposure • Human papillomavirus infection (HPV) • Epstein–Barr virus infection (EBV) • Family history and genetic predisposition • Exposure to industrial chemicals and air pollution • Occupational exposure to textile and flour dust
STAGES • Stage I • Tumor is confined to the nasal cavity or one paranasal sinus. • No invasion of adjacent structures. • No regional lymph node involvement (N0). • No distant metastasis (M0).
CONTI.. • Stage II • Tumor has grown larger or extends into nearby areas within the nasal cavity or sinus. • May involve bone erosion of the affected sinus. • No regional lymph node involvement (N0). • No distant metastasis (M0).
CONTI.. • Stage III • Tumor extends into adjacent structures (e.g., surrounding bone, orbit, palate, or nearby soft tissues) or • Cancer has spread to one lymph node on the same side of the neck (≤3 cm). • No distant metastasis (M0).
CONTI.. • Stage IVA • Tumor invades important nearby structures, such as: • Orbit (eye socket) • Skin of the face • Anterior skull base • Hard palate • May involve one or more regional lymph nodes. • No distant metastasis (M0).
CONTI.. • Stage IVB • Tumor invades critical structures, such as: • Brain • Cranial nerves • Nasopharynx • Major blood vessels • Large or multiple cervical lymph node involvement may be present. • No distant metastasis (M0).
CONTI.. • Stage IVC (Metastatic Disease) • Cancer has spread to distant organs regardless of the primary tumor size or lymph node status. • Common sites of metastasis include: • Lungs • Liver • Bones • Brain
CLINICAL MANIFESTATIONS • Persistent unilateral nasal obstruction • Recurrent epistaxis (nosebleeds) • Blood-stained nasal discharge • Facial pain or swelling • Nasal congestion not responding to treatment • Reduced or loss of smell (anosmia)
CONTI.. • Headache • Loosening of upper teeth • Swelling or ulcer of the hard palate • Bulging of the eye (proptosis) or double vision (diplopia) • Weight loss and fatigue
DIAGNOSTIC EVALUATION •History and Physical Examination •Nasal Endoscopy •Biopsy (Gold Standard) •Computed Tomography Scan
CONTI.. •Magnetic Resonance Imaging •Positron Emission Tomography / CT Scan •Chest X-ray •Laboratory Investigations (CBC, LFT, RFT)
MANAGEMENT •SURGICAL MANAGEMENT •Endoscopic endonasal resection: Minimally invasive removal of small tumors through the nostrils. •Partial or total maxillectomy: Removal of part or all of the upper jaw when the maxillary sinus is involved.
CONTI.. •Craniofacial resection: Performed when the tumor extends to the skull base or cranial cavity. •Orbital exenteration: Removal of the eye and surrounding tissues if the orbit is extensively involved.
CONTI.. •2. Radiation Therapy •Radiation therapy uses high-energy X-rays to destroy cancer cells.
CONTI.. • 3. Chemotherapy • Chemotherapy uses anticancer drugs to destroy cancer cells or slow their growth. • Common drugs: • Cisplatin • Carboplatin • 5-Fluorouracil (5-FU) • Docetaxel
CONTI.. •4. Targeted Therapy •Targeted therapy blocks specific molecules involved in cancer growth. •Example: •Cetuximab (targets the epidermal growth factor receptor)
CONTI.. • 5. Immunotherapy • Immunotherapy stimulates the body's immune system to attack cancer cells. • Examples: • Pembrolizumab • Nivolumab
CONTI.. • 6. Palliative Care • Provided for advanced or incurable disease to improve quality of life by: • Relieving pain • Controlling bleeding and nasal obstruction • Managing symptoms • Providing psychological and emotional support
NASAL CANCER created by KIRAN K. KARETHA