The Penn Head and Neck Cancer program is a unique, multidisciplinary collaboration between Penn Ear Nose and Throat (ENT) and the Abramson Cancer Center. Our experts have pioneered the latest treatment approaches for sinus and nasal cancer using minimally invasive techniques including endoscopic tumor resection. With this minimally invasive treatment, tumors can be removed without any facial incisions, a vast majority of the time.
Difference in Treatments Based on Type of Sinus and Nasal Cancer
Treatment options for sinus and nasal cancer will depend on the following:
- Where the tumor is in the sinuses or nasal cavity and whether it has spread.
- The size of the tumor.
- The type of cancer.
- The patient's age, health and medical history.
- Whether the cancer has just been diagnosed or has come back.
After treatment, frequent and careful follow-up is important because there is an increased risk of developing a second kind of cancer in the head or neck.
Treatment for the different types of sinus and nasal cancer include:
Squamous Cell Carcinoma
Squamous cell carcinoma of the sinus and nasal cavity is usually treated with surgery. This may be followed by radiation therapy and, in some instances, chemotherapy.
Olfactory Neuroblastoma (Esthesioneuroblastoma)
Treatment for olfactory neuroblastoma includes a combination of surgery and radiation therapy. Depending on certain characteristics, chemotherapy may be used. Given the small number of patients treated annually in the U.S., it is recommended that treatment should be done at a specialized center, such as the Abramson Cancer Center. We are home to a dedicated skull base oncology team who see a large volume of these rare cases and are highly experienced in treating olfactory neuroblastoma.
Sinonasal Undifferentiated Carcinoma (SNUC)
SNUCs are treated very aggressively. Treatment includes surgical resection followed by chemotherapy and radiation therapy.
Sinonasal Neuroendocrine Carcinoma (SNEC)
SNECs are a very aggressive cancer, and are treated accordingly. The treatment of SNEC includes aggressive, multidisciplinary therapies, including surgical resection followed by chemotherapy and radiation therapy.
Mucosal Melanoma
Treatment for mucosal melanoma is typically multidisciplinary and includes surgery followed by radiation and chemotherapy.
Hemangiopericytoma
Previously, treatment for hemangiopericytomas was invasive, consisting of large open surgeries with facial incisions. At Penn, these tumors can be resected endoscopically without facial incisions. Depending on the amount of blood supply, these tumors can also be embolized preoperatively (a procedure performed by a interventional radiologist to reduce the amount of bleeding during surgery). If they extend into the intracranial cavity often a neurosurgeon is involved in the resection to ensure complete removal of the tumor. Surgery may be followed by radiation therapy to prevent recurrence, usually localized to the postoperative site and particularly in cases where the tumor was not totally removed.
Adenocarcinoma
Surgical resection is the usual treatment for adenocarcinoma, and advanced stage disease is treated by surgery in conjunction with radiation therapy.
Adenoid Cystic Carcinoma (ACC)
Treatment is typically surgery followed by radiation therapy. Chemotherapy is generally not used for adenoid cystic carcinoma.
Chordomas
The treatment for a chordoma depends on many things, including your general health and the size and position of the tumor. Where possible, surgery is used to remove the tumor. This can typically be performed endoscopically through the nasal cavity avoiding any incision or craniotomy. If it is too difficult to remove the chordoma completely, radiation therapy and chemotherapy may be considered after surgery to destroy any remaining tumor cells. To date, chemotherapy has not been shown to be very effective in treating chordomas but if surgery isn’t possible, it may be used in conjunction with radiation therapy.
Skull Base Tumors
Many skull base tumors are extremely complex and require highly specialized treatment from multiple experts. Our otorhinolaryngologists work to create individualized treatment plans with a diverse team of neurosurgeons, oncologists, endocrinologists, plastic and reconstructive surgeons, and many more at the Penn Cranial Base Surgery Program. Having pioneered many of the latest minimally invasive surgical procedures for these conditions, many tumors deemed previously inoperable are now treatable here at Penn.