Nasal Cavity & Paranasal Sinus Cancer, from the CureRays guide library.

Nasal and paranasal sinus cancers form in the space behind the nose and the air pockets around it; they are treated with surgery and precisely targeted radiation that protects the nearby eyes and brain.

What it is.

Nasal cavity and paranasal sinus cancer is a rare cancer that develops in the nasal cavity (the hollow space behind the nose) or in the paranasal sinuses (the air-filled pockets in the bones around the nose and eyes). Because these spaces are roomy, tumors can grow for a while before causing symptoms, which often resemble ordinary sinus problems: persistent nasal stuffiness or blockage on one side, nosebleeds, a reduced sense of smell, facial pain or pressure, a lump or numbness on the face, watery eyes, or changes in vision if the tumor presses near the eye. Several different cell types can occur here, including squamous cell carcinoma (the most common), adenocarcinoma, and rarer tumors such as esthesioneuroblastoma (which arises from smell-related nerve tissue). Risk factors include long-term exposure to certain industrial dusts and chemicals, such as wood or leather dust. These cancers sit close to critical structures — the eyes, the brain, and major nerves — so treatment is carefully planned by a multidisciplinary team and frequently combines surgery with highly precise radiation designed to control the cancer while protecting these delicate neighbors.

How radiation treats it.

Radiation uses focused high-energy beams to damage the DNA inside cancer cells so they can no longer grow and divide. For nasal and sinus cancers, radiation is a key treatment — often given after surgery to clean up any remaining cancer cells, or as the main therapy when surgery is not possible. The central challenge is that these tumors sit right next to the eyes, optic nerves, and brain, so the radiation must be both effective against the cancer and gentle to those vital structures. Modern techniques meet this challenge: IMRT shapes the dose to the intricate anatomy of the region, and proton therapy stops precisely at the target with almost no dose beyond it, which is especially helpful for tumors near the eye or skull base. Treatment is given as a series of short daily sessions over several weeks and is painless during delivery. Side effects can include nasal dryness or crusting, fatigue, skin changes, and effects on taste or the eye, all of which are monitored and managed by the team. Your radiation oncologist will design a plan aimed at controlling the cancer while protecting your vision and brain function.

The ways we can treat it.

Intensity-modulated radiation therapy (IMRT). IMRT sculpts the radiation dose to the complex shape of the nasal and sinus region, concentrating it on the tumor while sharply limiting dose to the eyes, optic nerves, and brain.

Proton therapy. Proton beams stop precisely at the target and deliver little dose beyond it, making them especially valuable for tumors wrapped around the eye or against the skull base, helping preserve vision and protect the brain.

Stereotactic radiosurgery. Highly focused radiation can treat a small, well-defined tumor or boost a specific area with pinpoint accuracy and steep dose fall-off around critical structures.

Questions we hear often.

Will treatment affect my vision? Protecting the eyes is a top priority because these tumors sit so close to them. Modern radiation techniques such as IMRT and proton therapy are specifically designed to deliver the dose to the cancer while sparing the eyes and optic nerves. Your team will discuss any risk to vision and how they plan to minimize it; in some advanced cases involving the eye, more extensive treatment may be needed, which they will explain fully.

Why do I need radiation if the tumor was removed by surgery? Radiation after surgery targets any microscopic cancer cells that may remain, especially in this region where tumors sit near critical structures and may extend in ways that are hard to fully remove. Adding radiation lowers the chance the cancer will come back.

Are these cancers curable? Many are, particularly when found before they involve the eye or brain and when treated with the combination of surgery and precise radiation. Outcomes depend on the cell type, the stage, and the exact location, and your multidisciplinary team will give you a clear picture for your specific situation.

This guide is informational only. It is not medical advice — please confirm anything here with your care team.