Nose and Sinus Cancers

Nasal and Paranasal Tumors

Duke’s team of specialists regularly diagnose and treat rare and complex nose and sinus cancers. Our expertise has given hope to people who were told their tumors were inoperable or untreatable. We use advanced techniques and collaborate with colleagues who specialize in each step of the process to treat your cancer while prioritizing your quality of life.

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About Nose and Sinus Cancers

Although the nose is small, it houses many different types of cells that can turn into many different types of tumors, including:

Adenocarcinomas
Adenoid cystic carcinomas
Melanomas
Mucoepidermoid tumors
Olfactory neuroblastomas (also called esthesioneuroblastomas)
Sarcomas
Squamous cell carcinoma
Undifferentiated carcinoma

Complex Tumors
Most nose and sinus tumors are types of skull base tumors -- growths on or near the bones that support the brain. Nasal and paranasal tumors are challenging to treat because they can invade the brain, the eye, and other important nearby structures, like nerves that control your sense of smell and sight. As a result, they can cause a wide range of symptoms like nosebleeds, facial pain, numbness or weakness, trouble breathing through the nose, loss of vision or smell, headaches, and stroke.

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Duke Health offers locations throughout the Triangle. Find one near you.

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Nose and Sinus Cancer Tests

If your doctor or otolaryngologist (ear, nose, and throat doctor) suspects a nasal or paranasal tumor, certain tests will help determine your diagnosis. In addition to reviewing your medical history and conducting a thorough physical exam, your doctor may order one or more of these tests.

Imaging Scans

X-ray, MRI, CT, and PET scans help your doctors determine the tumor’s location and size, and whether cancer has spread to any other part of the body. Some scans may require contrast dye, given via an injection. Results will be reviewed by neuroradiologists who specialize in interpreting images of the head and neck.

Biopsy

A surgeon uses a needle to remove a small piece of the tumor. Then the sample is sent to a specialized head and neck pathologist for testing. The pathologist will examine the tissue to determine whether it is cancerous (malignant), its grade (how it compares to normal tissue), what kind of tumor it is, and other important factors. Depending on the tumor’s location, a biopsy may be performed in a doctor’s office with local numbing or in an operating room with general anesthesia. Certain tumors may not be reachable for biopsy without surgery.

Genetic Testing

By analyzing your genes, doctors may be able to learn more about your specific tumor and whether it might respond to chemotherapy or other targeted therapies.

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Nose and Sinus Cancer Treatments

Most nasal and paranasal tumors are treated with a combination of surgery and radiation therapy. However, different types of tumors respond best to certain therapies. We offer a range of treatments to offer you the best option.

Surgery

There are two main surgical approaches for nose and sinus cancers. If the tumor isn’t too deep inside the skull, surgeons may be able to reach it through the nostrils using an endoscope -- a hollow, flexible tube. Because this technique requires no external incisions, it leaves little or no visible scarring and significantly speeds recovery time. If the tumor can’t be reached endoscopically, your surgeons may use a traditional open incision. This will require a longer hospital stay, around three days.

Because of the complexity of these procedures, various specialty surgeons may be involved, including head and neck surgeons, sinus specialists, neurosurgeons, and oculoplastic surgeons. If surgery could alter your appearance, our plastic and reconstructive surgeons and endoprosthesis experts can work with you to devise a plan to restore it.

Radiation Therapy

Used to destroy cancer cells, shrink tumors, and reduce the risk of recurrence, radiation therapy may be recommended before or after surgery. A radiation oncologist will create a treatment plan that targets your cancer while minimizing damage to surrounding healthy tissue.

Chemotherapy

Chemotherapy can be offered alone or before surgery to shrink the tumor or to determine how the tumor responds to chemotherapy, since not all tumors are affected by it. Chemotherapy may be best suited for tumors that are very close to the eye or invading the brain, making surgery very risky. It is also best for certain types of cancer and based on previous treatments.

Immunotherapy

Immunotherapy uses your body’s own immune system to fight cancer cells. This treatment is typically reserved for cancers that are too difficult to remove surgically or that have already spread (metastasized) to other areas of the body.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2025–2026.

Why Choose Duke

Pathology Expertise
Determining the exact type of nose or sinus tumor is critical to creating a treatment plan that gives you the best chance of success. Our pathologists are subspecialized -- meaning they have received additional training -- in identifying these rare types of head and neck cancers.

Patient Navigators Coordinate Your Care
Our skull base tumor patient navigators guide you through your treatment step-by-step. They help schedule appointments, coordinate visits, communicate your test results, and prepare you for surgery. And they are available to answer all of your questions along the way.

Team Approach to Care
Nasal and paranasal tumors affect more than just the nose and sinuses. That’s why we work with a team of subspecialists to ensure we are considering every aspect of your health and well-being. Our head and neck experts meet as a group weekly to discuss the details of your case and agree on next steps.

Advanced Surgical Options
Research shows that hospitals and surgeons who perform more surgeries tend to have better outcomes. You'll be among others from around the region and beyond who travel to Duke for sinus cancer care. When people have particularly complicated cases -- for example, tumors that affect the carotid artery (the main vessel supplying blood to the brain) -- we’ve offered solutions that other centers couldn’t.

Research Leaders
Our researchers are dedicated to learning more about sinus and nasal cancers, even rare types that are not studied as often, to discover new and improved therapies.

Patient Resources

Endoscopic Skull Base Surgery Program

This page was medically reviewed on 04/04/2023 by

Ralph Abi Hachem, MD, MSc | Ear, Nose and Throat Doctor