The short answer
Nasal and sinus cancers are usually treated with surgery and radiation together, with chemotherapy playing a smaller role and used mostly for advanced disease. These tumors sit close to the eyes, brain and major nerves, so vision, smell, breathing and how your face looks are part of the decision.
Surgery is common at every stage, and the aim is to remove the cancer plus a margin of healthy tissue or bone, with neck lymph nodes taken too if the cancer has spread there.
Stage I cancers are often treated with surgery alone, while stage III and IV cancers often get high-dose radiation before or after surgery, especially in the maxillary sinus behind the cheekbone.
Radiation to this part of the face and skull can change thyroid function over time, so your team may check thyroid levels with blood tests during follow-up.
Reconstructive surgery is often part of the plan when a lot of tissue or bone has to come out, so ask about it before surgery rather than only afterwards.
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The full explanation.
The short answer
Nasal cavity and paranasal sinus cancers form in the spaces around your nose and behind your face. Treatment usually combines surgery and radiation therapy. Chemotherapy plays a smaller role. It is mostly used for advanced disease. Which combination fits you depends on the exact location, stage, and how the tumor is growing.
Surgery: the main treatment for most stages
Surgery is a common treatment at every stage. The goal is to remove the cancer, plus a margin of healthy tissue or bone around it. If cancer has spread to lymph nodes in the neck, your surgeon may remove those too. These tumors sit close to the eyes, brain, and major nerves. That makes surgery here more complex than removing a tumor elsewhere in the body. Ask your surgeon what structures are near your tumor. Also ask how that shapes the operation.
Radiation therapy
Radiation uses high-energy rays to kill cancer cells. It comes in two forms. External radiation is delivered by a machine outside your body. Internal radiation places radioactive material directly near the tumor. For early, stage I cancers, treatment is often surgery alone. Sometimes surgery is combined with radiation, depending on which sinus is involved. For more advanced stage III and IV cancers, doctors often give high-dose radiation before or after surgery. This is especially true for cancers of the maxillary sinus, the sinus behind your cheekbone.
Chemotherapy
Chemotherapy uses drugs to stop cancer cells from growing or dividing. It can kill the cells directly, or stop them from splitting into new cells. It can be systemic, meaning it travels through your bloodstream to reach your whole body. It can also be regional, meaning it targets one specific area. Chemotherapy is used less often than surgery or radiation for these cancers. It is more commonly added for advanced disease.
Side effects worth planning for
Radiation to this part of the face and skull can affect nearby structures. It can change thyroid function over time. Your team may check thyroid levels with blood tests during follow-up. Radiation and surgery here can also affect breathing and smell. Some people need extra help adjusting to breathing changes afterward. Ask your team early what support is available. This can include breathing exercises or a referral to a specialist. Do not wait until a problem feels unmanageable.
What surgery and radiation can mean for your face
These cancers sit near the eyes, nose, and facial bones. Treatment can affect how your face looks or functions. This includes vision, smell, and speech. Reconstructive surgery is often part of the plan. This applies when a lot of tissue or bone needs removal. Ask about this before surgery, not only afterward.
Which symptoms cannot wait
Contact your care team the same day for a fever of 100.4°F (38°C) or higher. If you are having chemotherapy, though, treat that reading differently: CDC counts a fever during chemotherapy as a medical emergency, so ring your team immediately, day or night, and only head for an emergency department if you cannot reach them quickly — tell the staff there that you are on chemotherapy. Also call for sudden vision changes, a severe headache, or new confusion. These can signal that the cancer or treatment is affecting structures near the brain or eyes. They need prompt evaluation, not a wait for your next scheduled visit. Heavy nosebleeds that will not stop with firm pressure also need same-day attention.
How this fits with your overall care
Surgery here can be complex. Care is usually coordinated by a team. This often includes a head and neck surgeon, a radiation oncologist, and sometimes a reconstructive surgeon. Ask who is leading your care. Also ask how the different specialists talk to each other. This matters more if you are being treated at more than one center.
What to ask your care team
- Which sinus or nasal area is affected, and how does that shape my treatment options?
- Will I need surgery, radiation, or both, and in what order?
- How might treatment affect my vision, smell, breathing, or appearance, and what support is available?
- What symptoms should prompt a same-day call rather than waiting for my next appointment?
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Common questions
What does treatment usually involve?
Usually a combination of surgery and radiation therapy. Chemotherapy plays a smaller role and is mostly used for advanced disease. Which combination fits you depends on the exact location, the stage, and how the tumor is growing.
Why is surgery here more complex?
These tumors sit close to the eyes, brain and major nerves, which makes surgery more complex than removing a tumor elsewhere in the body. The goal is to remove the cancer plus a margin of healthy tissue or bone around it, and neck lymph nodes may be removed too if the cancer has spread there. Ask your surgeon what structures are near your tumor and how that shapes the operation.
When is radiation used?
For early, stage I cancers, treatment is often surgery alone, and sometimes surgery combined with radiation depending on which sinus is involved. For more advanced stage III and IV cancers, doctors often give high-dose radiation before or after surgery, especially for cancers of the maxillary sinus behind the cheekbone. Radiation is given either externally by a machine or internally by placing radioactive material near the tumor.
What side effects should I plan for?
Radiation to this part of the face and skull can change thyroid function over time, so your team may check thyroid levels with blood tests during follow-up. Radiation and surgery here can also affect breathing and smell, as well as vision, speech and how your face looks. Reconstructive surgery is often part of the plan when a lot of tissue or bone needs removing, so ask about it before surgery rather than only afterwards.
Which symptoms cannot wait?
Contact your care team the same day for a fever of 100.4°F (38°C) or higher, sudden vision changes, a severe headache, or new confusion. These can signal that the cancer or treatment is affecting structures near the brain or eyes, and they need prompt evaluation. Heavy nosebleeds that will not stop with firm pressure also need same-day attention. One exception on the fever: if chemotherapy is part of your treatment, whether alone or given with radiation, CDC counts that same temperature as a medical emergency. Call your care team straight away, day or night, and if you cannot reach them quickly go to an emergency department and say you are having chemotherapy.
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Sources last checked: 2026-08-13 what this meansLast updated: 2026-08-18Next planned review: 2027-01-22
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How this page was created
Cancer Explained does not originate medical claims. Every page restates guidance already published by the National Cancer Institute, the CDC, the USPSTF and the FDA, in plain language, with the source cited so you can check the original yourself. AI does the translating and organizing; automated checks test claims, citations, clarity and safety before anything publishes. We do not employ clinicians and do not intend to — our work is translation and navigation, not clinical judgment. Nothing here is personal medical advice, and no page can account for your particular situation.
Editorial status: Source checked — This page was written with AI assistance and checked line by line against the sources listed on it. That confirms the sources support what the page says. It is not a medical review, and it does not confirm the page is complete or right for your situation.
Human medical review: not completed. Pages here are not signed off by a clinician before they publish. That is not an oversight we are quietly working around: we restate published guidance and cite it, so the authority belongs to the source rather than to us, and every page names where its claims come from — you can verify us instead of trusting us. Where a volunteer clinician has reviewed a page, their name and credentials appear on it; where no name appears, no clinician has checked it. We are glad to have reviewers and are recruiting them, and we do not hold pages back waiting for one. Use this site to understand your situation and to ask better questions of the people treating you.
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