Nasal cavity and paranasal sinus cancers (including esthesioneuroblastoma)
Prepared with OnCo (onco.cc/prep/sinonasal/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
15 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example Histological subtype and Hyams grade, IDH2 R172 mutation, SMARCB1/SMARCA4 loss, NUT immunohistochemistry to exclude NUT carcinoma, HPV status), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (resectable squamous carcinoma, adenocarcinoma, esthesioneuroblastoma), which of the standard options do you recommend and why?
- 6.Am I a candidate for Cisplatin, and what side effects should I expect?
- 7.For my situation (sinonasal undifferentiated carcinoma), which of the standard options do you recommend and why?
- 8.Am I a candidate for Cisplatin, Etoposide, Platinum + etoposide (EP / CE), and what side effects should I expect?
- 9.For my situation (unresectable or metastatic), which of the standard options do you recommend and why?
- 10.Am I a candidate for Pembrolizumab, Nivolumab, Enasidenib, and what side effects should I expect?
- 11.Are there clinical trials I could join, for example of Proton therapy, Enasidenib, Pembrolizumab?
- 12.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 13.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 14.I read that “Late presentation: most tumours are locally advanced at diagnosis; awareness in ENT clinics and imaging AI are the response”. How does that affect my plan?
- 15.I read that “No randomised trials exist for any sinonasal histology; international consortia are pooling cases”. How does that affect my plan?
The words I may hear
- Head and neck subsites (oral cavity, oropharynx, larynx): Head and neck cancer is really several cancers named by exact location: mouth (oral cavity), back of the throat (oropharynx, where HPV cancers arise), voice box (larynx), lower throat (hypopharynx) and behind the nose (nasopharynx).
- HPV status (HPV-positive / HPV-negative): Whether a cancer is caused by human papillomavirus.
- Rare cancers: Rare cancers are those with fewer than about 6 new cases per 100,000 people per year.
Tests and results to bring
Biomarker results to ask for: Histological subtype and Hyams grade (esthesioneuroblastoma), IDH2 R172 mutation (SNUC), SMARCB1/SMARCA4 loss, NUT immunohistochemistry to exclude NUT carcinoma, HPV status (non-keratinising squamous), Occupational exposure history (wood dust).
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Resectable squamous carcinoma, adenocarcinoma, esthesioneuroblastoma: Endoscopic or cranioendoscopic resection with negative margins followed by IMRT or proton therapy for advanced stage, high grade or close margins; concurrent cisplatin for positive margins or nodal disease. (IMRT / IGRT (modern external beam), Proton therapy, Cisplatin, Robotic & minimally invasive surgery)
- Unresectable or metastatic: Platinum-based chemotherapy, and pembrolizumab or nivolumab per head and neck squamous indications for squamous histology; trials for IDH2-mutant SNUC (enasidenib) and SWI/SNF-deficient carcinoma. (Pembrolizumab, Nivolumab, Enasidenib)
- Sinonasal undifferentiated carcinoma: Induction platinum-etoposide; responders proceed to definitive chemoradiotherapy, non-responders to surgery plus radiotherapy (response-adapted approach, JAMA Oncol 2019). (Cisplatin, Etoposide, Platinum + etoposide (EP / CE), IMRT / IGRT (modern external beam))
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.