Skin cancer is commonly associated with areas of the body heavily exposed to the sun, such as the face, arms, and legs. However, it can develop in less obvious locations, including inside the nasal cavity. While internal forms of skin cancer are less frequent than those on external skin, understanding their nature and indicators can help individuals recognize when to seek medical advice.
Understanding Skin Cancer in the Nasal Cavity
The nasal cavity is lined with various types of cells, some similar to those found on the skin. The most common forms of skin cancer that can affect the nasal cavity are squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and melanoma. SCC is the most prevalent type of cancer found within the nasal cavity and paranasal sinuses, accounting for over 60% of cases.
Basal cell carcinoma, common on the external nose due to sun exposure, can also appear internally. Melanoma, arising from pigment-producing cells, typically develops on sun-exposed skin but can also form on the mucous membrane lining the nasal cavity. These internal melanomas are rare but can be aggressive. These malignancies require attention due to their location and potential impact on nasal function and surrounding structures.
Key Signs to Watch For
Symptoms often do not appear until the cancer has grown larger. A persistent sore inside the nose that does not heal, or that repeatedly crusts over and returns, can be a warning sign. Unexplained or frequent nosebleeds, especially if occurring only from one nostril, may also indicate a problem.
Other symptoms include a persistent blockage or congestion in one nostril that does not improve with typical remedies, or a noticeable lump or growth inside the nose. Some individuals might experience changes in their sense of smell or persistent pain or pressure in the nasal area. While these symptoms can be caused by many less serious conditions, their persistence warrants a medical evaluation to determine the underlying cause.
Factors Increasing Your Risk
While direct sun exposure is the primary risk for external skin cancers, prolonged or indirect UV ray exposure can still contribute to internal nasal skin cancers. Smoking and tobacco use are significant risk factors for nasal cavity cancers, including squamous cell carcinoma.
Certain occupational exposures to substances such as wood dust, leather dust, nickel, and chromium are linked to an increased risk of these cancers. Human papillomavirus (HPV) infection, particularly high-risk types like HPV16, has been associated with a percentage of sinonasal squamous cell carcinomas. Chronic inflammation, such as that caused by long-term sinusitis, may contribute to a higher risk of certain sinonasal malignancies over time, although the overall likelihood remains low.
Pathways to Diagnosis and Treatment
Diagnosing skin cancer inside the nose begins with a thorough physical examination, including a careful inspection of the nasal passages. A doctor may use a nasal endoscope, a thin, flexible tube with a camera, to visualize the internal structures of the nose. If a suspicious area is identified, a biopsy is performed to collect tissue samples for laboratory analysis, which is essential for confirming the presence and type of cancer.
Imaging studies like CT scans or MRI scans are used to determine the extent of the tumor, assess if it has spread to surrounding tissues or lymph nodes, and help guide treatment planning. Treatment options vary based on the cancer type, size, and stage, and may include surgery to remove the tumor, radiation therapy, or chemotherapy. Mohs micrographic surgery, which removes thin layers of tissue while examining each layer microscopically, is preferred for its precision and ability to preserve healthy tissue, especially for basal cell and squamous cell carcinomas in delicate areas like the nose. Early detection through prompt evaluation of symptoms significantly improves treatment outcomes.