Sinus infections and cancer treatment: What to know

While they sit in the middle of your face, you may not think much about your sinuses until they start giving you trouble.

“Think of them as little pouches of air,” says  sinus cancer and skull base tumor surgeon Shirley Su, M.B.B.S. “Without them, our heads would be very heavy.”

Sinusitis, or sinus infections, can be a constant reminder of your last common cold or the start of allergy season. If you’re undergoing certain types of cancer treatments, you may find yourself suffering from these common infections even more than usual. Here, Su explains why and how to get relief.

What is sinusitis?

You have four pairs of sinuses – behind your cheekbones, in the center of your forehead, between your eyes and behind your eyes. They are all connected to your nose.

“Because sinuses have hair and a lining like your nose, whatever affects your nose also affects your sinus,” says Su.

Your sinuses produce secretions to help you breathe and keep your nose clean. When those secretions become thick and difficult to drain, the drainage pathways get blocked and the stagnant fluid gets infected – resulting in sinusitis. 

Sinusitis and cancer treatment 

Usually, sinusitis happens because of a virus, a bacterial infection or an allergy. But some cancer patients may experience these infections more frequently.

Patients undergoing chemotherapy treatment have compromised immune systems and may get more viral infections. Alternately, patients who have undergone a stem cell transplant may experience year-round allergies due to an overactive immune system.

“Someone who is used to having two or three sinus infections a year may notice more frequent or prolonged episodes after cancer treatment,” says Su.

When we are children, our immune systems adapt to what’s around us so that we are not allergic to most things in our environment. But people who have undergone a stem cell transplant have reengineered immune systems and their allergy profile often changes.

Sinusitis’ impact on head and neck cancer patients

Head and neck cancer patients who have had surgery or undergone radiation also may have unique challenges with their sinuses. 

“Your nose is actually a very complicated organ,” says Su. “Direct radiation to the head and neck organs can disrupt immune functions and the mechanisms that help us clear our mucus and infections.”

You may get chronic infections from organisms that usually get cleared by mucus. Without the mucus, the nose is dry and doesn't produce enough fluid to humidify the air. This can lead to discomfort and dryness. 

If you’re diagnosed with head and neck cancer, it’s important to seek multidisciplinary care at a cancer center like UT MD Anderson to help address these challenges.

Can sinusitis be a sign of cancer?

While sinus infections are not necessarily a sign of cancer, some symptoms need a doctor’s examination, including: 

• Facial pain or pressure without other signs of infection
• Sudden and/or repeated nosebleeds that are severe
• Swelling or deformity in the cheek, nasal area or around the eye
• One-sided eye symptoms, such as double vision, blurred vision or bulging
• Tearing of the eye on one side (tears running down your cheek)
• Swelling or deformity in the cheek, nasal area or around the eye
• Facial numbness
• Loosening of the teeth 
• Bulges on the roof of the mouth or upper jaw

If your symptoms don’t respond to decongestants, nasal sprays or antihistamines, and last longer than two to three weeks, you should see an ENT for an examination.

How to get sinusitis symptom relief

While Su cautions that there is no quick fix for sinus infections, there are things you can do to make yourself more comfortable, including:

• Use filtered water and saline to help move the mucus.
• Use nasal decongestants for a short period of time (48 hours or less).
• If you suffer from allergies, talk to your doctor about which antihistamines may be best for you for prolonged use. 

Su also says to remember that it takes time to recover from viral infections and that you don’t necessarily need antibiotic treatment. But if your sinusitis lasts for more than three weeks and you have yellow or green mucus with an accompanying fever, see a doctor. 

Request an appointment at UT MD Anderson online or call 1-877-632-6789.