While frequent nosebleedscan be a sign of a more serious problem, including cancer of the nasal cavity, getting nosebleeds once a month probably is not frequent enough to cause alarm. In general, nosebleeds are more common during winter months. The humidity goes down, people spend more time indoors, and the nasal lining starts to dry and crack. Irrigating your nose with a saline solution two to three times a day can help relieve some of the dryness and reduce the frequency of nosebleeds. A little Vaseline around the outside of the nose will also help. If you are taking aspirin or other blood-thinning medication, these can also contribute to frequent nosebleeds. If your nosebleeds get worse or more frequent, I would have an ear, nose and throat specialist look inside your nose for any growths or masses that may be the cause. Q2. My dad had nasal polyps. Is he at increased risk for cancer in the nasal cavity? Should he be getting any kind of regular screening tests? Nasal polyps are usually associated with chronic inflammation of the nose caused by allergies or chronic sinusitis. Most nasal polyps are benign, and treatment can consist of steroids and other medications, with surgery reserved for non-responsive or advanced disease. Polyps that occur in only one side of the nose (unilateral) are more suspicious and should always be biopsied. The specimen should be carefully evaluated to rule out other diseases that can mimic nasal polyps such as an inverting papilloma (IP). IP is a locally aggressive tumor and although benign, can progress to a malignancy in a small percentage of cases. The treatment for IP is surgical resection. Bleeding and pain associated with unilateral polyps are even more suspicious and should be a warning sign of a possible underlying cancer. But if your dad did not have these symptoms and his other findings were consistent with nasal polyps, there is very little risk of developing nasal cancer. He should follow his doctor’s recommendation regarding treating any underlying causes of the polyps such as nasal allergies. Q3. My father has a peripheral nerve sheath tumor and the biopsy result is anaplastic type. The CT scan said that the growth is at maxillary and frontal sinus eroded to sphenoidal bone. There is no other lymph node involvement or metastasis. I’d like to know the staging and treatment options. If there will be radiation and chemo, how many cycles can he expect? Most nerve sheath tumors are benign growths that occur on sensory nerves of the face or neck. A very small percentage of these tumors are cancerous. These malignancies can be aggressive and require a combination of treatments (known as multimodal therapy) including surgery, radiation and, in some cases, chemotherapy. Surgery in this area typically involves the removal of involved sinuses, an operation called a maxillectomy. The surgeon has to follow the nerve back to the point of origin at the brain in order to obtain cancer-free margins. Whether or not a cancer is amenable to this type of surgery depends on what other surrounding structures are involved (eye, brain or carotid artery, for example). Since these surgeries can be extensive and can lead to functional and cosmetic changes, individual treatment decisions have to be made between the patient and doctor. If treatment involves radiation and/or chemotherapy either before or after surgery, the radiation oncologist will determine the total dose of radiation needed and then divide the total dose into more manageable daily doses. The duration of treatment, therefore, will depend on the total dose recommended, but generally is between five and seven weeks of daily treatment. Q4. I underwent treatment for nasal cavity cancer last year. I heard that vitamin A can help prevent the tumor from coming back. Is that true? How much should I take? There are studies that suggest vitamin A and related compounds called retinoids can reverse the early changes seen in cancer cells. This has led to studies looking at chemo prevention of new cancers and recurrent cancers in patients at risk. Unfortunately, the data is still very mixed, with some studies suggesting a benefit to taking vitamin A, and others showing no benefit or even a harmful effect of taking vitamin A. Other new studies are looking at the benefits of vitamin A in certain thyroid cancers. So until more studies are done, I would not recommend taking vitamin A or any other vitamins in high doses. Mega doses of vitamin A can seriously damage your liver as well as your skin. Quitting smoking and eating a balanced diet are still the best ways to minimize your risk of head and neck cancer. Learn more in the Everyday Health Oral, Head, and Neck Cancer Center.
