Cancer of the Nasal and Paranasal Sinuses in Dogs

 Nasosinal Tumors

Description – Tumors of the nasal cavity and paranasal sinuses consist of 1% of all canine neoplasms. The intranasal lesions mostly manifest themselves as adenocarcinoma, squamous cell carcinoma and undifferentiated carcinoma. The remaining, however, comprise fibrosarcoma, chondrosarcoma, osteosarcoma and undifferentiated sarcoma. Among them carcinomas and sarcomas are the most aggressive. At the time of diagnosis the rate of metastasis is usually low but at the time of death it is around 40% to 50%. The common metastatic sites are the regional lymph nodes and the lungs whereas the less common sites include the bones, kidneys, liver, skin and brain.

 Benign tumors like polyps and fibromas too have been found.

The average age of dogs with nasosinal tumors is 10 years. A predilection has been reported among medium and large breeds. 


Nasal Adenocarcinoma in Dogs

Nose cancer (or nasal adenocarcinoma) occurs when too many cells in the animal's nasal and sinus passages come together. The disease progresses slowly and occurs both in dogs and cats. Studies have shown nose cancer is more common in larger animal breeds than in smaller ones, and it may be more common in males than females. Options exist when the disease is caught early and aggressively treated.


Chondrosarcoma of the Nasal and Paranasal Sinuses in Dogs

A chondrosarcoma (CSA) is the second most common primary tumor in dogs, accounting for ten percent of all primary bone tumors. This is a malignant, invasive and fast spreading tumor in dogs. A CSA of the nasal and paranasal sinuses arises from the mesenchymal tissue, a connective collagenous tissue that is found throughout the body, and metastasizes to other parts of the body, including the nasal bones. It usually occurs on one side of the nasal cavity and extends to the other side over time.


Nasal Squamous Cell Carcinoma in Dogs

Both the inside of the nose and the paranasal sinuses are covered in the same type of tissue, called the epithelium. The outer layer of this tissue is scale like, and is called the squamous epithelium. Tumors that grow from this squamous epithelium are called squamous cell carcinomas.

Squamous cell carcinomas are the second most common type of nasal tumor that dogs get. They usually grow slowly over several months. Most commonly, they occur on both sides of the nose, and it is common for this kind of cancer to spread to the bone and tissue near it. In some cases, this type of nasal tumor will spread to the brain, causing seizures. Squamous cell carcinomas in the nose and sinuses are usually seen in dogs over nine years old, but they have been seen in dogs as young as three years old.

Diagnosis

Your veterinarian will need a complete background medical history leading up to your dog's disease symptoms. Routine blood tests include a complete blood count, biochemistry profile, urinalysis and platelet count. The results may show normal levels. Your veterinarian will also examine the blood samples for evidence of fungal or bacterial infections. Aspergillus is sometimes found in dogs with nasal tumors.

Radiographic studies can be helpful in confirming the diagnosis, but even this type of diagnostic method is challenging. Computed tomography (CT) scans and magnetic resonance imaging (MRI) will often produce a more substantial image of the extent of invasion. An endoscope -- a tubular device with an attached camera that allows for a closer look at the diseased area -- can also be used examine the internal structure of the nasal canal, and may also be used to collect tissue specimens for biopsy, but because of the small space, this can be difficult. Other methods for collecting tissue and fluid samples may be employed, including fine needle aspiration, and suction. Biopsy is the only way to conclusively diagnose nasal cancer.

Your veterinarian may also take radiographs of other areas of the body to evaluate if metastasis is taking place.



Causes – The etiology of nasosinal tumors is largely unknown but some reports suggest that animals living in urban areas are at an increased risk. This is primarily due to the nasal filtering of pollutants. Exposure to passive smoking and fossil fuel combustion products like those produced by coal or kerosene heaters may accentuate the risk of this type of cancer.

Symptoms – Some of the most common clinical signs may include epistaxis (bloody nasal discharge), mucopurulent discharge (nasal discharge containing mucous and pus), facial deformity from bone erosion and subcutaneous extension of the tumor, sneezing, dyspnea (shortness of breath) or stertorous breathing (harsh noisy breathing), exophthalmus (abnormal protrusion of the eye) and ocular discharge due to obstruction of the nasolacrimal duct (carries tears from the lacrimal sac into the nasal cavity).

On rare occasions animals with large tumors involving the caudal region of the nasal cavity may have neurological signs including seizures, behavioral changes, paresis (partial loss of movement), circling and obtundation (dog that does not have full mental capacity).



Treatment – By the time nasal carcinoma is detected, the disease has already become highly infiltrative. The degenerative nature of the disease and its critical location of the tumor near the brain and eyes renders it non-amenable to treatment and makes surgery impossible.  So, radiation therapy using high-energy mega voltage equipment is the only conventional treatment of choice for nasosinal tumors. It covers the entire nasal cavity, including, bone.

However, radiation has many disadvantages. The side effects of irradiation vary with protocols. Acute toxicities that result from irradiation include oral mucositis (inflammation and ulceration of the mouth), rhinitis (running nose), desquamation (shedding of the outer layers of the skin) and keratoconjunctivitis (inflammation of the cornea and conjunctiva) and blepharitis (ocular disease characterized by inflammation of the eyelid margins).

This state of affairs continue for 2-8 weeks after therapy for which oral antibiotics and pain medications are prescribed. However, if oral mucositis, attains severe proportions, esophagostomy (surgical opening into the esophagus) and gastrostomy (surgical opening into the stomach) tube feedings may be needed in the short term.

Sometimes the side effects of radiation may set in late. But they can be even more dangerous than the acute ones. These may include cataracts (cloud that develops in the crystalline lens of the eye), keratitis (condition in which the cornea of the eye becomes inflamed), atrophy (wasting away of the part of the body), keratoconjunctivitis, anterior uvea, hemorrhage, degeneration, brain necrosis (brain death), seizures, optic nerve degeneration, osteonecrosis (bone collapse) and fibrosis (development of excess fibrous connective tissue in an organ). Some complications develop late after therapy and are generally non-treatable.

Prognosis – Without treatment the prognosis for nasal carcinoma is approximately 3 months. The median survival time of dogs with epistaxis is 88 days whereas those without epistaxis is 224 days. The median survival time after surgery is 3-6 months. The median survival time with high voltage irradiation is 8-19.7 months.


Lucy received no radiation nor chemotherapy. She only received the Tippner Cancer Protocol. She is now past 3 years since diagnosis by biopsy of nasal adenocarcinoma and has virtually no symptoms.







Lucy never did radiation or chemo, she only did the Tippner Protocol. The Tippner Cancer Protocol combines immunotherapy and molecular cancer therapy using off the shelf readily available inexpensive natural substances. She is past 3 years after diagnosis by biopsy

I buy most of the stuff from Swanson Vitamins. They are cheaper, in capsules for dosage changes, and carry almost everything I give to Lucy except for the Chinese Herbs Stasis Breaker prescription, and the Low Dose Naltrexone prescription. Here is a $5 off coupon link I found