Management of Nasal Vestibule Cancers

Cancers arising in the nasal vestibule, just inside the opening of the nose, are relatively uncommon and are usually squamous cell carcinomas.  They tend to behave like skin cancers and can be treated either with surgery or radiation therapy.  The disadvantage of surgery for all but the earliest tumors is that the cosmetic result may be suboptimal, depending on how much of the nose must be removed, and a complex reconstructive procedure may be required.  Radiation therapy alone is used to treat most of these cancers and usually consists of a combination of external beam irradiation and interstitial brachytherapy boosts.  The chance of cure is essentially the same after either surgery or radiation therapy for all but the most advanced cancers.  Very advanced cancers, which are more than 4 cm in diameter and invade bone, are probably best treated with a combination of surgery and radiation therapy because the chance of cure with radiation therapy alone in this instance is fairly low.