Q. Does blood in mucus from nose mean nasal cancer?

Answered by
Dr. Shyam Kalyan N
and medically reviewed by iCliniq medical review team.
Published on Jun 13, 2018 and last reviewed on: Oct 12, 2019

Hi doctor,

I am a 36-year-old male smoker. I have mild hay fever but no other medical issues. For the last week, I have been waking up with a one-sided blocked nose and slight throat irritation. The side of the nose blocked changes, I think depending on which side I lay down on. I then blow my nose hard, both sides and the blocked nose seems to disappear until the next morning. Mucus comes out when I blow. A few days ago a little blood streak with in the mucus but not last couple of days. I have been reading on nasal cancers and am really worried. About a week ago when I woke up with a blocked nose, my eyes and eyebrows were hurting. I am sure I had something similar last year. I have heard of MRI for a separate reason around 6 to 7 months ago and they said everything was fine including sinuses.

If it were nasal cancer would one nostril be blocked all day rather than just the morning? Also, would it always be the side of cancer (mine switched sides in the morning sometimes right nostril sometimes left)? Are these symptoms ones where I should be worried about cancer?

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
#

Hello,

Welcome to icliniq.com.

Answering your questions:

  1. If it were cancer then the block would always be there and that too on the same side or both side. Therewill not be any fluctuation or diurnal variation.
  2. It will always be the side where the cancer is.
  3. Symptoms, where you should be worried about cancer, are weight loss, loss of appetite, growth protruding out from nostril or protruding into the throat from behind the nose, and bleeding from the nose. The duration of these symptoms will be more than just a few weeks.

The explanation for your symptoms:

It appears like an acute rhinopharyngitis only. This is inflammation of the nasal and pharyngeal cavities. In the initial stages or when the immunity is good, it affects the way you have described. Mornings congestion of throat and nose block is common with rhinopharyngitis. You have mucus also. Mucus when dries up forms crusts inside the nose and when these crusts get dislodged they cause abrasions inside the nose and that can cause bleeding while you blow the nose. Hurting of brows and eyes could be due to sinusitis which is a sequela of rhinitis due to the block of sinus ostia which open into the nose.

Is there running nose, sneezing, decreased sense of smell or facial pressure? Any ear symptoms or a headache?

Suggestion:

See the quality of mucus, if it is thick yellow and smelly you may need a course of antibiotics. Otherwise nasal decongestants and systemic decongestants would suffice. In either case, avoid smoking till you are completely fine. Take non-spicy warm foods and do not drink till you get better. Avoid citrus fruits also. Drink plenty of warm liquids and water. Can apply few drops of Otrivin nose drops before sleeping in the night. Do not use the nose drops continuously for more than 4 or 5 days.

Investigations:

I do not feel you need to do any investigations now. But to rule out cancer, you may want to do a CT scan of nose and PNS (paranasal sinuses-non-contrast one). A complete blood count with serum IgE also would be ideal.

For more information consult an ENT otolaryngologist online --> https://www.icliniq.com/ask-a-doctor-online/ENT-Otolaryngologist

Thank you doctor,

Nose is a little runny in the morning then gets better. No sneezing, no decreased sense of smell. Facial pressure only happened in the morning about a week ago when the nose was blocked and a little when I bend down and stay there for about 20 seconds but no major pressure. No ear pressure either. That is good to know that it is not a symptom of nasal cancer. Like I said it is fine during the day but only blocked in mornings. The side it is blocked always fluctuates as well.

Dr. Shyam Kalyan N

Allergy Specialist Otolaryngology (E.N.T)
#

Hi,

Welcome back to icliniq.com.

Alright then. I will suggest some medicines to you. You try those and let me know.

  1. Otrivin nose drops two drops on each side of the nose before going to sleep. Use the drops in the morning also. After instilling the drops lay down supine for 10 minutes.
  2. Tablet Sinarest Levo (Levocetirizine 2.5 mg and Phenylephrine 10 mg) one tablet in the evening for 3 to 4 days.
  3. Tablet Paracetamol as and when you have pain.
  4. Steam inhalation if you are comfortable with it. I would not recommend warm saline gargles since many of my patients complain worsening of symptoms with it. But traditionally doctors do recommend that.
  5. Stay away from dust and smoke. Keep air conditioner at an optimum temperature and let it not be dry. Keep adequate humidity in the night when you sleep. In the daytime also do not be directly under the aircon blower.
  6. Follow rest of the precautions I told you. Like I said, do not rush and get the investigations done. Let's wait and see. Let me know if the quality of mucus changes or if there is any other symptom. Do revert back if you need anything.

For more information consult an ENT otolaryngologist online --> https://www.icliniq.com/ask-a-doctor-online/ENT-Otolaryngologist

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