Skin Cancer of the Eyelids

Home » Skin Cancer of the Eyelids » Signs and Symptoms, Diagnosis, Treatment, Prevention

Signs and Symptoms

Symptoms vary according to the type of skin cancer, but in most cases, the lesions are painless. They do not clear up on their own or with topical ointments. Over time, they grow larger and/or change shape and color. Sometimes they bleed, develop a crust, or discharge pus.

Diagnosis

The initial diagnosis is made by examination with a slit lamp microscope (instrument with a high intensity light source attached to a microscope) that allows the doctor to view the eye under high magnification. If the lesion looks suspicious, a biopsy is done. This procedure involves removing a small piece of the lesion and sending it to a laboratory for examination. A biopsy is necessary to make a definitive diagnosis.

Treatment

The most effective treatment is removal of the entire tumor to minimize the risk for recurrence and spread (metastasis). In a simple excision, the lesion is excised (cut away) with a small margin of healthy tissue. The healthy tissue is removed to ensure that stray cancer cells are removed. This technique is used for small, shallow tumors.

Moh's technique is especially useful in treating cancer of the eyelids. The lesion is removed layer by layer. Each layer is examined microscopically for cancer cells. Layers continue to be removed until cancer-free tissue is reached. This slow procedure helps preserve healthy tissue and produces better cure rates and cosmetic results after surgery.

When surgery leaves a disfiguring scar or involves removal of a significant part of the eyelid, reconstructive surgery can greatly improve the eyelid's function and cosmetic appearance. This type of surgery is performed by an ophthalmologist with training in plastic surgery.

Other Treatments
There are several treatment options for patients who are poor candidates for surgery and those who refuse a surgical procedure. If the lesion is superficial, a laser may be utilized to burn it off. Lasers have been used with success in basal and squamous cell carcinomas that have not penetrated too deeply into the skin. Laser treatment may not be appropriate because of the location of most eyelid tumors.

Cryosurgery involves using liquid nitrogen to freeze cancer cells. It does not ensure complete tumor eradication, however, and the rate of recurrence is high and there may be scarring.

Systemic chemotherapy and/or local radiation can also be used, but they are not as effective as surgery. If the tumor has metastasized, radiation and chemotherapy may be needed to treat the disease.

These modalities produce several side effects, such as:

• Gastrointestina disorders
  • Anorexia (loss of appetite)
  • Diarrhea or constipation
  • Esophagitis (inflammation of the esophagus)
  • Mouth sores
• Skin disorders
  • Dryness and itching
  • Hair loss
  • Rash

Prevention

Staying out of the sun or shielding the eyes with sunglasses can help prevent cancer of the eyelid. Protecting the eyes from prolonged sun exposure may also offer protection against other disorders that affect the eye.

It is important to be aware of lesions or irritation around the eyes, especially if they do not heal or if they change shape and color. Blepharitis or a chalazion that does not improve with treatment should be reported to a physician.

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