What treatment options do patients with cancer near the eye have? Treatment options for cancer near the eye depend on the size of the tumor, where it is located, how far it has spread, and the patient’s age, overall health, and preferences. The patient’s goal may be to preserve sight or save the eye. Another option is radiation therapy, which uses high-energy lasers to kill cancer cells. This method can damage healthy tissue around the eye.
The structures of the eyeball are prime candidates for cancer. They include the ciliary body, choroid, iris, and retina. The retina is a layer of cells at the back of the eye that connects to the brain through the optic nerve. It is this layer of cells that make up the image we see. Light that enters the eye passes through the lens, and the retina makes the image, which is sent to the brain. The eyeball is connected to the orbit by muscles and important nerves.
Patients with a tumor near the eye should have it evaluated by an ophthalmologist. This specialist will ask questions about the patient’s symptoms, as well as any family history of the disease. During this examination, the doctor will look inside the eye and use a special magnifying device. A biopsy may also be required. An ultrasound uses high-frequency sound waves to visualize the inside of the eye, and can reveal tumors.
Other types of cancer near the eye include transitional cell carcinoma, which affects the lacrimal gland. Symptoms of transitional cell carcinoma include excessive or bloody tears, frequent nosebleeds, and a mass in the inner bottom corner of the orbit. Treatment options for this type of cancer often includes radiation therapy. The patient may be asked to undergo chemotherapy as well as proton therapy, which reduces toxicity near the eye.
Children with cancer near the eye may also be affected by retinoblastoma, a type of tumor that begins in the retina, a light-sensitive layer of the eye. While this type of cancer is rare, it does account for about 3% of all children’s cancers. About 90% of eyelid cancers are basal cell carcinoma. While this type of cancer is not aggressive, it does not spread to other parts of the body.
Sebaceous carcinoma is another form of eyelid cancer. This type of cancer starts in the meibomian glands, which secrete a fatty secretion. Rarely, it begins in the Zeis gland, which produces tears. Cancers that start in these glands will generally be more difficult to remove. In some cases, patients may need to undergo surgery or radiation treatment to remove the eye completely. While a diagnosis of a condition such as sebaceous carcinoma is not possible in every case, it is possible to remove them without surgery.
Surgery is the treatment of choice for most nonmelanoma skin cancers in the eyelid. Dermatologists perform Mohs surgery in stages. Each stage requires a waiting period. The surgeon examines the margins of the tumor using a microscope. Then he removes additional tissue and repeats the procedure until there are no cancer cells left. Mohs surgery offers the best chance for cure and minimizes the amount of healthy tissue that is removed. It leaves the least visible scar.
