Eyelid is a thin layer or fold of the skin that covers the eye. It is one of the most sensitive layers of the body. Cancer which occurs on or in the eyelid is referred to as eyelid cancer. Eyelid cancer is a very rare disease and is broadly categorized into epithelial tumours as it is present on the outer surface of the body.
The most common types of cancers occurring in the eyelid are:
- Basal cell carcinoma – Basal cells are present in the lower epidermis under the squamous cells. It is the most common type of eyelid cancer. Patients suffering with eyelid cancer experience tumour in the lower lid of the eye. People with fair or pale skin are more prone to basal cell carcinoma. 80% of skin cancers arise in the epidermal layers of skin and they are directly related to exposure to sun.
- Sebaceous carcinoma – It is the second most common eyelid cancer. It occurs mostly in middle age to older adults. The glands of eyelids are called as meibomian gland. Meibomian glands discharge a fatty acid secretion that lubricates the eyelids. Sebaceous carcinoma is an aggressive carcinoma occurs on the upper eyelid. Sebaceous carcinoma is usually associated with radiation exposure. Patients suffering with sebaceous carcinoma need to undergo a surgery in severe cases. In few cases it results in the surgical removal of the eye.
- Squamous cell carcinoma – The top layer of the epidermis comprises of squamous cells. Skin cancer usually starts from this epidermal layer. The main cause of squamous cell carcinoma is exposure to sun rays. Squamous cell carcinoma also appears on the burned and damaged skin. The skin is burned and damaged due to exposure to chemicals or x-rays. Squamous cell carcinoma usually spread to the surrounding tissues.
- Melanoma – Melanocytes are the scattered cells present in the deepest layer of epidermis. These melanocytes produce melanin which is responsible for skin colour. Melanocyte carcinoma is also called as melanoma. Melanoma is the most serious type of skin cancer.
Basal cell carcinoma and squamous cell carcinoma can be cured easily in the initial stages, if diagnosed in the earlier stages. Melanoma spread to the other parts of the body.
There are several risk factors of eyelid cancer based on the type of cancer and its severity. Some people show several risk factors, never develops eye lid cancer. Whereas some people with no risk factor will develop cancer.
The following factors can increase the risk of eyelid cancer in patients.
- Exposure to UV radiation – Ultraviolet A (UVA) and ultraviolet B (UVB) both are present in the sun. UVB is responsible for basal cell cancer, squamous cell cancer and melanoma. Ultra violet A radiation penetrates deeper and causes photo aging.
- Fair skin – People with fair and pale coloured skin are at high risk of eyelid cancer. Skin which does not tan, but burns easily due to exposure of sun is also at risk of eyelid cancer.
- Age – Squamous cell cancer is found in people above 50 years of age.
- Gender – Eyelid cancer is found more in men when compared to women. Skin cancer cases in white men have increased in recent years.
- Individual history – Weak immune system is the common risk factor for eyelid cancer. People with low immunity and those who use certain medications are at high risk of basal carcinoma and squamous cell carcinoma.
- Sun burn or fragile skin history – People who experienced burned or injured skin are at high risk of eyelid cancer. Basal and squamous cell carcinoma occurs due to the long term exposure to sun. Melanoma is caused due to short term exposure to sun.
- Precancerous skin condition – Two types of lesions like actinic keratosis and Bowen disease can lead to the squamous cell carcinoma. Actinic keratosis also called as solar keratosis is characterised by rough, red and pink scaly patches on the skin. Bowen disease is characterized by bright pink or red scaly patches located on sun –exposed skin.
- Previous skin cancer – 35-40% of people diagnosed with basal cell cancer are more likely to suffer from a new cancer in 4-5 years of recovery. People with previous cancer history are more prone to eyelid cancer.
Eyelid cancer patients show visible symptoms as the cancer is present on the outer surface of the body. The common symptoms include:
- Swelling of the eye lid
- Thickening of eye lid
- Chronic infection of eyelid
- Ulceration of eyelid
When the visible symptoms appear, it is recommended to consult a doctor at the earliest. Doctors use many tests to diagnose the spread and severity of disease. Biopsy is the common method to diagnose cancer in many patients. Imaging tests are done to diagnose the spread of cancer to other parts of the body. There are certain factors which doctor should keep in mind before choosing any diagnostic test.
- Age Medical condition
- Types of cancer s
- Previous test results
Apart from the basic physical examination, there are few common tests which are done to detect eyelid cancer.
- Computed tomography
- Magnetic resonance imaging
- Positron emission tomography
- Ultra sound
Eyelid cancer can be cured in the initial stages, if diagnosed in the early stages of disease. A multidisciplinary team is required to treat patients with eye lid cancer. A multidisciplinary team comprises of doctors from different fields.
- Surgery – Surgery helps in removal of cancer from the body. In few cases it removes the surrounding tissue. Surgical methods vary depending on the size of the cancer.
- Biopsy – A surgical biopsy helps in either removing the part of the tumour or the complete tumour
- Radiation therapy – High energy X-rays are commonly used to destroy cancer cells. Radiation therapy is used only when the cancer cannot be treated with surgery.
- Chemotherapy – Chemotherapy helps in removal or killing of cancer cells. The cancer cell production is inhibited by stopping the cancer cells ability to grow and divide,
- Removal of eye-The eye is removed in very rare cases.