When a person notices an unusual tumor or “bump” in the eyelids, the first thing they want to know is if the tumor is cancerous. Not every tumor in the eyelids is cancer but eyelid cancer is very common, so a suspicious lesion must be examined by a surgeon or a dermatologist to rule out malignancy. Most types of cancer originate in the skin of the eyelids, not in the muscle, and are primarily caused but sun exposure, specifically UV light rays. This does not refer to recent exposure to ultraviolet light but exposure that happened many decades before the cancer developed. This means that a person that was exposed to UV light in their adolescent years, for example, by spending lots of time on the beach, may develop eyelid skin cancer in their fifties or sixties. Having said that, the important thing is not so much to know what caused the cancer but how to diagnose it and cure it.
How to diagnose eyelid skin cancer
Malignant eyelid tumors have specific characteristics that allow an eyelid surgeon or dermatologist to make a presumptive diagnosis of cancer. The word presumptive is important, here. What it means is that the tumor shows all the typical signs of cancer. However, to make a final diagnosis of cancer, the tumor must be biopsied. That is to say, to make a definitive diagnosis the tumor has to be removed and sent to a pathologist who will look at the specimen under a microscope and will be able to see the malignant cells. Therefore, any tumor that looks suspicious for cancer must be biopsied.
There are two kinds of biopsies: incisional and excisional. In the former, only a part of the tumor is removed and analyzed. The goal here is not to remove the lesion but to make a diagnosis. If the lesion proves to be cancer, the surgeon must decide how much tissue to remove and whether the patient needs to be referred to an oncologist for adjuvant treatment, such as radiotherapy or chemotherapy. In the latter, i.e., excisional biopsy, the whole tumor is removed. This is usually done for smaller and less aggressive tumors. Regardless of the type of biopsy, if the tumor turns out to be cancerous, the surgeon must sit down with the patient to explain the different treatment alternatives so that the patient can decide how to proceed.
Treatment of eyelid cancer
The treatment of malignant eyelid tumors is always surgical. That means that all eyelid cancers must be removed, without exception. For certain types of cancer, the surgical removal of the tumor will be curative. This is true of basal cell carcinoma and Bowen’s disease. On the other hand, malignant melanoma and invasive squamous cell carcinomas may have spread to other organs before they were diagnosed, so removing them will not cure the disease. In these cases, the patient must be referred to an oncologist who will decide the best treatment for the patient. This will usually require chemotherapy or radiotherapy.
Early diagnosis is the best cure
If a malignant tumor is removed before it spreads, a patient has a very high probability of staying cancer-free for the rest of his life. If you have a mass on your eyelid and you are not sure if it is benign, it is wise to have it examined by a specialist. Remember, a small cancer on the eyelid can be removed before it spreads. Therefore, early diagnosis of skin cancer is the best cure!
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