Cancer of the lacrimal gland

Cancer of the lacrimal gland is rare. There are different types of lacrimal gland cancer. Your treatment depends on your type of cancer, and how far it has grown (the stage). Treatment includes surgery, radiotherapy and chemotherapy.

The lacrimal glands

The lacrimal glands are above each eyeball, towards the outer part of the eyelid. The glands produce a fluid that cleans and protects the surface of the eyelid. Tears are part of this fluid. 

A growth or tumour in this area can be cancerous (malignant) or non cancerous (benign).

Risks and causes

Lacrimal gland cancer is a rare cancer, and not much is known about the possible cause. Research in this area involves small numbers of people and this makes it hard to find a common link.

We do know that lacrimal gland cancers can develop at any age. There are different types of lacrimal gland cancer. The average age of diagnosis depends on the type of lacrimal gland cancer.

For a type called adenoid cystic carcinoma, the average age of diagnosis, is around 40 years.

Another type is lymphoma of the lacrimal gland. This is more likely to be diagnosed in people around the age of 70 years. Lymphoma is a cancer of the lymphatic system. 

Symptoms

Many of the symptoms are similar to those of other eye cancers. The following are symptoms that you may notice in lacrimal gland cancer:

• a swelling or bulging of the eye

• watery eyes

• a lump around the area of the lacrimal gland (towards the outer part of the eyelids)

• problems with your eyesight, such as double or blurred vision

• pain around one eye

Do see your doctor or optician if you have any of these symptoms. Lacrimal gland cancer is rare and it’s likely that your symptoms could be due to something else. But it’s a good idea to get checked out.

Tests to diagnose lacrimal gland cancer

Tests for lacrimal gland cancer are the same for other eye cancers and may include: 

• eye examination

• MRI scan

• CT scan

• a sample of tissue (biopsy)

Types of lacrimal gland cancer

There are different types of lacrimal gland cancer. Some growths (or tumours) of the lacrimal gland are not cancerous.

Non cancerous (benign) tumours can sometimes transform into a cancer. So you usually have an operation to remove the tumour. Treatment can also reduce or get rid of any symptoms.

There are many different sub types of cancerous tumours (lacrimal gland cancer). Below are some examples:

Adenoid cystic carcinoma

Adenoid cystic carcinoma is the most common type of lacrimal gland cancer. It starts in the gland cells that line many parts of the body, including the lacrimal glands.

Carcinoma ex PA or pleomorphic adenocarcinoma

Carcinoma ex PA or pleomorphic adenocarcinoma is a less common type of lacrimal gland cancer. It starts as a non cancerous (benign) tumour and becomes cancerous.

Lymphoma

Lymphoma is a type of blood cancer that affects the lymphatic system. Different types of lymphoma can develop in the lacrimal gland.

Who treats lacrimal gland cancer?

A team of specialists in an eye centre usually look after you. Your multidisciplinary team (MDT) could include:

• an eye specialist (ophthalmologist)
• a surgeon 
• a cancer specialist (oncologist).

Treatment for lacrimal gland cancer

Your eye specialist will recommend the best treatment for you. The decision depends on:

• the type of lacrimal eye cancer and where it is in the eye
• the size of your tumour and how far it has grown or spread (the stage)
• your general health and level of fitness 

You might have one, or a combination of the following treatments.

Surgery

The treatment for most types of lacrimal gland cancers is surgery to remove the gland. But doctors don't usually offer surgery to people with lymphoma. They use chemotherapy and radiotherapy instead.

Your specialist might recommend that they remove the whole of your eyeball and surrounding skin. They recommend this for cancers that have spread outside the lacrimal gland affecting the eyeball, and the skin and muscle around it. This is called an orbital exenteration.

It can come as quite a shock if you need to have eye surgery. You will need time to come to terms with this change. Your specialist will explain your operation and what this means for you. 

Radiotherapy

You might have radiotherapy on its own, or in combination with surgery or chemotherapy. You usually have external radiotherapy.

Chemotherapy

You might have chemotherapy on its own. Or you may have it together with radiotherapy (chemoradiotherapy) for lymphoma.

There are different types of chemotherapy drugs. For lymphoma of the lacrimal gland, your chemotherapy treatment depends on a number of factors. These include the type of lymphoma you have.

Coping

Eye cancer can affect you physically and practically, as well as emotionally. Being diagnosed with a rare type of cancer can also be difficult because it can be hard to find information. And you may not meet anyone else with your type of cancer. 

Your specialist team is your best source of information. Do ask questions if you’re not sure about anything.

Our discussion forum Cancer Chat is a place for anyone affected by cancer. You can share experiences, stories and information with other people who know what you are going through.

There is support and advice available to help you cope with eye cancer and its treatment.