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  • Chris Thiagarajah MD

Common Eyelid Cancer Questions Patients have



Often when patients think or are told that they have eyelid cancer they have many questions. We often associate cancer with death. The good news is that for the vast majority of eyelid cancer, that is not the case. That being said, for any patient it is a concerning issue and is something that brings a plethora of questions. This blog article is meant to answer questions about eyelid cancer in Denver.

Why did I get eyelid cancer?

Eyelid cancer (most commonly basal cell carcinoma, squamous cell carcinoma and melanoma) are related to two things: genetics and environmental exposure. We know that sunlight and smoking contribute to eyelid cancer development. Having more sun and more smoking are risk factors for cancer development. Secondly, a patient’s individual risk for eyelid skin cancer is based on their genetic makeup. I have had patients who have eyelid cancer and are only 22 years old. This is most likely due to the fact that their genetics predispose them to eyelid skin cancer.

As the skin cells of the eyelid divide and grow over time. Sometimes as the cells divide they have mutate into cancer cells. Often these cancer cells are destroyed but sometimes they slip through the immune system. Sun exposure increase skin cell mutations. Smoking increases mutations and also decreases the ability of the immune system to destroy cancer cells once they show up. Some patients genetics increase the risk of having more cells that are more easily converted into cancer cells.

If I get the eyelid cancer removed can it come back?

It is very unlikely the eyelid cancer can come back. Regrowth of an eyelid cancer occurs less than 1% of the time. Mohs surgery with reconstruction by an eyelid (oculoplastic surgeon) is usually the best method to reduce recurrence.

If I have eyelid cancer and it is removed, will I be deformed?

The purpose of having an oculoplastic surgeon reconstruct your eyelid after skin cancer is removed, is to reduce the risk of deformity, loss of function of the eyelid or damage to the tear duct. This is critical to optimize the appearance of the eyelid. Most patients do not want to be deformed after eyelid reconstruction for an eyelid skin cancer and an oculoplastic surgeon is the best way to reduce the risk of this. Additionally, oculoplastic surgeons are well versed in the function of the eyelid to make sure it is properly protecting the eye and lubricating it. Of course, if a patient has eyelid cancer that engulfs the entire eyelid or eye socket, it may be more challenging for everything to look “completely normal” after reconstruction but most oculoplastic surgeons can make things look pretty darn good. Since it is their area of expertise it is likely that there is no other specialty that can optimize ones appearance after eyelid cancer removal.

Why do I need to be asleep for reconstruction of my eyelid cancer?

Eyelid cancer reconstruction can have discomfort and pain because the surgery is often more involved than removing the cancer. As a result, when a patient is sedated, it can be much more comfortable to have the eyelid reconstructed than when the patient is awake.

Is eyelid cancer reconstruction covered by insurance?

Eyelid cancer reconstruction is covered by insurance. It is not considered cosmetic surgery. That being said, what a patient needs to pay depends on their individual plan and deductible. It ultimately the responsibility of the patient to know their plan and what they are responsible for. In short, this is not cosmetic surgery but you may have to pay something depending on the type of insurance plan you have.

Do patients with eyelid cancer die?

That is extremely unlikely for basal cell or squamous cell carcinoma. Melanoma carries a risk of spread to the rest of the body and death. It is critical to have an oncologist on board for melanoma patients to check for spread of cancer. Melanoma of the eyelid should be managed by a team of doctors: Oculoplastic surgeon, dermatologists and oncologist.

What if l leave the eyelid cancer alone. Will it go away?

Absolutely not. It will continue to grow and most likely spread. I often explain to patients that eyelid cancer is like a parking ticket. A parking ticket will only double and triple if unpaid. Eyelid cancer will only grow and expand. It should be treated.

If I think I have eyelid cancer, what should I do?

You need to see an oculoplastic surgeon and get a biopsy so it should be checked. If you had a biopsy already and know you have eyelid cancer, you need to get treatment. I have removed the eye and eye socket from patients who have neglected to treat a small eyelid cancer that has grown into their eye socket. That was completely preventable with early treatment.


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