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Lacrimal Gland Tumor - Overview

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will find some basic information about this disease and the parts of the body it may affect. This is the first page of Cancer.Net’s Guide to Lacrimal Gland Tumor. To see other pages, use the menu on the side of your screen. Think of that menu as a roadmap to this full guide.

What is a lacrimal gland tumor?

The lacrimal glands are the glands that secrete tears and are located above and to the side of the eye. When lacrimal gland cells change and grow uncontrollably, they form a mass called a tumor. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.

Types of Lacrimal Gland Tumor

There are different types of tumors that can start in the lacrimal gland. It is important for the doctor to find out which type it is, since this will affect the treatment plan. Types include:

  • Benign mixed epithelial tumor. A benign mixed epithelial tumor is a noncancerous tumor that does not spread to other parts of the body but will continue to grow if not treated. This type of tumor begins in the cells that line the lacrimal gland.

  • Malignant mixed epithelial tumor. A malignant mixed epithelial tumor also begins in the cells that line the lacrimal gland. If it is not treated, it will spread to other parts of the body.

  • Lymphoma. Lymphoma can involve various structures of the eye. However, the conjunctiva and lacrimal glands are the most common. The conjunctiva is the mucous membrane lining the inner surfaces of the eyelids and the outer surface of the white of the eye.  Most eye-related lymphoma is non-Hodgkin lymphoma, and may be associated with systemic (whole body) or central nervous system (brain and spinal cord) lymphoma.

  • Adenoid cystic carcinoma (AdCC) of the lacrimal gland. AdCC is a rare form of adenocarcinoma, which is a broad term covering any cancer arising from glandular tissues. An AdCC tumor is characterized by a distinctive pattern, in which bundles of epithelial cells surround and/or infiltrate ducts or glandular structures within an organ. When an AdCC tumor of the lacrimal gland grows, it commonly pushes the eye forward and causes it to bulge. This condition is called proptosis. Another characteristic is pain caused by the tumor affecting local nerves.

The next section in this guide is Statistics and it helps explain how many people are diagnosed with this disease and general survival rates. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Lacrimal Gland Tumor - Statistics

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will find information about how many are diagnosed with this type of cancer each year. You will also learn some general information on surviving the disease. Remember, survival rates depend on several factors. To see other pages, use the menu on the side of your screen.

In general, a lacrimal gland tumor is rare. About half of lacrimal gland tumors are benign, and half are malignant. Malignant epithelial tumors of the lacrimal gland account for 2% of all orbital (eye socket) tumors. Adenoid cystic carcinoma (AdCC) is the most frequent epithelial orbital cancer, accounting for approximately 50% of malignant lacrimal gland tumors and 25% of all lacrimal gland tumors.

Survival rates depend on several factors, including the type and subtype of lacrimal gland tumor. The 5-year survival rate tells you what percent of people live at least 5 years after the cancer is found. Percent means how many out of 100. The 5-year survival rate of people with AdCC is estimated to be 50%, while the 15-year survival rate is estimated to be 25%. However, this and other survival rates depend on several factors, including the type of lacrimal gland tumor and stage of disease. Talk with your doctor about what to expect with your specific diagnosis.

It is important to remember that statistics on how many people survive this type of tumor are an estimate. The estimate comes from data based on people with a lacrimal gland tumor in the United States each year. So, your own risk may be different. Doctors cannot say for sure how long anyone will live with a lacrimal gland tumor. Also, experts measure the survival statistics every 5 years. This means that the estimate may not show the results of better diagnosis or treatment available for less than 5 years. Learn more about understanding statistics.

Source: DeAngelis, Dan, MD, FRCS, "Lacrimal Gland Tumors," http://reference.medscape.com/article/1210619-overview (April 2015.)

The next section in this guide is Risk Factors. It explains what factors may increase the chance of developing this disease. Or, use the menu to choose another section to continue reading this guide. 

Lacrimal Gland Tumor - Risk Factors

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will find out more about the factors that increase the chance of developing this type of cancer. To see other pages, use the menu on the side of your screen.

A risk factor is anything that increases a person’s chance of developing a tumor. Although risk factors often influence the development of a tumor, most do not directly cause a tumor. Some people with several risk factors never develop the tumor, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The following factors may raise a person’s risk of developing a lacrimal gland tumor:

  • Age. A lacrimal gland tumor occurs more frequently in people in their 30s.

  • A history of lymphoma. People who have a history of lymphoma are at higher risk for developing a periocular (around the eye) lymphoma.

  • Incomplete removal of a previous benign tumor. In some instances, if a noncancerous lacrimal gland tumor was not completely removed, there is a higher risk of a malignant lacrimal gland tumor occurring. Therefore, a careful evaluation after surgery is recommended for people having this type of surgery.

The next section in this guide is Symptoms and Signs and it explains what body changes or medical problems this disease can cause. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Lacrimal Gland Tumor - Symptoms and Signs

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will find out more about body changes and other things that can signal a problem that may need medical care. To see other pages, use the menu on the side of your screen.

People with a lacrimal gland tumor may experience the following symptoms or signs. Sometimes people with a lacrimal gland tumor do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not a tumor.

  • Vision problems, such as blurry vision
  • Pain in or around the eye
  • A fullness of the eyelid, or a mass that can be felt on the eyelid
  • Swelling around the eye
  • Double vision

If you are concerned about one or more of the symptoms or signs on this list, please talk with your ophthalmologist. An ophthalmologist is a medical doctor who specializes in eye care. Your doctor will ask how long and how often you’ve has been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.

If a tumor is diagnosed, relieving symptoms remains an important part of your medical care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.

The next section in this guide is Diagnosis and it explains what tests may be needed to learn more about the cause of the symptoms. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Lacrimal Gland Tumor - Diagnosis

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will find a list of the common tests, procedures, and scans that doctors can use to find out what’s wrong and identify the cause of the problem. To see other pages, use the menu on the side of your screen.

Doctors use many tests to diagnose a tumor and find out if it is cancerous, and if so, if it has spread to another part of the body, called metastasis. Some tests may also determine which treatments may be the most effective. For most types of tumors, a biopsy is the only way to make a definitive diagnosis of cancer.

If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has spread.

Your doctor may consider these factors when choosing a diagnostic test:

  • Age and medical condition

  • Type of tumor suspected

  • Signs and symptoms

  • Previous test results

In addition to a physical examination, the following tests may be used to diagnose a lacrimal gland tumor. Not all tests listed will be used for every person.

  • Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample removed during the biopsy is analyzed by a pathologist. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.

    The type of biopsy performed depends on the location of the tumor. In an incisional biopsy, the surgeon cuts into the tumor and removes a sample of tissue. In an excisional biopsy, used more commonly for benign mixed epithelial tumors, the surgeon removes the entire tumor. A fine needle biopsy removes a small amount of tissue for examination under a microscope by inserting a needle directly into the tumor to extract cells. The use of fine needle biopsy for a lacrimal gland tumor is controversial. Talk with your doctor for more information.

  • Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein or given as a pill to swallow.

  • Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow.

  • Positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into the patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body.

  • Bone scan. A bone scan uses a radioactive tracer to look at the inside of the bones. The tracer is injected into a patient’s vein. It collects in areas of the bone and is detected by a special camera. Healthy bone appears gray to the camera, and areas of injury, such as those caused by a tumor, appear dark.

After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is a cancerous lacrimal gland tumor, these results also help the doctor describe the cancer; this is called staging.

The next section in this guide is Stages and Grades, and it explains the system doctors use to describe the extent of the disease. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Lacrimal Gland Tumor - Stages and Grades

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. This section also covers grading which describes the composition of cells. To see other pages, use the menu on the side of your screen.

Staging is a way of describing where a tumor is located, whether it is cancerous, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to find out the tumor’s stage, so staging may not be complete until all the tests are finished.

Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis, which is the chance of recovery. There are different stage descriptions for different types of tumors.

The staging below describes lacrimal gland carcinomas. For more information on the staging of ocular non-Hodgkin lymphoma, see the Guide to Non-Hodgkin Lymphoma.

TNM staging system

One tool that doctors use to describe the stage is the TNM system. Doctors use the results from diagnostic tests and scans to answer these questions:

  • Tumor (T): How large is the primary tumor? Where is it located?

  • Node (N): Has the tumor spread to the lymph nodes? If so, where and how many?

  • Metastasis (M): Has the cancer metastasized to other parts of the body? If so, where and how much?

The results are combined to determine the stage of cancer for each person. There are five stages: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.

Here are more details on each part of the TNM system for lacrimal gland cancer:

Tumor (T)

Using the TNM system, the "T" plus a letter and/or number (0 to 4) is used to describe the size and location of the tumor. Some stages are also divided into smaller groups that help describe the tumor in even more detail. Specific tumor stage information is listed below:

TX: The primary tumor cannot be evaluated.

T0 (T plus zero): There is no tumor.

T1: The tumor is 2 centimeters (cm) or smaller and may or may not extend outside of the lacrimal gland to the orbital soft tissue.

T2: The tumor is between 2 cm and 4 cm and likely extends to the orbital soft tissue.

T3: The tumor is greater than 4 cm and likely extends to the orbital soft tissue.

T4: The tumor has invaded the periosteum (the membrane of connective tissue that covers the bone) or the orbital bone.

T4a: The tumor has invaded the periosteum.

T4b: The tumor has invaded the orbital bone.

T4c: The tumor has extended beyond the orbit to adjacent structures, including the brain and sinuses.

Node (N)

The “N” in the TNM staging system stands for lymph nodes, the tiny, bean-shaped organs that help fight infection. Lymph nodes near the lacrimal gland are called regional lymph nodes. Lymph nodes in other parts of the body are called distant lymph nodes.

NX: The regional lymph nodes cannot be evaluated.

N0 (N plus zero): There is no regional lymph node metastasis.

N1: There is regional lymph node metastasis.

Metastasis (M)

The “M” in the TNM system indicates whether the cancer has spread from the lacrimal glands to other parts of the body, called distant metastasis.  

MX: Distant metastasis cannot be evaluated.

M0 (M plus zero): There is no distant metastasis.

M1: There is metastasis to other parts of the body.

Grade (G)

Doctors also describe this type of cancer by its grade (G), which describes how much cancer cells look like healthy cells when viewed under a microscope. The doctor compares the cancerous tissue with healthy tissue. Healthy tissue usually contains many different types of cells grouped together.

If the cancer looks similar to healthy tissue and contains different cell groupings, it is called differentiated or a low-grade tumor. If the cancerous tissue looks very different from healthy tissue, it is called poorly differentiated or a high-grade tumor.

The cancer’s grade may help the doctor predict how quickly the cancer will spread. In general, the lower the tumor’s grade, the better the prognosis.

GX: The tumor grade cannot be identified.

G1: Describes cells that look more like healthy tissue cells (well differentiated).

G2: The cells are somewhat different (moderately differentiated).

G3: The tumor cells look very much alike (poorly differentiated).

G4: The cells barely resemble normal cells (undifferentiated).

Recurrent: Recurrent cancer is cancer that has come back after treatment. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.

Used with permission of the AJCC, Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Seventh Edition, published by Springer-Verlag New York, www.cancerstaging.org. Please note that AJCC’s Eighth Edition (2017) has been released; related changes to the information provided above are underway. Please check back soon for updated staging definitions or talk with your doctor about whether these changes affect your diagnosis.

Information about the cancer’s stage will help the doctor recommend a specific treatment plan. The next section in this guide is Treatment Options. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Lacrimal Gland Tumor - Treatment Options

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will learn about the different ways doctors use to treat people with this type of tumor. To see other pages, use the menu on the side of your screen.

This section outlines treatments that are the standard of care (the best known treatments available) for this specific type of tumor. When making treatment plan decisions, patients are also encouraged to consider clinical trials as an option.

A clinical trial is a research study to test a new approach to treatment to evaluate whether it is safe, effective, and possibly better than the standard treatment. Clinical trials may test such approaches as a new drug, a new combination of standard treatments, or new doses of current therapies. Your doctor can help you review all treatment options.

For more information, see the About Clinical Trials section and Latest Research sections.

Treatment overview

For this type of tumor, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. For example, patients who receive radiation therapy to the eye may need to also talk with an ophthalmologist or plastic surgeon to make sure the eye can still function after treatment. This team may also include a variety of other health care professionals, including physician assistants, oncology nurses, social workers, pharmacists, counselors, dietitians, and others.

Patients should have a sense that their doctors have a coordinated plan of care and are communicating effectively with one another. If patients do not feel that the team is communicating effectively with them or each other about the goals of treatment and the plan of care, patients should discuss this with their doctors or get additional opinions before treatment.

Descriptions of the most common treatment options for lacrimal gland tumor are listed below. Goals of treatment include complete removal of the tumor, as well as maintaining the health and vision of the patient’s eye(s).

Treatment options and recommendations depend on several factors, including:

  • The type and stage of tumor

  • Possible side effects

  • Whether one or both eyes are involved

  • Whether the tumor is cancerous

  • The patient’s preferences

  • The patient’s overall health

Your care plan may also include treatment for symptoms and side effects, an important part of your care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.

Surgery

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. Surgery to the eye is common in the treatment of a lacrimal gland tumor. During surgery, the ophthalmologist will remove parts of the affected eye. Or, if necessary, the entire eye (called enucleation; see below) will be removed, depending on the size and spread of the tumor.

Possible side effects of eye surgery are similar to that of any surgery. They include a risk of infection, problems with anesthesia (medication used during surgery to block awareness of pain), and pain.

Learn more about the basics of cancer surgery.

Having an eye removed

Sometimes it is medically necessary to remove the eye. Because of this visual loss, a person with one eye may have trouble with depth perception. Most people adjust to these differences, which support from the health care team.

Many people worry about what they will look like when they have an eye removed. The cosmetic surgery available today usually yields good cosmetic results. To fill the area left by the missing eye, the person is fitted for a prosthesis, which is an artificial eye. The prosthesis will look and behave almost the same as a natural eye. For example, the artificial eye will move along with the person’s remaining eye, just not as much as a natural eye moves. Family members may be able to tell that the eye is not real, but it is unlikely that strangers will know.

If enucleation is required, talk with your doctor about a prosthesis. It may take many weeks for you to receive one. Also, ask about support services that may be available to you to help adjust to the loss of an eye. Learn more about rehabilitation.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to destroy cancer cells. It is most often used for lacrimal gland lymphoma. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a specific time.

There are different types of radiation therapy, including:

  • External-beam radiation therapy. The most common type of radiation, external-beam radiation therapy is given from a machine outside the body.

  • Proton therapy. Also called proton-beam therapy, this is a type of external-beam radiation therapy that uses protons rather than x-rays. At high energy, protons can destroy cancer cells.

  • Intensity modulated radiation therapy (IMRT). IMRT is another way to deliver external-beam radiation therapy. The intensity is varied to more precisely target the tumor. As a result, IMRT damages less surrounding healthy tissue than is possible with traditional radiation treatment. IMRT may also reduce the damage to nearby important organs.

The dosage of radiation used and the site and type of the tumor significantly affect the risks of side effects. Common side effect of radiation therapy to the eye area include:

  • Cataracts. A cataract is when the lens of the eye becomes cloudy. People with cataracts may have cloudy or foggy vision, have trouble seeing at night, and/or have problems with glare from the sun or bright lights. If the cataract is causing major problems with a person's eyesight, the cataract can be surgically removed.

  • Loss of eyelashes and/or a dry eye. These side effects can occur with external-beam radiation therapy and proton-beam radiation therapy.

The following side effects are less common and can cause a loss of vision:

  • Radiation retinopathy: The development of abnormal blood vessels in the retina

  • Radiation optic neuropathy: Optic nerve damage

  • Neovascular glaucoma: A painful condition where new blood vessels develop and block the outflow of fluid from the eye

If there is significant damage to the eye from radiation therapy, the eye may need to be removed (see above). Other side effects from radiation therapy may include fatigue, mild skin reactions, upset stomach, or loose bowel movements. Most of these side effects go away soon after treatment is finished. Talk with your doctor about the risks and benefits of the different types of radiation therapy. Learn more about the basics of radiation therapy.

Chemotherapy

Chemotherapy is the use of drugs to destroy tumor cells, usually by stopping the cancer cells’ ability to grow and divide. Chemotherapy is given by a medical oncologist, a doctor who specializes in treating a tumor with medication.

Systemic chemotherapy gets into the bloodstream to reach tumor cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed. For a lacrimal gland tumor, chemotherapy may also be delivered through the blood vessel (intra-arterial) feeding the eye and the tumor by inserting a catheter in the groin area. The doctor guides the catheter into position with the help of imaging technology to reach the blood vessel in the head.

A chemotherapy regimen (schedule) usually consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time.

The side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, or diarrhea. These side effects usually go away once treatment is finished.

Learn more about the basics of chemotherapy and preparing for treatment. The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions by using searchable drug databases.

Immunotherapy

Immunotherapy, also called biologic therapy, is designed to boost the body's natural defenses to fight the tumor. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function.

Rituximab (Rituxan) is the most common immunotherapy used in the treatment of a lacrimal gland tumor. It is also used for the treatment of non-Hodgkin lymphoma.

Learn more about the basics of immunotherapy.

Treatment by type of lacrimal gland tumor

Below is an outline of the common treatments used depending on the type and stage of the lacrimal gland tumor. In addition to standard treatments, patients are encouraged to talk with their doctors about clinical trials that are open to them, no matter the type or stage of the tumor.

  • Benign mixed epithelial tumor. The most common type of treatment for a benign mixed epithelial tumor is an excisional biopsy, where the tumor is removed surgically (see Diagnosis). The prognosis is more favorable if the tumor is completely removed.

  • Malignant mixed epithelial tumor. The most common treatment for a malignant mixed epithelial lacrimal gland tumor is the complete surgical removal of the tumor.

  • Lymphoma. Lymphoma may be treated with external-beam radiation therapy, chemotherapy, immunotherapy, or a combination of these treatments. The chance of recovering from a lymphoma of the lacrimal gland is higher if only one eye is affected. The specific treatment for ocular lymphoma depends on whether other parts of the body are affected, so it is important to know the stage of the lymphoma.

  • AdCC of the lacrimal gland. AdCC is an aggressive form of cancer, and the most common type of treatment for AdCC is a procedure called exenteration. In this procedure, the surgeon removes the lacrimal gland, eyeball, muscles, and all orbital contents and adjacent bone. A combination of chemotherapy and radiation therapy may also be used as part of the treatment plan. Treatment is most successful when the cancer has not spread. More details about AdCC treatment options can be found here.

Getting care for symptoms and side effects

A tumor and its treatment often cause side effects. In addition to treatment to slow, stop, or eliminate the tumor, an important part of care is relieving a person’s symptoms and side effects. This approach is called palliative or supportive care, and it includes supporting the patient with his or her physical, emotional, and social needs.

Palliative care is any treatment that focuses on reducing symptoms, improving quality of life, and supporting patients and their families. Any person, regardless of age or type and stage of tumor, may receive palliative care. It works best when palliative care is started as early as needed in the cancer treatment process.

People often receive treatment for the tumor and treatment to ease side effects at the same time. In fact, patients who receive both often have less severe symptoms, better quality of life, and report they are more satisfied with treatment. Palliative care can also help if treatment involves changes to your face to help you find emotional support to cope with such changes to your appearance.

Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional support, and other therapies. You may also receive palliative treatments similar to those meant to eliminate the cancer, such as chemotherapy, surgery, or radiation therapy. Talk with your doctor about the goals of each treatment in the treatment plan.

Before treatment begins, talk with your health care team about the possible side effects of your specific treatment plan and palliative care options. And during and after treatment, be sure to tell your doctor or another health care team member if you are experiencing a problem so it can be addressed as quickly as possible.

Learn more about palliative care

Metastatic lacrimal gland tumor

If a tumor has spread to another location in the body, it is called metastatic lacrimal gland cancer. Patients with this diagnosis are encouraged to talk with doctors who are experienced in treating this stage of cancer, because there can be different opinions about the best treatment plan. Learn more about getting a second opinion before starting treatment, so you are comfortable with the treatment plan chosen. This discussion may include clinical trials.

Your health care team may recommend a treatment plan that includes a combination of surgery, radiation therapy, immunotherapy, and chemotherapy. Palliative care will also be important to help relieve symptoms and side effects.

For most patients, a diagnosis of metastatic cancer is very stressful and, at times, difficult to bear. Patients and their families are encouraged to talk about the way they are feeling with doctors, nurses, social workers, or other members of the health care team. It may also be helpful to talk with other patients, including through a support group.

Remission and the chance of recurrence

A remission is when a tumor cannot be detected in the body and there are no symptoms. This may also be called having “no evidence of disease” or NED.

A remission may be temporary or permanent. This uncertainty causes many people to worry that the tumor will come back. While many remissions are permanent, it’s important to talk with your doctor about the possibility of the tumor returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the tumor does return. Learn more about about coping with the fear of recurrence.

If the tumor does return after the original treatment, it is called a recurrent lacrimal gland tumor. It may come back in the same place (called a local recurrence), nearby (regional recurrence), or in another place (distant recurrence).

When this occurs, a cycle of testing will begin again to learn as much as possible about the recurrence. After testing is done, you and your doctor will talk about your treatment options. Often the treatment plan will include the treatments described above such as surgery, chemotherapy, and radiation therapy. However, they may be used in a different combination or given at a different pace. Usually, surgery is the first option for treating a recurrence if it hasn’t been done already.

If there is no standard drug available, your doctor may suggest participation in a clinical trial, including a phase I clinical trial . This phase is where new drugs are tested to find out the safety and effective dose of the drug, although not necessarily whether the drug is effective for treating this type of tumor. Learn more about the phases of clinical trials.

Whichever treatment plan you choose, palliative care will be important for relieving symptoms and side effects.

People with a recurrent tumor often experience emotions such as disbelief or fear. Patients are encouraged to talk with their health care team about these feelings and ask about support services to help them cope. Learn more about dealing with recurrence.

If treatment fails

Recovery from a lacrimal gland tumor is not always possible. If the tumor cannot be cured or controlled, the disease may be called advanced or terminal.

This diagnosis is stressful, and it is difficult to discuss for many people. However, it is important to have open and honest conversations with your doctor and health care team to express your feelings, preferences, and concerns. The health care team is there to help, and many team members have special skills, experience, and knowledge to support patients and their families. Making sure a person is physically comfortable and free from pain is extremely important.

Patients who have an advanced tumor and who are expected to live less than six months may want to consider a type of palliative care called hospice care. Hospice care is designed to provide the best possible quality of life for people who are near the end of life. 

You and your family are encouraged to think about where you would be most comfortable: at home, in the hospital, or in a hospice environment. Nursing care and special equipment can make staying at home a workable alternative for many families. Learn more about advanced cancer care planning.

After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.

The next section in this guide is About Clinical Trials and it offers more information about research studies that are focused on finding better ways to care for people with a tumor. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Lacrimal Gland Tumor - About Clinical Trials

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will learn more about clinical trials, which are the main way that new medical approaches are tested to see how well they work. To see other pages, use the menu on the side of your screen.

What are clinical trials?

Doctors and scientists are always looking for better ways to care for patients with a lacrimal gland tumor. To make scientific advances, doctors create research studies involving volunteers, called clinical trials. In fact, every drug that is now approved by the U.S. Food and Drug Administration (FDA) was previously tested in clinical trials.

Many clinical trials are focused on new treatments, evaluating whether a new treatment is safe, effective, and possibly better than the current (standard) treatment. These types of studies evaluate new drugs, different combinations of existing treatments, new approaches to radiation therapy or surgery, and new methods of treatment. Patients who participate in clinical trials are often among the first to receive new treatments before they are widely available. However, there is no guarantee that the new treatment will be safe, effective, or better than a standard treatment.  

There are also clinical trials that study new ways to ease symptoms and side effects during treatment and managing the late effects that may occur after treatment. Talk with your doctor about clinical trials regarding side effects. In addition, there are ongoing studies about ways to prevent the disease.

Deciding to join a clinical trial

Patients decide to participate in clinical trials for many reasons. For some patients, a clinical trial is the best treatment option available. Because standard treatments are not perfect, patients are often willing to face the added uncertainty of a clinical trial in the hope of a better result.

Other patients volunteer for clinical trials because they know that these studies are the only way to make progress in treating lacrimal gland tumors. Even if they do not benefit directly from the clinical trial, their participation may benefit future patients with lacrimal gland tumor.

Sometimes people have concerns that, in a clinical trial, they may receive no treatment by being given a placebo or a “sugar pill.” However, placebos are usually combined with standard treatment in most cancer clinical trials. When a placebo is used in a study, it is done with the full knowledge of the participants. Find out more about placebos in cancer clinical trials.

Patient safety and informed consent

To join a clinical trial, patients must participate in a process known as informed consent. During informed consent, the doctor should list all of the patient’s options so that the person understands how the new treatment differs from the standard treatment. The doctor must also list all of the risks of the new treatment, which may or may not be different from the risks of standard treatment. Finally, the doctor must explain what will be required of each patient in order to participate in the clinical trial, including the number of doctor visits, tests, and the schedule of treatment.

Patients who participate in a clinical trial may stop participating at any time for any personal or medical reason. This may include that the new treatment is not working or there are serious side effects.

Clinical trials are also closely monitored by experts who watch for any problems with each study. It is important that patients participating in a clinical trial talk with their doctor and researchers about who will be providing their treatment and care during the clinical trial, after the clinical trials ends, and/or if the patient chooses to leave the clinical trial before it ends. 

Finding a clinical trial

Research through clinical trials is ongoing for all types of tumors. For specific topics being studied for a lacrimal gland tumor, learn more in the Latest Research section.

Cancer.Net offers a lot of information about clinical trials in other areas of the website, including a complete section on clinical trials and places to search for clinical trials for a specific type of cancer.

In addition, this website offers free access to a video-based educational program about cancer clinical trials, located outside of this guide.

The next section in this guide is Latest Research and it explains areas of scientific research currently going on for this type of cancer. Or, use the menu on the side of your screen to choose another section to continue reading this guide.    

Lacrimal Gland Tumor - Latest Research

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will read about the scientific research being done now to learn more about this type of tumor and how to treat it. To see other pages, use the menu on the side of your screen.

Doctors are working to learn more about lacrimal gland tumors, ways to prevent them, how to best treat them, and how to provide the best care to people diagnosed with this disease. The following areas of research may include new options for patients through clinical trials. Always talk with your doctor about the diagnostic and treatment options best for you.

  • Radioimmunotherapy. Radioimmunotherapy is a treatment that combines the effectiveness of radiation therapy with immunotherapy. A radioactive material is attached to a protein that identifies the tumor cells as targets. Then, a monoclonal antibody carries the radiation to the target cells. The radioactivity kills the cells with which it comes in contact. The most common form of radioimmunotherapy that is being researched is ibritumomab tiuxetan (Zevalin), which is used in the treatment of lymphoma.

  • Improved radiation therapy. Many hospitals and cancer centers offer methods that better focus radiation therapy to the tumor, helping reduce damage to the rest of the eye. One of these methods, called intensity-modulated proton therapy (IMPT), is being used for some types of eye cancer.

  • Chemotherapy. Researchers continue to explore new drugs and combinations of drugs that may benefit people with a lacrimal gland tumor.

  • Palliative care. Clinical trials are underway to find better ways of reducing symptoms and side effects of current lacrimal gland tumor treatments in order to improve patients’ comfort and quality of life.

Looking for More About the Latest Research?

If you would like additional information about the latest areas of research regarding a lacrimal gland tumor, explore these related items that take you outside of this guide:

The next section in this guide is Coping with Side Effects and it offers some guidance in how to cope with the physical, emotional, and social changes that a tumor and its treatment can bring. Or, use the menu on the side of your screen to choose another section to continue reading this guide. 

Lacrimal Gland Tumor - Coping with Side Effects

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will find out more about steps to take to help cope with physical, social, and emotional side effects. This page includes several links outside of this guide to other sections of this website. To see other pages, use the menu on the side of your screen.

Fear of treatment side effects is common after a diagnosis of a lacrimal gland tumor, but it may help to know that preventing and controlling side effects is a major focus of your health care team. This is called palliative care, and it is an important part of the overall treatment plan, regardless of the stage of disease.

There are possible side effects for every treatment, but patients don’t experience the same side effects when given the same treatments for many reasons. That can make it hard to predict exactly how you will feel during treatment. 

Common side effects from each treatment option for a lacrimal gland tumor are described in detail within the Treatment Options section. Learn more about the most common side effects of a tumor and different treatments, along with ways to prevent or control them. Side effects depend on a variety of factors, including the tumor’s stage, the length and dosage of treatment(s), and your overall health.

Talking with your health care team about side effects

Before treatment begins, talk with your doctor about possible side effects of each type of treatment you will be receiving. Ask which side effects are most likely to happen, when they are likely to occur, and what can be done to prevent or relieve them.

For lacrimal gland tumor, treatment sometimes changes or alters the way you look. It’s important to talk with your health care team about changes with your self-image or body image. This is a natural reaction, and many people need help coping with these changes.

And, ask about the level of caregiving you may need during treatment and recovery, as family members and friends often play an important role in the care of a person with a lacrimal gland tumor. Learn more about caregiving.

In addition to physical side effects, there may be emotional and social effects as well. Patients and their families are encouraged to share their feelings with a member of their health care team who can help with coping strategies, including concerns about managing the cost of your cancer care

During and after treatment, be sure to tell the health care team about the side effects you experience, even if you feel they are not serious. Sometimes, side effects can last beyond the treatment period, called a long-term side effect. A side effect that occurs months or years after treatment is called a late effect.

Treatment of both types of effects is an important part of survivorship care. Learn more by reading the Follow-up Care section of this guide or talking with your doctor.

The next section in this guide is Follow-up Care and it explains the importance of check-ups after cancer treatment is finished. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Lacrimal Gland Tumor - Follow-Up Care

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will read about your medical care after treatment for the tumor is completed, and why this follow-up care is important. To see other pages, use the menu on the side of your screen.

Care for people diagnosed with a lacrimal gland tumor doesn’t end when active treatment has finished. Your health care team will continue to check to make sure the tumor has not returned, manage any side effects, and monitor your overall health. This is called follow-up care.

This plan may include regular physical examinations and/or medical tests to monitor your recovery for the coming months and years. Learn more about the importance of follow-up care.

Watching for recurrence

One goal of follow-up care is to check for a recurrence. A tumor recurs because small areas of tumor cells may remain undetected in the body. Over time, these cells may increase in number until they show up on test results or cause signs or symptoms. During follow-up care, a doctor familiar with your medical history can give you personalized information about your risk of recurrence. Your doctor will also ask specific questions about your health. Some people may have blood tests or imaging tests as part of regular follow-up care, but testing recommendations depend on several factors including the type and stage of tumor originally diagnosed and the types of treatment given.

Managing long-term and late side effects

Most people expect to experience side effects when receiving treatment. However, it is often surprising to survivors that some side effects may linger beyond the treatment period. These are called long-term side effects. In addition, other side effects called late effects may develop months or even years afterwards. Long-term and late effects can include both physical and emotional changes.

Talk with your doctor about your risk of developing such side effects based on the type of tumor, your individual treatment plan, and your overall health. If you had a treatment known to cause specific late effects, you may also have certain physical examinations, scans, or blood tests to help find and manage them.

Keeping personal health records

You and your doctor should work together to develop a personalized follow-up care plan. Be sure to ask about any concerns you have about your future physical or emotional health. ASCO offers forms to help create a treatment summary to keep track of the treatment you received and develop a survivorship care plan once treatment is completed.

This is also a good time to decide who will lead your follow-up care. Some survivors continue to see their oncologist, while others transition back to the general care of their family doctor or another health care professional. This decision depends on several factors, including the type and stage of the tumor, side effects, health insurance rules, and your personal preferences.

If a doctor who was not directly involved in your care for lacrimal gland tumor will lead your follow-up care, be sure to share your treatment summary and survivorship care plan forms with him or her, as well as all future health care providers. Details about your treatment are very valuable to the health care professionals who will care for you throughout your lifetime.

The next section in this guide is Survivorship and it describes how to cope with challenges in everyday life after a diagnosis. Or, use the menu on the side of your screen to choose another section to continue reading this guide

Lacrimal Gland Tumor - Survivorship

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will read about how to cope with challenges in everyday life after a diagnosis of a lacrimal gland tumor. To see other pages, use the menu on the side of your screen.

What is survivorship?

The word survivorship means different things to different people. Two common definitions include:

  • Having no signs of a tumor after finishing treatment.

  • The process of living with, through, and beyond the diagnosis. According to this definition, survivorship begins at diagnosis and includes people who continue to have treatment over the long term, to either reduce the risk of recurrence or to manage chronic disease.

In some ways, survivorship is one of the most complex aspects of the experience because it is different for every person.

Survivors may experience a mixture of strong feelings, including joy, concern, relief, guilt, and fear. Some people say they appreciate life more after a diagnosis and have gained a greater acceptance of themselves. Others become very anxious about their health and uncertain of how to cope with everyday life.

Survivors may feel some stress when frequent visits to the health care team end following treatment. Often, relationships built with the medical care team provide a sense of security during treatment, and people miss this source of support. This may be especially true as new worries and challenges surface over time, such as any late effects of treatment, emotional challenges including fear of recurrence, sexuality and fertility concerns, and financial and workplace issues.

Every survivor has individual concerns and challenges. With any challenge, a good first step is being able to recognize your fears and talk about them. Effective coping requires:

  • Understanding the challenge you are facing,

  • Thinking through solutions,

  • Asking for and allowing the support of others, and

  • Feeling comfortable with the course of action you choose.

Many survivors find it helpful to join an in-person support group or an online community of survivors. This allows you to talk with people who have had similar first-hand experiences. Other options for finding support include talking with a friend or member of your health care team, individual counseling, or asking for assistance at the learning resource center of the center where you received treatment.

Changing role of caregivers

Family members and friends may also go through periods of transition. A caregiver plays a very important role in supporting a person diagnosed with a tumor, providing physical, emotional, and practical care on a daily or as-needed basis. Many caregivers become focused on providing this support, especially if the treatment period lasts for many months or longer.

However, as treatment is completed, the caregiver's role often changes. Eventually, the need for caregiving related to the diagnosis will become much less or come to an end. Caregivers can learn more about adjusting to life after caregiving in this article.

A new perspective on your health

For many people, survivorship serves as a strong motivator to make positive lifestyle changes. 

People recovering from a lacrimal gland tumor are encouraged to follow established guidelines for good health, such as not smoking, limiting alcohol, eating well, and managing stress. Regular physical activity can help rebuild your strength and energy level. Your health care team can help you create an appropriate exercise plan based upon your needs, physical abilities, and fitness level. Learn more about making healthy lifestyle choices.

In addition, it is important to have recommended medical check-ups and tests (see Follow-up Care) to take care of your health. Rehabilitation may also be recommended, and this could mean any of a wide range of services such as physical therapy, career counseling, pain management, nutritional planning, and/or emotional counseling. The goal of rehabilitation is to help people regain control over many aspects of their lives and remain as independent and productive as possible.

Talk with your doctor to develop a survivorship care plan that is best for your needs.

Looking for More Survivorship Resources?

For more information about survivorship, explore these related items. Please note these links will take you to other sections of Cancer.Net:

  • ASCO Answers Cancer Survivorship Guide: This 44-page booklet (available as a PDF) helps people transition into life after treatment. It includes blank treatment summary and survivorship care plan forms.

  • Cancer.Net Patient Education Video: View a short video led by an ASCO expert that provides information about what comes next after finishing treatment.

  • Survivorship Resources: Cancer.Net offers an entire area of this website with resources to help survivors, including for survivors in different age groups.

The next section offers Questions to Ask the Doctor to help start conversations with your health care team. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Lacrimal Gland Tumor - Questions to Ask the Doctor

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will find some questions to ask your doctor or other members of your health care team, to help you better understand your diagnosis, treatment plan, and overall care. To see other pages, use the menu on the side of your screen.

Talking often with the doctor is important to make informed decisions about your health care. These suggested questions are a starting point to help you learn more about medical care and treatment. You are also encouraged to ask additional questions that are important to you.

You may want to print this list and bring it to your next appointment, or download Cancer.Net’s free mobile app for an e-list and other interactive tools to manage your care.

Questions to ask after getting a diagnosis

  • What is my diagnosis?

  • What type of tumor is it? Is it cancerous?

  • If benign, will it turn malignant?

  • Can you explain my pathology report (laboratory test results) to me?

  • What is the stage and grade of this tumor? What does this mean?

  • Do I need treatment right away?

Questions to ask about choosing a treatment and managing side effects

  • How often do you treat people with this type of tumor?

  • What are my treatment options?

  • What clinical trials are open to me? Where are they located, and how do I find out more about them?

  • What treatment plan do you recommend? Why?

  • What are the advantages of combining surgery and chemotherapy and radiation therapy?

  • What is the goal of each treatment? Is it to eliminate the cancer, help me feel better, or both?

  • Could this affect my vision? How and for how long?

  • What are the other possible side effects of this treatment, both in the short term and the long term?

  • Should I get a second opinion?

  • What is my prognosis (chance of recovery)?

  • Who will be part of my health care team, and what does each member do?

  • Who will be coordinating my overall treatment?

  • How will this treatment affect my daily life? Will I be able to work, exercise, and perform my usual activities?

  • Could this treatment affect my sex life? If so, how and for how long?

  • Could this treatment affect my ability to become pregnant or have children? If so, should I talk with a fertility specialist before cancer treatment begins?

  • If I’m worried about managing the costs related to my medical care, who can help me with these concerns?

  • What support services are available to me? To my family?

  • Whom should I call for questions or problems?

  • Is there anything else I should be asking?

Questions to ask about having surgery

  • What type of surgery will I have? Will lymph nodes be removed?

  • How long with the operation take?

  • How long will I be in the hospital?

  • Can you describe what my recovery from surgery will be like?

  • What are the possible long-term effects of having this surgery?

  • Can you recommend an experienced surgeon?

  • How will you be able to tell if the entire tumor was removed during surgery?

  • Will I have problems with my vision afterwards? For how long?

  • What changes to my appearance can I expect?

  • Will I need to see a plastic surgeon?

  • Will I need to see an ocularist (a person who makes prosthetic eyes) or an anaplastologist (a person who works with the surgery team to reconstruct the face)?

Questions to ask about having an eye removed

  • How do I adjust to using one eye?

  • How long will it take me to recover?

  • What rehabilitation services are available?

  • How soon can I get a prosthesis (artificial eye)?

  • When do I get a permanent prosthesis?

  • How do I care for my prosthesis?

Question to ask about having radiation therapy, chemotherapy, or immunotherapy

  • What type of treatment is recommended?

  • What is the goal of the treatment?

  • How long will it take to give this treatment?

  • What does the preparation for this treatment involve?

  • What is the risk to my vision with this treatment?

  • What side effects can I expect during treatment?

  • What are the possible long-term effects of having this treatment?

  • What can be done to relieve the side effects?

Questions to ask about planning follow-up care

  • What is the risk of the cancer returning? Are there signs and symptoms I should watch for?

  • What long-term side effects or late effects are possible based on the cancer treatment I received?

  • What follow-up tests will I need, and how often will I need them?

  • How do I get a treatment summary and survivorship care plan to keep in my personal records?

  • Who will be coordinating my follow-up care?

  • What survivorship support services are available to me? To my family?

The next section in this guide is Additional Resources, and it offers some more resources on this website beyond this guide that may be helpful to you. Or, use the menu on the side of your screen to choose another section to continue reading this guide.  

Lacrimal Gland Tumor - Additional Resources

This section has been reviewed and approved by the Cancer.Net Editorial Board, 08/2015

ON THIS PAGE: You will find some helpful links to other areas of Cancer.Net that provide information about your medical care and treatment. This is the final page of Cancer.Net’s Guide to Lacrimal Gland Tumor. To go back and review other pages, use the menu on the side of your screen.

Cancer.Net includes many other sections about the medical and emotional aspects of a lacrimal gland tumor, both for the person diagnosed and their family members and friends. This website is meant to be a resource for you and your loved ones from the time of diagnosis, through treatment, and beyond.

Beyond this guide, here are a few links to help you explore other parts of Cancer.Net:

This is the end of Cancer.Net’s Guide to Lacrimal Gland Tumor. Use the menu on the side of your screen to select another section to continue reading this guide.