Treatment

The treatment of a lacrimal gland tumor depends on the size and location of the tumor, whether one or both eyes are involved, if the tumor is cancerous, whether the cancer has spread, and the person's overall health. In many cases, a team of doctors may work with the patient to determine the best treatment plan.

This section outlines treatments that are the standard of care (the best treatments available) for this specific type of tumor. Patients are also encouraged to consider clinical trials as a treatment option when making treatment plan decisions. A clinical trial is a research study to test a new treatment to prove it is safe, effective, and possibly better than standard treatment. Your doctor can help you review all treatment options. For more information, visit the Clinical Trials section.

Below are general descriptions of different types of treatment, followed by an outline of which treatments are used based on the type of lacrimal gland tumor.

Surgery

Surgery to the eye is quite 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 (enucleation), depending on the size and spread of the tumor.

Possible side effects of eye surgery are similar to that of any surgery, including a risk of infection, problems with anesthesia (medication used during surgery to block sensation and pain impulses along the nerve pathways to the brain), and pain.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. It is most often used for lacrimal gland lymphoma. There are different types of radiation therapy. The dosage used, and the site and type of the tumor significantly affects the risks of side effects.

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

Proton-beam or charged-particle radiation therapy. This type of therapy targets high-energy particles (not x-rays) at the tumor. This type of radiation therapy can reduce the possibility of damage to nearby tissue.

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

Radiation therapy may result in a variety of short-term and long-term side effects, so it is important to talk with your ophthalmologist (a medical doctor who specializes in diseases and function of the eye) and/or oncologist (a doctor who specializes in treating cancer) about what to expect. The extent of side effects depends on the type and dose of radiation therapy the person receives, where the tumor is located, and the person's overall health.

Cataracts are a very common side effect of radiation therapy to the eye area. A cataract is opacity (a lack of transparency) of the lens or capsule of the eye. 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.

Also, loss of eyelashes and/or a dry eye can occur with external-beam radiation therapy. Other possible side effects are more uncommon. Radiation retinopathy is the development of abnormal blood vessels in the retina. Radiation optic neuropathy involves nerve damage in the eye. Neovascular glaucoma is a painful condition in which new blood vessels develop and block the regular release of fluid from the eye. If there is significant damage to the eye from radiation therapy, the eye may need to be removed.

Chemotherapy

Chemotherapy is the use of drugs to kill cancer cells. Systemic chemotherapy is delivered through the bloodstream, targeting cancer cells throughout the body. The side effects of chemotherapy depend on the individual and the dose used, but can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications for you, their purpose, and their potential side effects or interactions with other medications. Learn more about your prescriptions through Cancer.Net's Drug Information Resources, which provides links to searchable drug databases.

Immunotherapy

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

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

Treatment by type of lacrimal gland tumor

Lymphoma

Lymphoma may be treated with external-beam radiation therapy, chemotherapy, immunotherapy, or a combination of these therapies. 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. Therefore, it is important to know the 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.

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.

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: During Treatment.