Could It Be Cancer

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Don't Ignore Eyelid Lumps and Bumps

• Cancerous Eyelids
• Non-cancerous Eyelids
• Unusual Lesions
• Learn about Skin Cancer

If you have noticed areas around your eyes that have changed in appearance or sensitivity, please consult your doctor immediately or schedule an appointment with Dr. Cockerham’s office. The following information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly. Read our disclaimer

Patient Education

• Eyelid Skin Cancer

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Basal Cell Carcinoma

Cancerous

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Squamous Cell Carcinoma

Cancerous

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Eyelid Melanoma

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Sebaceous Cell Carcinoma

This information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly. Read our disclaimer

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Unusual Lesions

This information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly. Read our disclaimer

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Non-Cancerous

This information is not meant to replace the advice of your physician and is not to be considered medical advice, diagnosis or treatment. Should you have any concern please contact your physician directly. Read our disclaimer

Skin Cancer: By the Numbers

• Skin cancer is the most common form of cancer in the United States.1
• Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.1
• One in five Americans will develop skin cancer in the course of a lifetime. 2
• Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the two major forms of non-melanoma skin cancer.3
  • Between 40 and 50 percent of Americans who live to age 65 will have either skin cancer at least once.
  • BCC is the most common form of skin cancer; about one million of the cases diagnosed annually are basal cell carcinomas. 4 BCCs are rarely fatal, but can be highly disfiguring.
  • SCC is the second most common form of skin cancer. More than 250,000 cases are diagnosed each year1, resulting in approximately 2,500 deaths.2

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Eyelid Oncology

Listen
Ask the right questions

Look
For warning signs

Feel
The region of interest

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Classic Risk Factors

• Elderly Caucasian
• Light complexion/blue eyes
• Actinic damage (sun damage)
• Cigarette smoking

American Cancer Society. Cancer Facts & Figures 2009. Atlanta: American Cancer Society; 2009.
Robinson JK. Sun Exposure, Sun Protection, and Vitamin D. JAMA 2005; 294: 1541-43.
"Sun Protection." National Cancer Institute's Cancer Trends Progress Report - 2007 Update. 15 April 2008. Click Here for Link.
"What is Squamous and Basal Cell Skin Cancer?" American Cancer Society. 5 May 2008. Link.

More than 90 % of Non-Melanoma Skin Cancer is Caused by Sun Exposure

• Unprotected exposure
• Outdoors even in the fog
• Tanning booths
• Through car, home or office windows
• Yet only 33% of women and 10% of men wear daily sun block
• Learn More: www.skincancer.org

Risk Factors Specific to Squamous Cell Carcinoma

• HPV 16 and 18 (Human papilloma virus)
• Immunosuppression (weakened immune system)
• HIV – atypical, younger patients
• Organ transplant
• Xeroderma pigmentosum ( a genetic skin disorder)
• Predisposition for epithelial tumors

Incidence Of Skin Cancers in the Young

Incidence:

• Melanoma has tripled
• Squamous cell carcinoma and basal cell carcinoma have doubled

1 in 5 Americans in their 20's and 30's will be diagnosed with skin cancer.
Men: are twice as likely as women to be diagnosed with skin cancer.

Skin Cancer Affects Non-Caucasians Too

Melanoma of the skin
Hispanic: birth to death risk
Male: .45 (1 in 221)
Female: .49 (1 in 205)

Skin Cancer MORE deadly for African Americans, Asians & Latinos

Caucasians

1974-1976: 81 %
1995-2001: 92 %

African Americans

1974-1976: 67%
1995-2001: 76%

Melanoma Surveillance, Epidemiology and End Results Program, 1975-2002, National Cancer Institute 2005; American Cancer Society, Surveillance Research, 2006

U.S. Skin Cancer Statistics

• Incidence of has tripled since 1980
• Early detection is crucial !

What to Look for

History: Have you had a prior skin cancer ?

• If history of BCCA -> 50% have second lesion at 5 years
• If history of SCCA -> 75% have second lesion at 5 years

Think beyond the face:

• Women: lower legs
• Men: back

Do you have:

• Pain ? (Usually painless)
• Intermittent scaling or scabbing?
• Irritation when wearing glasses?

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Warning Signs

American Cancer Association’s ABCDE

• A - Asymmetry - draw a line down the center
• B - Border irregularity - Uneven, scalloped or notched
• C - Color variations - Brown, tan, black mixed with red, white or blue
• D - Diameter > Larger than a pencil’s eraser

American Cancer Society’s Look for warning signs ABCDE

Evolution = NEW ANYTHING

• Grows or shrinks (suddenly)
• Irritation, redness
• Scaling
• Crusting, oozing or bleeding
• Tenderness or pain
  

Eyelid Specific Warning Signs

• Telangiectasis (increase of small blood vessels)
  
• Vessel blanching (whitening of the blood vessels)Loss of lashes
  
• Trichiasis (misdirected eye lashes) Hyperpigmentation (increase of pigmentation) Hypopigmentation (decrease of pigmentation Sebaceous)

Cell Carcinoma The Worst Offender

• Least common
• 50% misdiagnosed
• Average age: 72 years old
• Women: Men = 2:1
• Ectropion/entropion 10%
• Caruncle 5% (inner corner of the eye)
• Chronic conjunctivitis, cyst or pannus (red, inflamed eye)

Palpation is Important

• Feel the region of interest
• Firm
• Irregular
• Nodular
• Check for lymph nodes

Conclusion

• ABCDE too simplistic > Eyelids have their own special clues
• Suspicious lesions MUST be biopsed > If the answer doesn’t make sense; a second biopsy should be done.
• Wear Sun block