Lacrimal Gland Carcinoma, from the CureRays guide library.

Lacrimal gland carcinoma is a rare cancer of the tear-producing gland above the eye — most often the adenoid cystic type — that tends to invade along nerves; treatment combines eye-preserving surgery with high-dose proton or neutron radiation to control disease while protecting vision.

What it is.

The lacrimal gland sits in the upper outer corner of the eye socket and makes the watery part of your tears. Cancers of this gland are rare, and the most common and most challenging is adenoid cystic carcinoma, a tumor that grows slowly but has a strong tendency to creep along the tiny nerves around the eye (perineural invasion), which makes it hard to remove completely and prone to coming back. Other lacrimal gland cancers include carcinoma arising in a previously benign mixed tumor and several less common types. Patients often notice a firm lump near the upper outer eyelid, a bulging or downward-and-inward displaced eye, double vision, or pain — pain being a clue that points toward cancer rather than a benign growth. Historically, treatment meant removing the entire eye and surrounding tissue, but modern care increasingly favors eye-preserving surgery combined with high-dose radiation. Because these tumors invade along nerves and sit beside the eye, brain, and optic nerve, specialized radiation — proton beams or neutron beams at expert centers — is used to deliver a strong, shaped dose while sparing vision. Some centers also use chemotherapy delivered into the artery feeding the gland before surgery. Long-term follow-up is essential because adenoid cystic carcinoma can recur or spread to the lungs many years later.

How radiation treats it.

Radiation damages the DNA inside cancer cells so they can no longer divide and survive, while healthy cells are better at repairing themselves. Lacrimal gland cancers — especially adenoid cystic carcinoma — invade along the small nerves around the eye, so radiation is shaped to cover not just the tumor but the nerve pathways it may have followed. Because the eye, optic nerve, and brain sit right next to the target, specialized particle beams (proton or neutron) are used at expert centers to deliver a high, tumor-killing dose while sparing those delicate structures and protecting vision. Radiation is given as short, painless daily sessions and leaves no radioactivity in your body, so you remain safe to be around family and children.

The ways we can treat it.

Surgery. Removes the tumor, ideally preserving the eye; the goal is to take out as much disease as possible while protecting vision and the structures of the socket.

Proton / neutron radiation. Particle beams concentrate a high dose on the tumor and the nerve pathways it may follow while sparing the eye, optic nerve, and brain just beyond the target.

Chemotherapy (selected). Given into the feeding artery before surgery at some centers, or systemically for advanced disease, to shrink the tumor and treat spread.

Questions we hear often.

Will I lose my eye? Not necessarily. Modern care increasingly favors eye-preserving surgery combined with high-dose radiation rather than removing the whole eye. Whether the eye can be saved depends on how far the tumor extends, and your team will aim to protect both your vision and your chance of cure.

Why is special proton or neutron radiation used? These cancers invade along nerves and sit right next to the eye, optic nerve, and brain. Proton and neutron beams can deliver a strong dose to the tumor and nerve pathways while sparing those delicate structures, improving local control while protecting vision.

Why do I need follow-up for so many years? Adenoid cystic carcinoma grows slowly and can come back at the original site or spread to the lungs many years later. Long-term eye exams, imaging, and chest checks let your team catch any recurrence early, when it is most treatable.

This guide is informational only. It is not medical advice — please confirm anything here with your care team.