Radiation treatment of cancer of the eyelids.

Eyelid cancers are not uncommon tumours and are usually basal cell or more rarely squamous cell in character. Their importance lies in their special situation since unlike cancer arising elsewhere in the skin they can by their natural progression or as a consequence of the effects of treatment cause impairment or even loss of vision. Although these tumours are 'malignant', death of the patient rarely results from failure of local control, unless the disease is very advanced or was mismanaged at the outset. In the case of squamous cell cancer, death may occasionally result from metastatic spread. It should be an obvious ethical maxim that no patient should be submitted to a major surgical operation if an established and equally effective alternative non-surgical procedure is available. In the case of skin cancer generally and the lids in particular radiotherapy provides such an alternative since its curative value has been firmly established during the past 50 years. The reluctance of ophthalmologists to advise the use of radiant energy appears to relate to the calamities that first attended its use by the pioneer ophthalmologists at the beginning of this century. The story of their heritage of ocular disasters has been transmitted from generation to generation ignoring the fact that progress in radiotherapy has been such that under modern conditions most of the complications, particularly the more gruesomely destructive ones,