BACKGROUND: Eye cancer is a rare condition that struck almost 2,400 people in the United States in 2008, according to the American Cancer Society. The disease can affect the eye itself or outer parts of the eye like the eyelid. Cancer that affects the inside of the eye is called intraocular cancer and can originate either inside the eyeball or in another part of the body. Cancer that spreads from another part of the body into the eye is called secondary intraocular cancer and is actually more common than primary intraocular cancer. The most common intraocular cancer in adults is melanoma. Melanomas of the eye develop from pigment-producing cells called melanocytes most often found in the choroid, or the blood vessel layer beneath the retina. Choroid cells actually have the same kind of pigment as melanocytes in the skin. Most other intraocular melanomas begin in the iris and are slow-growing. Another common type of intraocular cancer is lymphoma. This type of eye cancer starts in immune cells in the eyes. Cancers of the eyelid are usually skin cancers. The most common eye cancer in children is retinoblastoma, which begins in cells of the retina. The Eye Cancer Network says retinoblastoma affects approximately 300 children in the United States each year and more than 90 percent can be cured by early detection and treatment.
SYMPTOMS: Many cases of eye cancer exhibit no symptoms and are picked up during routine eye exams. However, symptoms that can point to eye cancer include a dark spot on the iris that is enlarging, distorted vision, flashing lights, blurred vision and floating objects in the vision field. The most common symptoms of retinoblastoma are a white pupil and misaligned eyes.
TREATMENT: Just like other cancers, treatment for eye cancer depends on the type and how advanced it is. Options include surgery, radiation therapy, freezing or heat therapy, laser therapy and systemic chemotherapy. Surgery has become less common and radiation therapy has grown in popularity as a treatment option. Unfortunately, surgery usually means removal of the entire eyeball, or enucleation. This procedure is used for some smaller melanomas and often for larger melanomas. In addition, eye cancers that recur are usually treated by enucleation. During the same surgery in which the eye is removed, surgeons usually implant an artificial eye. The American Cancer Society says patients who have had enucleation and those who have had radiation therapy for eye cancer respond similarly when asked about their quality of life after treatment.
AVOIDING EYE REMOVAL: Radiation therapy for the eyes can be either external or internal. External beam radiation is commonly used for retinoblastoma and tumors that have spread from another part of the body. This type of radiation has been shown to do more damage to the eye, and sometimes removal of the eye is necessary after treatment. To remedy this problem, some doctors treat eye cancers with plaque brachytherapy. This type of internal radiation therapy delivers a highly concentrated dose of radiation to the tumor. The source of the radiation is small radioactive seeds attached to a gold or steel bowl called a plaque. That plaque is attached to the wall of the eye to cover the base of the eye tumor. Paul Finger, M.D., an ophthalmic oncologist at the New York Eye Cancer Center in New York, N.Y., says he usually leaves the plaque in for a week. During that week, the patient must stay in their house. After the plaque is removed, the patient can resume normal activity. Dr. Finger recently created a plaque with a special slot that can surround the optic nerve. This new design enables the treatment of tumors of the optic nerve. "What I created allows us to treat a whole group of patients that weren't treatable before," says Dr. Finger.
FOR MORE INFORMATION, PLEASE CONTACT:
Paul T. Finger, MD
Director, Ocular Tumor Service
The New York Eye and Ear Infirmary
310 East 14th St.
New York, NY 10003
(212) 832-8170
pfinger@eyecancer.com <mailto:pfinger@eyecancer.com>
http://www.paultfingermd.com
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