Eye Cancer

Eye cancer is a cancer that forms in tissues of and around the eye. Some of the cancers that may affect the eye include melanoma (a rare cancer that begins in cells that make the pigment melanin in the eye), carcinoma (cancer that begins in tissues that cover structures in the eye), lymphoma (cancer that begins in immune system cells), and retinoblastoma (cancer that begins in the retina and usually occurs in children younger than 5 years)1.

 

Intraocular Melanoma

 

Intraocular melanoma is a disease in which malignant (cancer) cells form in the tissues of the eye. Intraocular melanoma begins in the middle of 3 layers of the wall of the eye. The outer layer includes the white sclera (the "white of the eye") and the clear cornea at the front of the eye. The inner layer has a lining of nerve tissue, called the retina, which senses light and sends images along the optic nerve to the brain2.

The following sizes are used to describe intraocular melanoma:

  • Small The tumor is at least 5 millimeters in diameter and from 1 to 3 millimeters thick.
  • Medium The tumor is less than 16 millimeters in diameter and from 2 to 10 millimeters thick.
  • Large The tumor is at least 16 millimeters in diameter or more than 10 millimeters thick.
  • Diffuse The tumor is flat and grows widely across the uvea3.

 

Treatment of Eye Cancer

 

Surgery

Surgery is the most common treatment for intraocular melanoma. The following types of surgery may be used:

  • Local tumor resection: Surgery to remove the tumor and a small amount of healthy tissue around it.
  • Enucleation: Surgery to remove the eye and part of the optic nerve. This is done if the tumor is large and vision cannot be saved. The patient may be fitted for an artificial eye after enucleation.
  • Exenteration: Surgery to remove the eye and eyelid, and muscles, nerves, and fat in the eye socket. The patient may be fitted for an artificial eye or facial prosthesis after exenteration.

Watchful Waiting

Watchful waiting is closely monitoring a patient’s condition without giving any treatment until symptoms appear or change. A series of pictures is taken over time to keep track of changes in the size of the tumor and how fast it is growing.

Radiation therapy

Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.

Localized plaque radiation therapy is a type of internal radiation therapy that may be used for tumors of the eye. Radioactive seeds are attached to a disk, called a plaque, and placed directly on the wall of the eye where the tumor is located. The side with the seeds faces the eyeball and delivers radiation to the eye. The plaque, which is often made of gold, helps protect nearby tissues from radiation damage.

Charged-particle radiation therapy is a type of external radiation therapy. A special radiation therapy machine aims tiny, invisible particles, called protons or helium ions, at the cancer cells to kill them with little damage to nearby normal tissues. Charged-particle radiation therapy uses a different type of radiation than the x-ray type of radiation therapy.

Gamma Knife radiosurgery may be used for some melanomas. This non-surgical treatment aims tightly focused gamma rays directly at the tumor so there is little damage to healthy tissue. Gamma Knife is a type of stereotactic radiosurgery.

Photocoagulation

Photocoagulation is a procedure that uses laser light to destroy blood vessels that supply nutrients to the tumor, causing the tumor cells to die. Photocoagulation may be used to treat small tumors. This is also called light coagulation.

Thermotherapy


Thermotherapy is the use of heat to destroy cancer cells. Thermotherapy may be given using:

  • A laser beam aimed through the dilated pupil or onto the outside of the eyeball.
  • Ultrasound.
  • Microwaves.
  • Infrared radiation (light that cannot be seen but can be felt as heat).

 

New types of treatment are being tested in clinical trials:

 

Patients may want to think about taking part in a clinical trial. For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment. Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.4

Search for clinical trials in Georgia.

Adapted from the National Cancer Institute's PDQ Database:

1http://www.cancer.gov/dictionary/?CdrID=444991. (Accessed June 2016)

2http://www.cancer.gov/types/eye (Accessed June 2016)

3http://www.cancer.gov/cancertopics/pdq/treatment/intraocularmelanoma/Patient/page2. (Accessed June 2016)

4http://www.cancer.gov/cancertopics/pdq/treatment/intraocularmelanoma/Patient/page4. (Accessed June 2016)