Eye Cancer & Tumors – A Problem for All Ages
In India, the rate of eye cancer is comparatively less. It is 0.3-0.4%, among them 70-80% cases are seen in adults and rest in the child. The chances of recovery are high when directed earlier. Eye cancer can be primary or metastatic based on the site of origin of the disease process. In the primary case, the eye cancer starts from within the eye and in the metastatic case, it spreads from other organs to the eye. Early detection is always helpful in all types of cancer, but people ignore all the symptoms face in the primary stage.
Types of eye cancers?
There is a different kind of eye cancers, they are:
- Eye or intraocular melanoma: conjunctival, choroidal
- Squamous cell carcinoma
- Lymphoma or Primary intraocular lymphoma: it is associated with lymphoma in the brain ( called primary central nervous system (CNS) lymphomas, usually bilateral)
- Retinoblastoma – It is seen mostly in the children of the age group from 1 month to 4 years. It is the case of metastatic cancer where cancer spreads from the lung or breast.
Signs and symptoms of eye cancers?
Most of the symptoms of eye cancers are innocuous and patients often ignore this in the initial stages. A list of signs and symptoms are mentioned below.
- Flashlight or floaters
- Blurred vision, haloes, and shadows around images, especially bright light cause eye cancer.
- A dark nevus or mole on the white part of the eye which increases in size can cause eye cancer. It is a blood vessel that bleeds when the situation deteriorates.
- If someone loses vision can be an indication of eye cancer.
- Bulging of one eye or both causes eye cancer. It is called proptosis.
- Any lump or tumour in the eyes or eyelid can be the reason for eye cancer. When it increases get blood vessels and affect the eyes.
- Colour changing of the iris
- White reflexes in the pupil are the symptoms of eye cancers.
What are the danger signs to watch out for, in children, for retinoblastoma?
Retinoblastoma is a kind of disease which are mostly seen in children or infants. As the symptoms are not so harsh, children often ignore this so parents should be careful of the infant or the child. Signs of retinoblastoma
The surrounding iris is lighter in colour than the centre of the eyes and the pupils. If you see any white discolouration in children ( especially if it is associated with a squint in the same eyes), you must seek help from the doctors. This white reflex can be checked with the flash for taking pictures, similarly, the red-eye can be checked with torchlight, though it can be seen in pictures.
- In some cases, eyes appear to be looking in different directions. Any acquired squint in small children must be diagnosed by an eye doctor.
- Eye redness and swelling, excessive tearing may be a reason for retinoblastoma
How is the staging of eye tumours done?
A thorough eye checkup can help in determining the clinical stages. Radiological tests and pathological tests are done after the biopsy. Doctors suggest PET scans look for secondary tumours or for primary tumours to check materialistic cancer. To plan for treatment, doctors follow standardized international staging systems like American Joint Committee on Cancer (AJCC) TNM system and the system which is used by the Collaborative Ocular Melanoma Study (COMS) group. In addition, doctors provide the patients with a prognosis and they collaborate with colleagues in other disciplines like oncology, radiation medicine and oncosurgery for patient care.
What is the treatment for eye tumours?
Doctors use three basic modalities of treatment for eye cancers. Those are radiotherapy, surgery and chemotherapy. There is a multidisciplinary team that decides the procedure of the treatments. They first customise the treatment according to the need of the patients. It is depended on several other factors and they are:
- Type of eye cancer and its grade can determine the aggressiveness of the tumour and its malignant potential.
- The rate of tumour growth, size, present stage, the extent of spread locally and distant sites are some other factors.
- Treatment depends on the site of the tumour, whether it is on the eyelids, conjunctiva or within the eye or spreads more extensively.
- Treatment also depends on the general health and other coexisting diseases of the patient. Without this, the patient’s age and his/her choice are also important.
Working on the following fundamental principles, the opthalmologist takes care of eye cancer:
- A doctor always gives priority to saving the lives of the patients.
- Ophthalmologists try to save the sight of the patients as much as possible.
- They try to preserve the functional and structural integrity of the eye.
- Doctors also try to preserve the cosmetic appearance of the eyeball and surrounding areas.
Based on this, your opthalmologist can choose any of the options listed below
In laser therapy, a laser beam is directed towards the eye locally so that it can destroy the tumour.
In this case, a plate is impregnated with the therapeutic agent which is used to direct the treatment to the specific location alone and minimize the damage to the surrounding tissue.
In radiotherapy, radiation is used to destroy the tumour cells. It doesn’t affect the surrounding part or any tissue. Proton therapy, a better radiation process, is proved to minimize collateral damage to the surrounding areas and it has also a good track record in giving an accurate dose to the affected areas.
In limited resection, part of the eyes which is affected by cancer is removed. Iridectomy, choroidectomy, eyelid resection are some examples.
In this treatment, the eyeball is removed and the eye muscles and eyelids aren’t removed. Later, a prosthetic eye is used to get better cosmetic results.
This treatment is done by removing partial eye contents and it leaves behind the sclera or the white part of the eye. Enucleation and evisceration need prosthetic eyes without vision.
In this extensive surgery, the eye and all orbital contents are removed and then a specially designed prosthesis is fitted to hold the appearance of the face.
In chemotherapy, special drugs are used which may be administered orally or by injection so that it can fight the cancer cells.