Posted Date: Jul 14, 2005
Intraocular melanoma, a rare cancer, is a disease in which cancer (malignant) cells are found in the part of the eye called the uvea. The uvea includes the iris (the colored part of the eye), the ciliary body (a muscle in the eye), and the choroid (a layer of tissue in the back of the eye). The iris opens and closes to change the amount of light entering the eye. The ciliary body changes the shape of the lens inside the eye so it can focus. The choroid layer is next to the retina, the part of the eye that makes a picture. The uvea contains cells called melanocytes, which contain color. When these cells become cancerous, the cancer is called a melanoma.
Intraocular melanoma occurs most often in people who are middle aged. If there is melanoma that starts in the iris, it may look like a dark spot on the iris. If melanoma is in the ciliary body or the choroid, a person may have blurry vision or may have no symptoms, and the cancer may grow before it is noticed. Intraocular melanoma is usually found during a routine eye examination, when a doctor looks inside the eye with special lights and instruments.
The chance of recovery (prognosis) depends on the size and cell type of the cancer, where the cancer is in the eye, and whether the cancer has spread.
Once intraocular melanoma is found (diagnosed), more tests will be done to find out exactly what kind of tumor the patient has and whether cancer cells have spread to other parts of the body. This is called staging. A doctor needs to know the stage to plan treatment. Intraocular melanoma is staged based on the area of the eye where the tumor is found and the size of the tumor.
Intraocular melanomas of the ciliary body occur in the back part of the eye.
Medium and large size choroidal melanomas are more than 3 millimeters in thickness.
There are treatments for all patients with intraocular melanoma. In some cases a doctor may watch the patient carefully without treatment until the cancer begins to grow. When treatment is given, three types of treatment are commonly used:
Radiation therapy uses x-rays or other high-energy rays to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy) or from putting materials that contain radiation (radioisotopes) in the area where the cancer cells are found (internal radiation therapy). In intraocular melanoma, internal radiation may be put next to the eye using small implants called plaques. Radiation can be used alone or in combination with surgery.
Laser therapy is a treatment that uses an intensely powerful beam of light to destroy the tumor. The laser may be used with a special dye that is injected into the tumor, causing the laser to heat the dye and kill the tumor. This is called thermotherapy. Photocoagulation is another treatment that uses a laser to destroy the blood vessels that feed the tumor, killing the tumor indirectly.
The choice of treatment depends on where the cancer is in the eye, how far it has spread, and the patient's general health and age.
Standard treatment may be considered because of its effectiveness in patients in past studies, or participation in a clinical trial may be considered. Not all patients are cured with standard therapy and some standard treatments may have more side effects than are desired. For these reasons, clinical trials are designed to find the best ways to treat cancer patients and are based on the most up-to-date information. A large clinical trial is ongoing in many parts of the country for patients with intraocular melanoma. To learn more about clinical trials, call the Cancer Information Service at 1-800-4-CANCER (1-800-422-6237); TTY at 1-800-332-8615.
For medium sized choroidal melanomas, treatment may be one of the following:
For large choroidal melanomas, treatment may be one of the following:
Treatment will depend on the treatment the patient received before, the patient's age and health, where the cancer came back, and how far the cancer has spread. The patient may want to take part in a clinical trial.
Links to the NCI Dictionary of Cancer Terms were added to this summary.
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Before starting treatment, patients may want to think about taking part in a clinical trial. A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about new treatments, the risks involved, and how well they do or do not work. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard."
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