Retinoblastoma is cancer that forms in the retina of the eye. Treatments for this type of cancer vary depending on the extent of the cancer, whether the tumor is in one or both eyes and whether the cancer has spread to other parts of the body. Because this type of cancer is so rare, it’s important to have a doctor and a treatment facility that is experienced in dealing with retinoblastoma.
The goals of treatment are:
• Eliminate cancer and save the life of the patient
• Save as much vision as possible
• Save the eye if possible
• Avoid second cancers or recurrence of cancer
Treatment of retinoblastoma may include:
• Surgery – If the tumor is very large, the vision in the effected eye is usually destroyed. In this case, treatment is often surgery called enucleation. During the procedure, the doctor will remove the entire eye plus part of the optic nerve. During the same surgery, an optic implant is placed in the eye socket to take the place of the eyeball. This implant can later be replaced with an artificial eye that will match the real eye in appearance, but will not provide any vision. Once an eye is removed, that side will be permanently blind. If both eyes must be removed, the result is complete blindness.
• Radiation - This involves killing cancer cells or shrinking tumors using high-energy radiation such as X-rays. Radiation can be beamed at the area from outside the eye, or can be given by inserting radioactive material into the body very close to the tumor.
• Cryotherapy– Extreme cold can be used to kill cancer cells and eliminate tumors in a specific area.
• Photocoagulation – This treatment is also called laser therapy. A laser beam travels through the pupil of the eye to burn out the tumor. Risks include damage to surrounding cells in the retina.
• Thermotherapy– This method of treatment used ultrasound, microwaves, or infrared rays to apply heat to the tumor. These rays are not as hot as the laser used in photocoagulation, which may be safer for surrounding blood vessels in the eye. Thermotherapy can be used alone for small tumors or may be combined with chemotherapy for larger tumors.
• Chemotherapy – This treatment uses cancer-killing drugs to eliminate cancer cells. In some cases, chemotherapy may be used first to shrink tumors so other treatments such as photocoagulation or cryotherapy can be more effective. Chemotherapy often travels through the body in the bloodstream and may be used to eliminate cancer that has spread from the eye to other parts of the body. Chemotherapy drugs must be given over time, with a rest period in between doses to allow the body to recover. In severe cases, intense chemotherapy may be combined with stem cell transplants to help the body recover necessary cells that may be killed by the chemotherapy drugs.
The doctor will recommend which of these treatments is most appropriate. New treatments are also being developed through clinical trials that may be available as treatment options.
Overall, treatment of retinoblastoma has a very high rate of success. However, patients with hereditary retinoblastoma appear to be at increased risk of other types of cancer including bone cancer, soft tissue sarcoma, melanoma, and tumors in the brain. Patients with non-hereditary retinoblastoma do not appear to be at increased risk for other types of cancer.
Sources:
National Cancer Institute
American Cancer Society
University of Michigan Kellogg Eye Center
Retinoblastoma Follow-up Study
For more information: retinoblastoma overview.