Eye cancer

General information

Eye cancer is the growth of malignant cells in the eye’s tissues. In adults, most eye cancers are secondary tumors that spread to the eye from other parts of the body (more often from the breast and sometimes from the lungs, kidneys, and prostate). Cancer cells spread through the blood or lymphatic system.

Among primary eye tumors, retinoblastoma and melanoma are distinguished. Retinoblastoma is the most common form of primary eye cancer in children (more often in children under five years of age). Malignant melanoma of the eye is most common in adults (average age 60 to 65 years). Most primary eye cancers affect only one eye, but retinoblastoma affects both eyes in about one-third of cases. In the early stages, all forms of eye cancer have no symptoms, but a growing tumor can cause increasingly severe pain and vision impairment. Cancerous tumors originating in the eye can spread (metastasize) beyond the eye to the optic nerve, brain, or the rest of the body, so early diagnosis and treatment are essential.

Malignant tumors can affect many different parts of the eye, including the retina, iris, and optic nerve. In adults, uveal melanoma (a lesion of the vasculature of the eye) is the leading primary malignant tumor of the eye. It is often asymptomatic and carries the risk of spreading to the liver, lungs, and skin.

The best method of diagnosing uveal melanoma is direct examination of the patient, namely indirect ophthalmoscopy, although other methods are also used.

Symptoms of eye cancer

Symptoms are determined by the type of eye tumor. The following are the most common eye tumors and their associated symptoms:

• Melanoma is usually in its early stages, but as it grows, it can cause visual disturbances, retinal detachment, bleeding, and pain.
• Choroidal hemangioma is a benign tumor from the vasculature of the eye that can cause central vision loss and retinal detachment.
• A chorioidal nevus is a benign eye tumor similar to common moles on the skin. It can result in loss of peripheral or central vision.
• Conjunctival tumors occur on the outer lining of the eye and cause pain and visual disturbances.
• Tumors of the eyelid are accompanied by the development of edema, pain, impaired vision, and the functioning of the tear ducts.
• Ocular tumors involve the bones surrounding the eyeball and may be accompanied by bulging of the eye and detached retina.

Retinoblastoma is a malignant tumor of the retina. It develops from immature embryonic cells. Retinoblastoma can be monocular or binocular.

Tumors and associated inflammation can occur behind the eyeball. These often cause the eye to protrude anteriorly, a condition known as exophthalmos. In addition to ocular tumors, the most common causes of exophthalmos are hyperfunction of the thyroid gland (basilar disease) and lymphoid tumors.

Eye cancer treatment

Eye cancer treatment is determined by the localization of the tumor and the presence of metastases, i.e., foci of the spread of malignant cells to other organs. Most often, melanoma of the eye is treated with surgery and radiation therapy. In addition, special ophthalmic applicators, which are small radioactive metal plates or rods placed near the tumor, are used. Stereotactic radiosurgery is another treatment option.

Surgical treatment

Surgical treatment for melanoma of the eye usually involves removing part or all of the eyeball in what is known as enucleation. This surgery is necessary if the tumors are large or other treatments are impossible. Patients are offered a special prosthetic eye if the entire eyeball is removed. Surgery remains the standard treatment for eye tumors.

Radiation therapy

Radiation therapy is used alone or after surgery. There are two types of radiotherapy: external and internal. They both involve the use of radioactive radiation to destroy malignant cells.

Internal radiotherapy uses special ophthalmic applicators: small radioactive “grains” implanted into the tissue near the tumor. The implants are usually left near the tumor for a week and then removed.

External radiotherapy is commonly used to treat tumors in the eye socket. It involves aiming radiation beams at the tumor to limit radiation damage to surrounding tissues.

In addition, radiation therapy shows efficacy in treating eye melanoma but is often accompanied by side effects. Patients receiving radiotherapy often experience redness and dry eyes. In some cases, cataracts develop after radiation therapy, which can be treated with surgery. Eyelash loss and shortening may occur. Optic nerve damage, glaucoma, and abnormal blood vessels in the retina are much less common.

Stereotactic radiosurgery

Various radiosurgical systems allow high-energy radiation to be delivered to the tumor. Almost all methods involve the use of a metal frame, which is fixed to the patient’s skull bones with screws to immobilize the head and more accurately target the tumor. Local anesthetics are used when the frame is inserted, and despite this, the procedure is very uncomfortable and painful for the patient.

The TrueBeam radiosurgery system does not require a head frame. This system allows high doses of radiation to be delivered to the tumor with minimal impact on healthy tissue.

In some cases, TrueBeam treatment is preferable to standard radiation therapy because it preserves healthy tissue surrounding the tumor. Treatment of tumors of the eye and eye socket is particularly challenging due to their proximity to vital brain structures.

The TrueBeam System is an effective treatment option for these tumors because the delivery of radiation is highly targeted. Tumors of the eye and eye socket significantly reduce patients’ quality of life, and the TrueBeam System, in turn, allows you to save your vision.

All these treatment options are available in more than 530 hospitals worldwide (https://doctor.global/results/diseases/eye-cancer). For example, Enucleation of the eyeball can be performed in 5 clinics across Germany (https://doctor.global/results/europe/germany/all-cities/all-specializations/procedures/enucleation-of-the-eyeball).