EN
Melanoma of the eyes account for approximately 5-7% of the total number of melanoma cases. An eye-striking tumor from melanocytes progresses very rapidly, sprouts into neighboring tissues and gives metastases quickly.
READ IN THE ARTICLE:
What are the types of eye melanoma
Stages of eye melanoma
Methods of treatment of eye melanoma
Prognosis for melanoma of the eye
Clinics treating Eye melanoma
What are the types of eye melanoma?
Eye Melanoma can have different localization. Degree of malignancy depends on the part of the eye affected by the tumor.
- Malignant neoplasm of the eyelid – a rare and most malignant type of tumor;
- A conjunctival eye tumor is also rare tumor with high malignancy;
- Melanoma of the choroid of the eye (tumor of the eye choroid – 85% of cases, melanoma of the iris of the eye – 6%, cancer of the ciliary body of the eye – 9%) – the tumor with such localization is often mistakenly called retinal melanoma. These are less malignant tumors, but still have a high mortality rate.
STAGES OF THE EYE MELANOMA
Consider the stages of the most common eye tumors that are formed in the choroid of the organ.
Tumor of the eye choroid:
- T1A – melanoma of the eye in the initial stage, the tumor has a size up to 7×3 mm;
- T1B – the neoplasm reaches 10×3 mm;
- T2 – the size of the tumor is 15×5 mm, it extends beyond the outer capsule of the eye;
- T3 – malignant neoplasm reaches 15×5 mm;
- T4 – metastases are diagnosed in distant organs.
Tumor of the ciliary body:
- T1 – eye melanoma in the initial stage, the tumor is in the boundaries of the ciliary body;
- T2 – the oncology process extends to the iris / anterior chamber of the eye;
- T3 – the tumor grows into a choroid;
- T4 – metastases are diagnosed in other organs.
Iris cancer:
- T1 – the tumor is localized within the iris;
- T2 – the oncology process reaches 1 quadrant and the angle of the anterior chamber of the eye;
- T3 – the tumor affects couple of quadrants, anterior chamber angle, choroid or ciliary body;
- T4 – cancer process oversteps the boundaries of the eye and there is metastasis.
TREATMENT METHODS OF EYE MELANOMA
The program for the treatment of retinal melanoma or more correctly the vascular shell, depends on the place of onset of the tumor, the oncological stage, the concomitant diseases and the general health of the patient. The main method of treating melanoma of the eye is surgery.
Excision of the tumor can be supplemented by radiotherapy, chemotherapy, as well as treatment with targeted drugs. These methods can be prescribed both before and after surgery.
Operation with melanoma of the choroid of the eye presupposes excision of the tissues affected by the tumor and a small number of surrounding healthy tissues or the enucleation (total removal) of the eyeball at advanced stages. Treatment of melanoma of the choroid of the eye also involves radiotherapy.
When the tumor is localized within the vascular envelope and its small size, it is possible to destroy the tumor with a laser, low or high temperatures: laser- and dia thermocoagulation, cryodestruction, etc.
Preservation of the eye is associated with a risk of recurrence of the melanoma of the eye. Therefore, the decision on this possibility is taken after a thorough diagnosis and refinement of the stage. At the third and fourth stage of the melanoma of the eye, it is most often impossible to save the eye.
Radiation therapy is effective in melanoma of the eye along with radiosurgery and brachytherapy. With the help of the Cyber-Knife radiosurgical unit, it is possible to perform an organ-preserving operation for non-surgical removal of the tumor. Brachytherapy of eye melanoma also allows you to destroy the tumor, retaining the organ and more than half of its functions. To do this, a source of radiation is placed in the eye tissue, which destroys the tumor and then is removed.
PROGNOSIS OF THE EYE MELANOMA
The highest percentage of survival is recorded with melanoma of the iris of the eye. However, it is more rare than other types of eye cancer.
The chances for successful cure of melanoma largely depend on its size. Thus, with melanoma of the choroid of the eye, the prognosis of a 5-year survival with a small choroidal melanoma (stage 1) is 84%. The five year survival rate for people with average choroidal melanoma (stage 1) is 68% and the five year survival rate for patients with big choroidal melanoma (stage 2) is reduced to 47%.
Regarding the occurrence of relapse with eye melanoma – patients with a tumor less than 0.76 mm have the lowest risk of returning the disease. With a tumor measuring 0.76-1.5 mm and larger, the risk of recurrence is significantly increased. Relapse of melanoma of the iris of the eye with metastasis to distant organs is less common than in choroidal melanoma. Within 5 and 10 years after treatment, metastases in iris tumors are found in only 4.1% and 6.9%, respectively, compared to 15% and 25% for choroidal melanomas.
Important question for every person who has been diagnosed with this is how many years a person live with eyes melanoma? The prognosis of 5 year survival for melanoma of the retina (correct – the choroid) on early reaches about 80%. However, everything depends on the tumor size , the degree of invasiveness and localization. For patients with eye melanoma, which has metastasized to distant parts of the body, the 5 year relative survival rate is only 10-15%.
WHAT ARE CLINICS FOR TREATMENT OF THE EYE MELANOMA?
The most effective treatment for melanoma is in Israel. The structure of the well-known Israeli clinic Assuta includes the specialized center Melanoma Unit. Here all kinds of melanoma are treated, including eye melanoma.
In the Melanoma Unit modern protocols of therapy, among which TIL (tumor infiltrating lymphocytes) – a tactic of treatment involving the use of immunity resources in the fight against the tumor are used.
In addition, modern surgical removal of neoplasm, cryo-and laser surgery is available in the center. Melanoma Unit also use SIRT-therapy, which involves the introduction of a radiation source directly into the tumor.
Since Melanoma Unit is a specialized center, the best doctors of Israel with the corresponding specialization are assembled here: oncodermatologists, oncologists, specialists in radiotherapy. Among them are such famous doctors as Professor Jacob Schechter and Prof. Haim Gutman.
