As ocular oncologist Renelle Lim, MD, sometimes wonders about how to keep your eyes safe from the sun. Eye cancer - is not the same thing as skin cancer, and any connection between sunlight and melanoma of the eye is not proven, - said Dr Lim, who is the only ocular oncologist in Connecticut.
Prior to joining the ophthalmology medicine at Yale University, Dr. Lim studied at the hospital, Will-of-the-Eye in Philadelphia, specializing in ocular oncology and plastic surgery for the eyes. At Yale, she often works with other specialists, including otolaryngologists and neurosurgeons, surgical removal of tumors precisely to protect nearby sensitive structures that may affect the external appearance of the patient.
eye cancer is rare, and the American Cancer Society predicts 3,500 new diagnoses in 2018. It can develop at any age, but the risk increases as people get older. Many cancer patients very well to treatment when the problem is diagnosed early. But often have no symptoms, so people with eye cancer have no idea what that something is wrong. For this reason, Dr. Lim says that the best thing anyone can do to detect eye cancer earlier - it be inspected once a year by an ophthalmologist.
Eye cancer is so rare. People are surprised to learn that they have it?
Yes, because many types of eye cancer may be asymptomatic. Sometimes it may be flashes of light, blurred vision. Sometimes it can be painful. But if the cancer is small and in a place that is not near vital structures of the eye, can generally be no symptoms.
What types of eye cancer are there?
Well, the cancer may exist near the eyes, on the surface of the eye or inside it. Cancer century - a skin cancer close to the eye. Thus, you can get a cell carcinoma, basal on the arm or back, or you can get it on the eyelid. Cancer can also occur after or at the eyeball orbit. These cancers can spread from other parts of the body.
Cancer that exist within the eye are different from skin cancer. Uveal (or eye) melanoma is the most common primary tumor in the eye. This occurs uvee or middle layer of the eyeball, and it can occur when a genetic mutation develops in the pigmented cells of the eye. It is unclear why it develops, although there are genetic predisposition syndromes that may be responsible for this.
People often do not realize that the cancer can spread from other parts of the body like the lungs or chest, and affect the eyes. In fact, the most common cancer of the eye is not the primary - a metastasis, or cancer that started in another part of the body and spread to the eye. Ophthalmologists will be looking for, if there is a history of cancer elsewhere in the body, and there are new ocular symptoms such as loss of vision or flashing lights.
Who is most at risk of these cancers?
Melanoma of the eye may be affected at all, but it tends to occur more than people with lighter hair and eye color. Some studies have shown that welders have a slightly increased risk of developing melanoma, which, according to some, is due to ultraviolet radiation from the welding tools or other environmental reasons. There is no convincing scientific evidence supporting the claim that exposure to the sun is associated with uveal melanoma. In addition, we do not really know what causes mutations that lead to cancer of the eye.
When you suspect cancer of the eye, how do you diagnose?
I am doing a full eye examination using a silt lamp and indirect ophthalmoscope. That gives me a full picture of what is happening inside the eye. It suffices to determine the mass which may be domed or have a mushroom configuration. I use several imaging techniques, to obtain as much information about the possibilities of a tumor. I use an ultrasound to determine the mass density and see its features and measure the thickness accurately. I also use optical coherence tomography, to shed light on the layers of the retina and to assess the presence of a thin liquid, characteristic tumor activity. I even use MRIs when you need it.
Sometimes I'm doing fine needle-biopsy to take a small sample of tumor cells, which then I give Cytopathology (pathologist who examines the cells). He or she will tell me if he is aggressive and can confirm the diagnosis in a few days.
How you treat cancer?
Tumors on the eye can manage local chemotherapy, targeted therapy, radiation, or surgical removal. Tumors in the eye are controlled differently. Typical treatment - this radiation in the form of brachytherapy. It is most often used for uveal melanoma, but it can also be used for other types of eye cancer.
We try to give the least amount of radiation dose, so that we can protect the vital structures such as the optic nerve, which transmits visual information from the retina to the brain. The goal is to maximize treat a tumor, but keep other areas of security.
How well it helps to save a person's vision?
Our success depends on the type of eye cancer and its stage of development. There is a probability of success of 95 to 98 percent for local tumor control. By shadow outlines tumor treatment begins, the radioactive device is placed directly over the tumor. Ophthalmoscopy or direct visualization are used to double-check the correct fields.
Is there anything you can do to prevent the disease?
I recommend to use sunglasses and sunscreen. The sun is not directly connected with uveal melanoma, but we know that exposure to ultraviolet radiation can affect the structure of the eyes and the patient's disposition to cataracts and cancer age. In general, to maintain a good immune system helps to prevent cancer - so, do not smoke, eat right, go in and take care of yourself!