How intraocular melanoma is treated

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:

• Surgery (taking out the cancer)
• Radiation therapy (using high-dose x-rays or other high-energy rays to kill cancer cells)
• Laser therapy (using an intensely powerful beam of light to destroy the tumor or blood vessels that feed the tumor).

Surgery is the most common treatment of intraocular melanoma. A doctor may remove the cancer using one of the following operations:

1. Iridectomy removes only parts of the iris.
2. Iridotrabeculectomy removes parts of the iris and the supporting tissues around the cornea, the clear layer covering the front of the eye.
3. Iridocyclectomy removes parts of the iris and the ciliary body.
4. Choroidectomy removes parts of the choroid.
5. Enucleation removes the entire eye.
6. Orbital exenteration removes the eye and other tissues within the eye socket.

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.

Treatment by stage

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.