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How Ocular Melanoma Is Treated

What to know about ocular melanoma treatment, including approaches like radiation, laser, cryotherapy, surgery, complementary treatment and more. Ocular melanoma is a rare type of cancer that starts in the dark-pigmented melanin cells of the eye. Understanding the best treatment options is top of mind for people diagnosed with this condition.The aim is to preserve as much vision as possible

  • Posted on 17th May, 2022 09:40 AM
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Ocular melanoma is a rare type of cancer that starts in the dark-pigmented melanin cells of the eye. Understanding the best treatment options is top of mind for people diagnosed with this condition.

The aim is to preserve as much vision as possible while eradicating ocular melanoma. From types of radiation therapy to laser treatment or surgery and more, it's important to know what each of these can offer.

This article will discuss treatments for ocular melanoma tumors, such as radiation or laser therapy, consider when surgery is called for, highlight the role complementary therapy may play, and more.

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Surgeries and Specialist-Driven Procedures

The type of treatment options available will depend in large part on the size and location of the tumor when you are diagnosed, as well as your own overall health.

In some cases, if the ocular melanoma is small enough, the ophthalmologist (eye doctor) or oncologist (cancer specialist) may recommend that it initially just be carefully watched.

Some melanomas may grow very slowly and it may be difficult at first to determine if this is truly a melanoma. So, your provider may hold off on all treatments in place of observing your condition for three to four months to see if the cells in question begin to grow.

Radiation Therapy

Traditionally, radiation therapy is offered in treating ocular melanoma. It is used to damage tumor cells, causing them to die. There are different types of radiation treatment. These can include:

  • Brachytherapy (plaque therapy): Small radioactive seeds are placed on a disk, also known as a plaque. The plaque is temporarily placed in the eye socket, on the outside of the eye and near the tumor. It is generally removed after several days. With small to medium-sized tumors, brachytherapy can eliminate the tumor and preserve vision in nine out of 10 cases.
  • External beam radiation: This treatment focuses a fine beam of radioactive particles on the tumor. It is often given over several days.
  • Focused radiation approaches: One possibility is proton-beam therapy, in which beams of light travel a certain distance before they release any radioactive energy, potentially sparing healthy tissue. Another approach is stereotactic radiosurgery. With this, radiation beams are precisely delivered with machines such as the Gamma Knife, CyberKnife, or Clinac.

Laser Therapy

Laser therapy may be offered together with brachytherapy or when radiation approaches or surgery are not feasible. Most commonly, transpupillary thermotherapy (TTT) involving use of light and heat is used to kill the tumor.

Another approach, laser photocoagulation, which burns tissue with high-energy light beams, is sometimes used to treat extremely small melanomas.

Cryotherapy

Cryotherapy, in which the tumor is frozen, may be useful for treating small ocular melanoma tumors.

Surgery

Surgery may be used to remove just the tumor itself, particularly if it is very small, or for removal of the eye if the tumor is too extensive or has already severely damaged the eye. Typically, it is only used for particularly large tumors or in cases in which the use of radiation is not possible.

Eye removal is reserved for cases in which the tumor takes up more than half of the socket, which may be causing pain and already involves significant vision loss. The eye can be replaced with an artificial one that does not see but cosmetically matches the other eye.

Topical Chemotherapy

Topical chemotherapy, such as interferon or Mitomycin-C, may be given with a particularly aggressive cancer such as melanoma of the conjunctiva (the clear tissue covering the white part of the eye) that has been surgically removed. The idea is to help ensure that this does not spread elsewhere.

Complementary and Alternative Medicine (CAM) 

In addition to standard therapy, some people opt for complementary and alternative medicine. These are actually different.

Complementary methods are not treatments themselves. Rather, they alleviate some of the side effects of treatment and help you to maintain a heightened sense of well-being. Some complementary therapies you may wish to consider include the following:

  • Meditating
  • Receiving acupuncture (thin needles are inserted at specific points, thought to direct energy)
  • Changing diet
  • Starting yoga (a mind-body practice involving physical poses, breathing exercises, and meditation)
  • Using guided imagery (using mental images to achieve relaxation)
  • Undergoing reflexology (applying pressure to specific points on the foot)
  • Getting a massage

While these methods won't treat ocular melanoma, they may help you to better deal with this diagnosis in the long run.

Alternative methods are treatments that some try instead of standard therapy. These may fall into one of two categories. Either they have not yet made their way through rigorous clinical trials, or, if they have, they've been found not to be effective.

Keep this in mind if you hear anything about megadoses of vitamins, herbs, homeopathy (where tiny amounts of a natural substance that in larger doses would cause illness are given), or other unsubstantiated treatment.

Summary

The aim of treatment for ocular melanoma is to eradicate the cancer while preserving vision. If the ocular melanoma is small enough, a wait-and-see approach to treatment will be taken. Commonly, types of radiation, including brachytherapy, external beam radiation, and focused radiation approaches, are first-line options.

With laser therapy, light and heat may be used to kill the tumor cells. Surgery may be needed for very small tumors, in cases in which radiation is not feasible, and in those instances in which it is necessary to remove the eye to help ensure the tumor does not spread elsewhere.

A Word From Verywell

Finding the best treatment for ocular melanoma means taking the size and location of the tumor into account. There is a variety of treatment options that can help to kill tumor cells while sparing healthy tissue. It will be up to your cancer team to decide which will be the best in your case.

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