Treatment options for eye melanoma, also known as ocular melanoma, depend on various factors including the size and location of the tumor, its growth pattern, and whether it has spread to other parts of the body (metastasis). Here are some common treatment approaches for eye melanoma:
Observation: Small, slow-growing tumors that are not causing symptoms or affecting vision may be monitored closely with regular eye exams and imaging studies (e.g., ultrasound) to assess tumor growth and progression over time. Observation may be appropriate for some cases of small, non-metastatic eye melanoma, particularly in elderly patients or those with underlying health issues.
Surgery: Surgical removal of the tumor is often recommended for localized eye melanomas that are confined to the eye and have not spread beyond the eye socket. Depending on the size and location of the tumor, different surgical techniques may be used, including:
Local Resection: Removal of the tumor along with a margin of healthy tissue to ensure complete excision while preserving vision whenever possible.
Enucleation: Removal of the entire eye (eyeball) may be necessary in cases of large or invasive tumors that cannot be safely resected while preserving vision. Enucleation is typically reserved for advanced or aggressive eye melanomas that pose a risk of vision loss or metastasis.
Radiation Therapy: Radiation therapy, including brachytherapy (internal radiation) or external beam radiation, may be used as a primary treatment for eye melanoma or as an adjuvant therapy following surgical resection to destroy remaining cancer cells and reduce the risk of recurrence. Radiation therapy is particularly effective for treating tumors located near critical structures within the eye that are difficult to access surgically.
Proton Beam Therapy: Proton beam therapy is a specialized form of radiation therapy that delivers targeted radiation to the tumor while minimizing damage to surrounding healthy tissues. Proton beam therapy may be recommended for large or irregularly shaped eye melanomas, as well as tumors located close to critical ocular structures (e.g., optic nerve, macula).
Thermal Laser Therapy: Laser therapy, such as transpupillary thermotherapy (TTT) or photocoagulation, may be used to treat small or early-stage eye melanomas by applying focused laser energy to the tumor to destroy cancer cells and promote tumor regression.
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Chemotherapy: Systemic chemotherapy is generally not considered a primary treatment for eye melanoma due to limited efficacy and significant side effects. However, chemotherapy drugs may be used in combination with other treatments as palliative therapy for advanced or metastatic eye melanoma to alleviate symptoms and improve quality of life.
Targeted Therapy: Targeted therapy drugs, such as immune checkpoint inhibitors or molecularly targeted agents, may be used in clinical trials or as experimental treatments for metastatic eye melanoma that has spread beyond the eye to other organs (e.g., liver, lungs). These drugs work by targeting specific genetic mutations or immune system pathways involved in cancer growth and progression.
Clinical Trials: Participation in clinical trials may offer access to novel treatment approaches, investigational therapies, or experimental drugs for individuals with advanced or treatment-resistant eye melanoma. Clinical trials are designed to evaluate the safety and efficacy of new treatments and may provide options for patients who have exhausted standard treatment options.
The choice of treatment for eye melanoma depends on individual factors, such as the stage of the disease, overall health, and treatment goals. It's essential for patients to discuss treatment options and make informed decisions in collaboration with a multidisciplinary team of healthcare professionals, including ophthalmologists, oncologists, radiation oncologists, and other specialists, to ensure the best possible outcomes and quality of life.
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