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Information from PDQ for Patients
Intraocular melanoma
208/01279
** DESCRIPTION **
-- What is intraocular melanoma? --
Intraocular melanoma, a rare cancer, is a disease in which cancer (malignant)
cells are found in the part of the eye called the uvea. The uvea contains
cells called melanocytes, which contain color. When these cells become
cancerous, the cancer is called a melanoma. The uvea includes the iris (the
colored part of the eye), the ciliary body (a muscle in the eye), and the
choroid (a layer of tissue in the back of the eye). The iris opens and closes
to change the amount of light entering the eye. The ciliary body changes the
shape of the lens inside the eye so it can focus. The choroid layer is next to
the retina, the part of the eye that makes a picture.
If there is melanoma that starts in the iris, it may look like a dark spot on
the iris. If melanoma is in the ciliary body or the choroid, a person may have
blurry vision or may have no symptoms, and the cancer may grow before it is
noticed. Intraocular melanoma is usually found during a routine eye
examination, when a doctor looks inside the eye with special lights and
instruments.
The chance of recovery (prognosis) depends on the size and cell type of the
cancer, where the cancer is in the eye, and whether the cancer has spread.
** STAGE EXPLANATION **
-- Stages of intraocular melanoma --
Once intraocular melanoma is found (diagnosed), more tests will be done to find
out exactly what kind of tumor the patient has and whether cancer cells have
spread to other parts of the body. This is called staging. A doctor needs to
know the stage to plan treatment. Intraocular melanoma is staged based on the
area of the eye where the tumor is found and the size of the tumor.
-- Iris --
Intraocular melanomas of the iris occur in the front colored part of the eye.
Iris melanomas usually grow slowly and do not usually spread to other parts of
the body.
-- Ciliary body/choroid, small size --
Intraocular melanomas of the ciliary body and/or choroid occur in the back part
of the eye. They are grouped by the size of the tumor.
Small size ciliary body or choroid melanoma is 2 to 3 millimeters or less
thick.
-- Ciliary body/choroid, medium/large size --
Intraocular melanomas of the ciliary body and/or choroid occur in the back part
of the eye. They are grouped by the size of the tumor.
Medium/large size ciliary body or choroid melanoma is more than 2 to 3
millimeters thick.
-- Extraocular extension --
The melanoma has spread outside the eye, to the nerve behind the eye (the optic
nerve), or to the eye socket.
-- Recurrent --
Recurrent disease means that the cancer has come back (recurred) after it has
been treated.
** TREATMENT OPTION OVERVIEW **
-- 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)
- photocoagulation (destroying 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:
Iridectomy removes only parts of the iris.
Iridotrabeculectomy removes parts of the iris and the supporting tissues
around the cornea, the clear layer covering the front of the eye.
Iridocyclectomy removes parts of the iris and the ciliary body.
Choroidectomy removes parts of the choroid.
Enucleation removes the entire eye.
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.
Photocoagulation is a treatment that uses a tiny beam of light, usually from a
laser, to destroy blood vessels and kill the tumor.
-- 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.
** IRIS MELANOMA **
If the tumor is small, there are no symptoms, and the tumor is not growing,
treatment may not be needed. If the tumor begins to grow or if there are
symptoms, treatment may be one of the following:
1. Surgery to remove parts of the iris (iridectomy).
2. Surgery to remove parts of the iris and the supporting tissues around the
cornea (iridotrabeculectomy).
3. Surgery to remove parts of the iris and the ciliary body
4. Surgery to remove the eye (enucleation).
** CILIARY BODY AND CHOROID MELANOMA, SMALL SIZE **
If the tumor is small, there are no symptoms, and the tumor is not growing,
treatment may not be needed. If the tumor begins to grow, or if there are
symptoms, treatment may be one of the following:
1. Internal radiation therapy.
2. External beam radiation therapy.
3. Surgery to remove the tumor and part of the iris or choroid
(iridocyclectomy or choroidectomy).
4. Surgery to remove the eye (enucleation).
5. External beam radiation therapy followed by enucleation.
** CILIARY BODY AND CHOROID MELANOMA, MEDIUM/LARGE SIZE **
If the tumor is not growing, treatment may not be needed. If treatment is
needed, it may be one of the following:
1. Internal radiation therapy.
2. External beam radiation therapy.
3. Surgery to remove the tumor and part of the iris or choroid
(iridocyclectomy or choroidectomy).
4. Surgery to remove the eye (enucleation).
5. External beam radiation therapy followed by enucleation.
6. A clinical trial. A large trial is in progress in many parts of the
country comparing standard treatments. Clinical trials are also testing
new treatments.
** EXTRAOCULAR EXTENSION MELANOMA **
Treatment may be one of the following:
1. Surgery to remove the eye and other tissues in the eye socket (orbital
exenteration) with or without radiation therapy.
2. Surgery to remove the eye (enucleation) with or without radiation therapy.
** RECURRENT INTRAOCULAR MELANOMA **
Treatment will depend on the treatment the patient received before, the
patient's age and health, where the cancer came back, and how far the cancer
has spread. The patient may want to take part in a clinical trial.
** TO LEARN MORE **
Call
For more information, U.S. residents may call the National Cancer Institute's
(NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237)
Monday through Friday from 9:00 a.m. to 4:30 p.m. Deaf and hard-of-hearing
callers with TTY equipment may call 1-800-332-8615. The call is free and a
trained Cancer Information Specialist is available to answer your questions.
Web sites and Organizations
The NCI's Cancer.gov Web site (http://cancer.gov) provides online access to
information on cancer, clinical trials, and other Web sites and organizations
that offer support and resources for cancer patients and their families. There
are also many other places where people can get materials and information about
cancer treatment and services. Local hospitals may have information on local
and regional agencies that offer information about finances, getting to and
from treatment, receiving care at home, and dealing with problems associated
with cancer treatment.
Publications
The NCI has booklets and other materials for patients, health professionals,
and the public. These publications discuss types of cancer, methods of cancer
treatment, coping with cancer, and clinical trials. Some publications provide
information on tests for cancer, cancer causes and prevention, cancer
statistics, and NCI research activities. NCI materials on these and other
topics may be ordered online or printed directly from the NCI Publications
Locator (https://cissecure.nci.nih.gov/ncipubs). These materials can also be
ordered by telephone from the Cancer Information Service toll-free at
1-800-4-CANCER (1-800-422-6237), TTY at 1-800-332-8615.
LiveHelp
The NCI's LiveHelp service, a program available on several of the Institute's
Web sites, provides Internet users with the ability to chat online with an
Information Specialist. The service is available from 9:00 a.m. to 10:00 p.m.
Eastern time, Monday through Friday. Information Specialists can help Internet
users find information on NCI Web sites and answer questions about cancer.
Write
For more information from the NCI, please write to this address:
National Cancer Institute
Office of Communications
31 Center Drive, MSC 2580
Bethesda, MD 20892-2580
** ABOUT PDQ **
PDQ is a comprehensive cancer database available on Cancer.gov.
PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information
database. Most of the information contained in PDQ is available online at
Cancer.gov (http://cancer.gov), the NCI's Web site. PDQ is provided as a
service of the NCI. The NCI is part of the National Institutes of Health, the
federal government's focal point for biomedical research.
PDQ contains cancer information summaries.
The PDQ database contains summaries of the latest published information on
cancer prevention, detection, genetics, treatment, supportive care, and
complementary and alternative medicine. Most summaries are available in two
versions. The health professional versions provide detailed information
written in technical language. The patient versions are written in
easy-to-understand, non-technical language. Both versions provide current and
accurate cancer information.
The PDQ cancer information summaries are developed by cancer experts and
reviewed regularly.
Editorial Boards made up of experts in oncology and related specialties are
responsible for writing and maintaining the cancer information summaries. The
summaries are reviewed regularly and changes are made as new information
becomes available. The date on each summary ("Date Last Modified") indicates
the time of the most recent change.
PDQ also contains information on clinical trials.
Before starting treatment, patients may want to think about taking part in a
clinical trial. A clinical trial is a study to answer a scientific question,
such as whether one treatment is better than another. Trials are based on past
studies and what has been learned in the laboratory. Each trial answers
certain scientific questions in order to find new and better ways to help
cancer patients. During treatment clinical trials, information is collected
about new treatments, the risks involved, and how well they do or do not work.
If a clinical trial shows that a new treatment is better than one currently
being used, the new treatment may become "standard."
Listings of clinical trials are included in PDQ and are available online at
Cancer.gov (http://cancer.gov/clinical_trials). Descriptions of the trials are
available in health professional and patient versions. Many cancer doctors who
take part in clinical trials are also listed in PDQ. For more information,
call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237); TTY at
1-800-332-8615.
Date Last Modified: 09/2002
******************************************************************************
* If you want to know more about cancer and how it is treated, or if you *
* if you wish to know about clinical trials for your type of cancer, you *
* can call the NCI's Cancer Information Service at 1-800-422-6237, toll *
* free. A trained information specialist can talk with you and answer *
* your questions. *
******************************************************************************
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This information has been brought to you by
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