Common Laser Surgery Used In Uncommon Cancer

Armen Hareyan's picture
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During a routine eye exam earlier this year, Mike Samogala learned he had a rare form of cancer known as melanoma of the eye. Because the cancer was so advanced, surgeons had to remove his eye to save his life.

"I was aware that there was melanoma, but I never thought of it being in the eye," says Samogala, 49, of Delaware, Ohio. "This was something no one could see coming, literally."

Although rare, it is the most common type of cancer that develops within the eyeball in adults, says Dr. Thomas Olencki, a medical oncologist at the James Cancer Hospital and Solove Research Institute who specializes in treating eye melanoma.

"If the tumor is discovered when it is small, it may be treated without removal of the eye," says Dr. Frederick Davidorf, an ophthalmologist at Ohio State's Medical Center. "If the tumor is relatively thin, it can be destroyed with laser surgery."

Approximately 90 percent of eye melanomas develop in the choroid, which is a thin, pigmented layer lining the eyeball that nourishes the retina and the front of the eye with blood. The disease, also known as uveal melanoma, afflicts about 2,400 Americans annually, and an estimated 240 people will die from it this year, according to the American Cancer Society.

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Location of the tumor within the eye determines the degree of visual loss from the surgery.

"Laser treatments may be used for very early, very thin melanomas that are not near the optic nerve," Olencki says. "These patients require closer follow up, but using the laser can preserve most of their vision in many cases and almost assure patients long-term survival."

Laser therapy is a vast improvement over surgical removal of the eye and radiation treatments.

"Our main goal is patient survival. With laser treatment, we can destroy the tumor and save the eye," says Davidorf, who is part of the multi-disciplinary team at Ohio State that treats eye melanoma patients. "We want to treat the disease early, before it has a chance to metastasize and spread to other parts of the body."

Melanoma of the eye is typically discovered during routine eye exams. Symptoms may include a decreased ability to see; floaters or flashes of light; visual field loss; a growing dark spot on the iris. Primary eye cancers can occur at any age, but most cases occur in people over age 50.

Doctors aren't sure what causes eye cancer, but as with most tumors, it likely has something to do with the patient's genetic makeup. His pale blue eyes may have put Samogala more at risk, according to the American Cancer Society. "Diagnosing eye melanoma early is truly critical because not only does it permit patients to retain much of their visual acuity, but it dramatically increases their overall survival," says Olencki.

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