Retinoblastoma is a cancer of the inner part of the eye which is known as the retina. The retina normally acts like a film of a camera that captures images and imparts us with vision.
Retinoblastoma is caused by a mutation in a gene controlling cell division, causing cells to grow out of control. In a little over half of the cases, this mutation develops in a child whose family has never had an eye cancer.
If the mutation runs in the family, there are major chances that the affected person’s child will also get affected. They will therefore have a high risk of developing Retinoblastoma themselves. The cancer generally affects children under the age of six. It is most commonly diagnosed in children aged between one to two years.
Few facts about Retinoblastoma
- Retinoblastoma is an eye cancer that can occur in any child. It is the most common eye cancer in children.
- There are 5000 new cases every year in the world, and 1500-2000 new cases in India.
- See the doctor in case of white shiny glitter in the centre of the eye, squint, poor vision, or red eye.
- Local therapy, chemotherapy, and radiotherapy can successfully treat the child and save the child’s vision, eye and life!
Signs and tests
The doctor will perform a complete physical exam, including an eye examination that is done after giving anaesthesia. Besides this, sonography (ultrasound scan) of the eye and a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan may be required.
The goals of treatment are to:
- Salvage life
- Salvage the eye
- Salvage vision
Treatment options depend upon the size and location of the tumour.
- Small tumours may be treated by Transpupillary Thermotherapy (TTT) or Cryotherapy. The challenge here is to minimize the scarring and provide optimum vision.
- H For large tumours, Chemoreduction (chemotherapy combined with focal treatment options like TTT) forms the mainstay of treatment. The aim here is to try and salvage the eye, and if possible the vision.
- Radiation may be used for recurrent tumours and tumours that have spread out of the eye, in conjunction with chemotherapy. Radiotherapy may be given via external route or by placing radioactive plaques on the eye known as plaque brachytherapy.
- The eye may need to be removed (a procedure called enucleation) if the tumour does not respond to other treatments. In some cases, it may be the first treatment.
- However, with the present day treatment modalities, there are several options available to salvage the eye, like high-dose chemotherapy, which is monitored by a radiation oncologist, periocular chemotherapy administered by an experienced ocular oncologist and external beam radiotherapy.
Restoration of vision and cure is possible!
If the cancer has not spread beyond the eye, cure and vision restoration are achievable with the advancements in treatment options available nowadays. If the cancer has spread beyond the eye, but within the orbit, the cure is around 70 per cent, and if the tumour spread is beyond the orbit into the brain and elsewhere, the cure is lower.
What are the survival rates for Retinoblastoma?
Nearly 95 % of children with retinoblastoma are cured.
- Both preservation of eye and vision is possible if detected early.
- When retinoblastoma spreads beyond the eye, a child usually has a very poor outcome.
- Early detection of Retinoblastoma is extremely important or the disease can be fatal.
It is always advisable to not mess with the eye. In case you notice anything wrong with the eye, you should see the doctor. Early diagnosis of cancer increases chances of treatment to be successful