In some cases, the recommended treatment for uveal melanoma is surgical removal of the tumor. Surgery is often recommended for tumors of large size and for iris melanomas. Surgery may also be recommended after radiation. It may also be recommended if the tumor grows after radiation or causes complications such as eye pain or severe vision loss. Surgery
Iridocyclectomy Removal of part of the iris (iridectomy) as well as the ciliary body (cyclectomy) where the tumor is present. Trans-scleral local resection Removal of the tumor through an opening in the wall, or the white part, of the eye. This is often used when the tumor is large. It is generally performed at specialized centers and may be combined with a radioactive plaque placed over the treated area to reduce the risk of tumor recurrence .
Types of surgery include: Enucleation Removal of the eye is sometimes
recommended in cases involving large tumors. This procedure is less common today due to the effectiveness of radiation for most small and medium tumors. Following enucleation, an artificial eye may be placed in the socket and, with the help of an ocularist, made to look like a natural eye. Iridectomy Removal of part of the iris where the tumor is present.
OTHER POSSIBLE TREATMENTS
Neoadjuvant Treatment
Transpupillary thermotherapy The temperature of the tumor is slowly raised, killing cancer cells and shrinking the tumor. This treatment is now less commonly used as a primary treatment and is more often used for very small tumors or as an adjunct to radiation. Gamma Knife A focused, single dose of radiation is given to the tumor, sparing healthy tissue in and around the eye. Gamma Knife is rarely used for primary ocular melanoma and is more often considered for melanoma metastases to the brain. Intraocular injections Injections in the eye are used to administer medications to treat a variety of ocular conditions. These may include steroids for inflammation and/or anti-VEGF (anti-angiogenic) agents, which shrink abnormal blood vessels. Intraocular injections are sometimes used if radiation has caused changes to the retina or optic nerve (radiation retinopathy).
Neoadjuvant treatment is a treatment used to reduce primary tumor size to reduce radiation or avoid enucleation. There are ongoing neoadjuvant clinical trials — speak to your doctor to see if neoadjuvant clinical trials are right for you. Adjuvant Treatment Adjuvant treatment is defined by treatment used after the primary treatment to prevent recurrence or spread of disease (plaque radiation, enucleation). Currently in UM, adjuvant treatments are in the clinical trial stage. In clinical trials, adjuvant treatments are often recommended for patients with high risk of recurrence. Speak to your doctor about adjuvant clinical trials to see if there is one that is right for you.
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