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Eye Melanoma – Treatment Options, Medications, and Management

What are the treatment options for eye melanoma? What are the common drugs and medications used to treat eye melanoma? What are the various ways to manage eye melanoma? What are the generic and brand names of drugs used for the treatment of eye melanoma?

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Treatment Options, Medications, and Management Plans for Eye Melanoma

New York (USA), May 03, 2018

What are the treatment options for eye melanoma?

Eye Melanoma Treatment Options: Once a diagnosis of eye melanoma is made, options of treatment depends on the location, site of origin within the eye, size of the tumor, as well as patient age, overall health, visual potential and status of the unaffected eye.

Because eye melanoma is resistant to conventional systemic therapies, early diagnosis and treatment is essential.

If the melanoma has metastasized, or multiplied, it can be more difficult to treat. Find an eye melanoma specialist to help you with your treatment decision.

The primary goals of treating the eye tumor include preventing metastasis, sparing the eye and preserving vision.

Treatment Options for Primary Eye Melanoma include:

– Plaque Radiotherapy (Brachytherapy)

– Proton Beam Radiotherapy

– Radiation Therapies

– Stereotactic Radiotherapy

In some cases, the recommended treatment for eye melanoma is surgical removal of the tumor. Surgery is normally recommended for tumors of large size and for iris melanomas in particular.

Surgery may also be recommended for recurrent disease, after initial radiation treatment.

Types of surgery for eye melanoma are:

– Enucleation

– Iridectomy

– Iridocyclectomy

– Trans-Sclera Local Resection

– Trans-Retinal Endoresection

Once eye melanoma has spread beyond the eye, it is considered to be metastatic. About half of eye melanoma patients will develop metastatic disease.

Treatment of metastatic eye melanoma is:

– Liver Directed Treatments: Resection, Ablation, and Radiation

– Systemic Treatments: Chemotherapy, Immunotherapy, Ipilimumab (Yervoy), Targeted therapy

– Transarterial Catheter-Directed Liver Therapies: Hepatic Arterial Chemoinfusion (HAI), Transarterial Chemoembolization (TACE), Immunoembolization, Radioembolization, Isolated Hepatic Perfusion (IHP)

Why it can sometimes be difficult to treat and manage an eye melanoma?

Treatment for eye melanoma depends on several factors, including where and what type of tumor it is, the size of the tumor, and the patient’s general health.

If there is a small lesion, a doctor may advise monitoring it instead of treating it straight away, as treatment can lead to some vision loss.

Surgery: A number of surgical options are available for eye melanoma.

1. Choroidectomy

2. Enucleation

3. Iridotrabeculectomy

4. Iridectomy

5. Iridocyclectomy

Radiation and other Targeted Therapy: Radiation therapy can destroy the genetic material of cancer cells and stop them from reproducing.

There are two types of radiation treatment for eye melanoma. These are teletherapy and brachytherapy.

For treating eye melanoma, the radiation is carefully targeted to destroy the cancer cells while limiting damage to healthy cells.

Transpupillary Thermotherapy (TTT): Transpupillary thermotherapy is a type of infrared laser therapy that uses heat in the form of a laser to minimize smaller tumors.

Cryotherapy: Cryotherapy can freeze the cancerous cells.

What are the benefits and risks of various treatment options for eye melanoma?

You may have one or a combination of following treatments for eye melanoma. Your treatment plan for eye melanoma will depend on factors such as the size and position of the tumor, your general health and your eyesight.

Treatment for eye melanoma may include:

1. Chemotherapy Eye Drops

2. Cryotherapy

3. Photodynamic Therapy (PDT)

4. Radiotherapy

5. Surgery

6. Transpupillary Thermotherapy (TTT)

1. Chemotherapy Eye Drops: Sometimes you are given chemotherapy eye drops after cryotherapy for eye melanoma. Your doctor will explain how to use the eye drops. The drops can make your eye and eyelid red and sore. Let your doctor know if this happens so they can help.

2. Cryotherapy: Cryotherapy can be given after surgery to reduce the risk of conjunctival melanoma coming back. The doctor solidifies the area to kill any cancer cells that may have been left behind after surgery. You may have a local or a general anaesthetic for this treatment.

3. Photodynamic Therapy (PDT): Photodynamic therapy may sometimes be used to treat some eye melanomas. This treatment uses a laser, or other light sources, combined with a light-sensitive drug to destroy eye cancer cells.

4. Radiotherapy: Radiotherapy uses high-energy rays to destroy the eye cancer cells, while doing as little harm as possible to normal cells. There are different types of radiotherapy – External radiotherapy and Proton Beam Radiotherapy.

5. Surgery: This may involve removing just the tumour, a small part of the eye, or sometimes the whole eye. The type of surgery you have depends on the size and position of the tumour.

6. Transpupillary Thermotherapy (TTT): Transpupillary thermotherapy can be used to treat very small eye melanomas, or after radiotherapy to reduce the risk of the cancer coming back. The doctor gives you a local anesthetic then uses a type of laser beam to destroy the cancer cells by heating them. You may require more than one treatment. You can go home a few hours after treatment.

What are the different medicines usually prescribed by doctors for eye melanoma?

Once a tumor is diagnosed as melanoma, treatment is needed to prevent further growth of the tumor, or spread of the tumor from the eye to other sites.

The type of treatment that is recommended depends on the size and location of the eye melanoma.

For small and medium sized melanomas, the most common form of treatment is radiation.

For large melanomas (thickness > 8 mm or basal diameter > 16 mm) the most common form of treatment is removal of the eye (enucleation).

In some cases, large tumors are treated with radiation if the treatment is possible, and there are convincing reasons to preserve the eye.

Other treatments that may be employed in special circumstances are laser photocoagulation, transpupillary thermotherapy, cryotherapy, or local resection of the tumor.

Prior to treatment for eye melanoma, certain screening tests are obtained to evaluate for the presence of the melanoma at sites distant from the eye (metastasis), and to serve as a baseline for comparison to future tests.

At the time of diagnosis of an eye melanoma, involvement of other sites can only be detected with current tests in approximately 2% of patients. However, there could be microscopic spread that is not noticeable with preoperative scans or blood tests.

The most common locations of distant involvement with melanoma of the eye are the liver and the lungs. As mentioned above, it is unusual to find evidence of involvement at the time of diagnosis of the eye tumor.

The peak incidence of the appearance of liver involvement is about 4 years after treatment of the eye tumor. However, metastasis may emerge even decades after treatment, so eye melanoma patients must be followed for an indefinite period after treatment to observe for metastasis.

The probability of metastasis is dependent on the size and the type of melanoma cells present in the tumor.

What are the common drugs and medications used to treat eye melanoma?

If your ophthalmologist suspects you have an eye melanoma, you may be referred to an eye surgeon who specializes in treating eye melanoma.

Different types of treatments are available for patients with eye melanoma. Some treatments are standard or currently being used, and some treatments are being tested in clinical trials.

What are the generic and brand names of drugs used for the treatment of eye melanoma?

Melanoma that has increased outside of the eye can be hard to treat, and unfortunately, standard chemotherapy drugs often are not very useful.

In recent years, medical researchers have developed newer types of drugs to treat advanced eye melanomas.

What are the essential drugs and treatments for managing eye melanoma?

More than one specialist with more than one type of treatment treats many persons with eye melanoma. This is known as a multidisciplinary team approach.

Treatment for eye melanoma may include cryotherapy, radiotherapy; surgery; chemotherapy eye drops; transpupillary thermotherapy, and photodynamic therapy. You may need one or a combination of these eye melanoma treatments.

Is it possible to treat an eye melanoma without medicine?

Your eye melanoma treatment options will depend on the location and size of the eye melanoma, as well as your preferences and your overall health.

A small eye melanoma may not require immediate treatment. If the melanoma is small and it is not growing, you may choose to wait and observe for signs of growth.

If the melanoma grows or causes complications, you may decide to undergo treatment at that time.

What are the various ways to manage eye melanoma?

The treatment method used for eye melanoma depends not only on the size and location of the tumor (choroid, ciliary body, or iris), but also whether or not the cancer has spread.

The patient’s overall health must also be considered. The foremost goals in treating eye melanoma are to prevent the spread of the tumor and to preserve the patient’s vision.

Observation may be used for the treatment of small or slowly growing eye melanoma tumors. It may also be the best option for those whose cancer is in their only functioning eye.

Surgery is a common procedure for the treatment of eye melanoma. A surgeon will remove the affected parts of the eye depending on the size and spread of the tumor.

In some cases, the removal of the eye or enucleation is the only practical treatment option in order to save the patient’s life.

Radiation therapy uses high-energy beams to kill the cancer. Radiation therapy can be conducted using proton beams (charged particles), brachytherapy (internal radiation), or traditional external radiation.

Why day-to-day care is essential for any eye melanoma management plan?

For day-to-day care and management plan for eye melanoma, you will need to find out more about steps to take to help cope with physical, social, and emotional side effects.

If you have eye melanoma or are close to someone who has eye melanoma, knowing what to anticipate can help you cope with this disease.

If eye melanoma does recur at some point, further treatment will depend on where the cancer is, what treatments you have had before, and how is your health.

Regardless of form of treatment of the eye tumor, patients with eye melanoma need to make a conscious decision about follow up screening for metastatic disease.

Caring and coping with eye melanoma includes learning about the diagnosis and eye melanoma treatment options, and communicating with your health care team.

Learn more about the treatment options, medications, and management plans for eye melanoma.

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