What is retinoblastoma?
This is a rare form of eye
cancer that usually occurs during childhood. It starts in the retina, the part
of the eye that captures light and sends images to the brain.
Symptoms
The first clue, and the most
obvious symptom, is that the eye is not looking correctly. In particular, his
normally black pupil may appear white. In the photo, instead of "red
eyes", a child with retinoblastoma will have a pupil that glows white when
light hits it.
Other symptoms include:
- An eye or eyes that appear larger than normal
- Cloudiness or discoloration in the center of the eye
- Eye pain
- Eyes that cross or look in different directions
- Redness in the white of the eye
- Vision problems
These symptoms can also be
caused by less serious problems. But as soon as possible, ask the doctor to
check for any vision problems in your child.
Causes
Retinoblastoma occurs when a
certain gene is changed or mutated in a child's DNA. The job of this gene is to
control cell division. When it doesn't work properly, retinal cells grow out of
control.
In most cases, genetic damage
occurs by chance and occurs in a single cell. This causes swelling in one eye.
Some children are born with a
damaged gene in every cell of their body. These children will likely have more
than one tumor and will have them in both eyes. They also have a higher chance
of getting other types of cancer. They can also pass the disease on to their
children.
Diagnostics
To diagnose this type of
cancer, an ophthalmologist carefully examines the inside of the eye using a
bright light and a magnifying glass. If it looks like cancer, the next step is
to find out how big the tumor is and if it has spread. Your child may take one
of the following tests:
- Ultrasound -
sound waves create images of your baby's eyes
- Magnetic resonance imaging - strong magnets and radio waves create detailed images of
the eye
- CT scanner -
multiple x-rays taken from different angles are stitched together to show more
information
The results help clinicians
choose the best course of action.
Treatment
The sooner cancer is detected,
the greater the chance of saving your child's vision. Doctors usually use a
combination of treatments, such as:
- Chemotherapy: Strong drugs help shrink the tumor before other treatments. If the cancer has not spread, drugs can be injected directly into the eye or into the blood vessels leading to it. If the cancer can spread or has already spread, your child will likely take medication by mouth or by vein so that it can act throughout the body.
- Cryotherapy: Touching a super-cooled metal probe freezes and kills cancer cells. It works best with small tumors in the front of the eye.
- Thermotherapy: a special laser kills cancer cells with heat. Doctors use it alone for small tumors or in combination with other treatments for large tumors.
- Laser therapy:
Another type of laser acts on the blood vessels that feed the tumor and
destroys them. This works for small tumors at the back of the eye.
- Radiation: There are two types of radiation therapy. For small tumors, the surgeon may sew a disc containing radioactive material to the eyeball near the tumor. Your child stays in the hospital for a few days while he works, then the disc is removed. Older technologies use a machine to focus radiation beams on tumors. This is usually only used if other strategies don't work.
- Surgery: If the tumor is very large at the time of discovery, it may not be possible to save the child's vision. In these cases, the eye may be removed.
It is nearly impossible for a
small child to sit still long enough for a close examination, let alone having
something done to their eye. Very young patients are usually sedated or tested
and treated.
What to expect
Retinoblastoma is almost always
curable, especially if it hasn't spread outside the eye.
Children who have been treated
for retinoblastoma need very careful follow-up. Your child will have frequent
checkups to watch for signs of a return of the cancer.
Frequent checks are important
for other reasons as well. Children who have the damaged gene in every cell may
have other types of cancer later in life because the gene does not help stop
the cancer the way a healthy gene would. And children who receive radiation or
chemotherapy are also more likely to get cancer again.
Most cancers caused in this
way can be treated if caught early.
Doctors recommend genetic testing to determine if your child has a type of genetic damage that can be passed down. Parents, siblings should also be tested.