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Ophthalmologists Called to Catch Cancers Earlier

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Significant advances in the management of eye cancer mean that early referrals to subspecialists are crucial when ophthalmologists suspect disease in their patients, two leaders in the field say.

“Don’t be afraid or embarrassed to contact an ocular oncologist,” said Carol Shields, MD, from Wills Eye Hospital in Philadelphia.

Improvements in prognosis and treatment are saving the eyes and lives of patients with uveal melanoma and retinoblastoma, said Timothy Murray, MD, from Ocular Oncology and Retina in Miami.

Because these cancers are so rare, there have been very few randomized clinical trials. Uveal melanoma, the most common primary eye cancer in adults, affects about 3000 Americans each year, and retinoblastoma, the most common eye cancer in children, affects about 300.

This means there is currently no consensus on standard of care. But ocular oncologists have helped each other move rapidly forward by tracking their own patients and sharing data with each other, said Murray, who will speak about advances in the field of ocular oncology at the virtual American Society of Retina Specialists (ASRS) 2020 Annual Meeting.

There was a time when enucleation was the only option for patients with uveal melanoma, but a transition to radiotherapy began in the late 1980s. Two forms — brachytherapy and charged-particle therapy — are now in use. And alternatives are being developed that allow ocular oncologists treat smaller and smaller tumors.

Imaging and genetic analyses can now help clinicians identify which cancers are most likely to metastasize.