Proton beam radiation therapy: Instead of using x-rays as in standard radiation therapy, this approach aims proton beams toward the cancer. For eye melanomas, the use of this type of radiation therapy is generally limited to newer methods that focus narrow beams of radiation on the tumor. In this approach, radiation from a source outside the body is focused on the cancer. The outlook for vision is not as good if the tumor is very close to the optic nerve, which carries visual images from the eye to the brain.
This treatment cures about 9 out of 10 small to medium size tumors and can preserve vision in some people, depending on what part of the eye the melanoma is in.
The full effect of the radiation on the tumor is not usually seen for 3 to 6 months. You will probably be able to go home the same day. Another surgery is then done to remove the plaque. You will probably stay in the hospital during this time. The plaque is usually left in place for at least a few days, although the exact amount of time depends on the size of the tumor and the strength of the radiation source. This can sometimes be done with local anesthetic (numbing medicine) and sedation, although sometimes general anesthesia might be needed (where you are in a deep sleep). The plaque is sewn in place on the eyeball with tiny stitches during a short operation. The radiation travels a very short distance, so most of it will be focused only on the tumor. The plaque is typically shaped like a very small bottle cap and has gold or lead on the outside to shield nearby tissues from the radiation. In this approach, a small carrier containing radioactive “seeds” (known as a plaque) is placed on the outside of the eyeball over where the tumor is. Studies have shown that in many cases it is as effective as surgery to remove the eye (enucleation). This has become the most common radiation treatment for most eye melanomas. This form of radiation therapy might also be called ocular brachytherapy or episcleral plaque therapy. An advantage over surgery is that the eye structure is preserved, which can result in a better appearance after treatment.ĭifferent types of radiation therapy can be used to treat eye cancers. Sometimes vision might be lost if the radiation damages other parts of the eye. Radiation therapy can often save some vision in the eye. It is a common treatment for eye melanoma. Radiation therapy uses high-energy x-rays to kill cancer cells.
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