Retinoblastoma, which is cancer in the retina of one or both eyes, affects mostly children under the age of 5. Standard retinoblastoma treatment types include radiation therapy, chemotherapy, and cryotherapy, as well as enucleation and thermotherapy. A pediatric oncologist works with other specialists to devise the appropriate treatment for retinoblastoma.
Radiation therapy as a retinoblastoma treatment involves the use of x-rays or something similar to eliminate cancer cells, as well as stop them from growing. Radiation treatments break down into two types — internal and external. Internal radiation therapy treats retinoblastoma tumors through a radioactive-sealed substance found in catheters, needles, or wires. External therapy sends radiation from a machine to the body to treat the tumor.
Like other types of cancers, retinoblastoma may be treated with chemotherapy. Once the patient takes the drug treatment intravenously or orally, the medicine travels through the bloodstream to kill the cancer cells or prevent them from growing. Depending on the cancer stage, retinoblastoma may be treated through a type of chemotherapy known as chemoreduction. During the process, the size of the tumor shrinks so that doctors can treat it locally, or in its exact location.
During cryosurgery, or cryotherapy, the surgeon uses a specialized instrument to freeze any cells that appear abnormal. Generally, the group of cells remains in situ, meaning that they have not spread throughout the body. As a preventative measure, the surgeon opts for this retinoblastoma treatment to remove the abnormalities because they may become cancerous in the future.
If the tumor is large enough to endanger the patient’s vision, then the doctor may recommend undergoing enucleation retinoblastoma treatment. Before the surgery, the doctor uses a microscope to check for any signs of the tumor spreading from the eye to nearby parts of the face or body. During the procedure, the surgeon removes the affected eye as well as part of its optic nerve, and then later provides the patient with an artificial eye. Afterward, the doctor must follow up with the patient for several years to check for signs of recurrence in the affected eye, as well as monitor for signs of retinoblastoma in the other eye.
Another type of treatment for retinoblastoma, thermotherapy, relies on heat to kill cancerous cells in the eye. Also known as laser therapy, thermotherapy may be used to destroy smaller cancer cells in the eye and surrounding areas. Thermotherapy involves the use of a laser beam, which doctors point toward the outside of the eyeball or dilated pupil. Doctors may also combine the treatment with chemotherapy to effectively eradicate larger tumors.
Medical experts in childhood cancers often oversee treatment of retinoblastoma and follow-up care. A retinoblastoma patient primarily works with a pediatric oncologist, who, in turn, works with a pediatric ophthalmologist to ensure the right surgical options. The team may also include a pediatric surgeon, radiation oncologist, and a pediatric nurse specialist, to name a few. Most types of retinoblastoma treatment require some form of follow-up to check for side effects, and recurring or new tumors.