Your eye melanoma treatment options will depend on the location and size of the eye melanoma, as well as your overall health and your preferences.
Waiting to treat small eye melanomas
A small eye melanoma may not require immediate treatment. If the melanoma is small and isn't growing, you and your doctor may choose to wait and watch for signs of growth.
If the melanoma grows or causes complications, you may choose to undergo treatment at that time.
Radiation therapy uses high-powered energy, such as protons or gamma rays, to kill cancer cells. Radiation therapy is typically used for small to medium-sized eye melanomas.
The radiation is usually delivered to the tumor by placing a radioactive plaque on your eye, directly over the tumor in a procedure called brachytherapy. The plaque is held in place with temporary stitches. The plaque looks similar to a bottle cap and contains several radioactive seeds. The plaque remains in place for four to five days before it's removed.
The radiation can also come from a machine that directs radiation, such as proton beams, to your eye (external beam radiation, or teletherapy). This type of radiation therapy is often administered over several days.
Treatment that uses a laser to kill the melanoma cells may be an option in certain situations. One type of laser treatment, called thermotherapy, uses an infrared laser and is sometimes used in combination with radiation therapy.
Photodynamic therapy combines medications with a special wavelength of light. The medicine makes the cancer cells vulnerable to light. The treatment damages the vessels and the cells that make up the eye melanoma. Photodynamic therapy is used in smaller tumors, as it isn't effective for larger cancers.
Extreme cold (cryotherapy) may be used to destroy melanoma cells in some small eye melanomas, but this treatment isn't commonly used.
Operations used to treat eye melanoma include procedures to remove part of the eye or a procedure to remove the entire eye. What procedure you'll undergo depends on the size and location of your eye melanoma. Options may include:
- Surgery to remove the melanoma and a small area of healthy tissue. Surgery to remove the melanoma and a band of healthy tissue that surrounds it may be an option for treating small melanomas.
Surgery to remove the entire eye (enucleation). Enucleation is often used for large eye tumors. It may also be used if the tumor is causing eye pain.
After the eye with melanoma is removed, an implant is inserted into the same position, and the muscles controlling movement of the eye are attached to the implant, which allows the implant to move.
After you've had some time to heal, an artificial eye (prosthesis) is made. The front surface of your new eye will be custom painted to match your existing eye.