Choroidal Melanoma: Causes, Symptoms, Diagnosis and Treatment

Choroidal melanoma symptoms are a bit different than the skin ailment often connected to the word melanoma. While they are both due to pigment cells obsessively splitting, they manifest in different ways due to the nature of their location. It’s not as easy to see, but even in eye melanoma, there are tiny, often discolored tumors.

Basic overview of choroidal melanoma symptoms

Instead of noticing the warning signs of the actual mole or freckle, changes in visual abilities will need to be taken into account. Blurred or partial loss of vision which can’t be corrected using contacts or glasses is one thing to look into.

Floating specs in your visual field (those transparent worm thingies) or random areas of unexpected white glares is another even to notice (like a flashing or blindspot).

Causes behind choroidal melanoma

Nobody knows the exact causes behind choroidal melanoma, but they have determined factors which contribute to vulnerability. Sun exposure goes hand in hand with melanoma although the exact mechanisms pulling the strings of this connection are not well understood. Of course, it’s complicated and not the matter of a sole puppet master. Other characteristics such as having bluer or greener eyes make you more vulnerable than someone with brown eyes.

Choroidal melanoma treatments

Although these will change between cases of varying severity and personal situations, overall, chemo and radiation drugs are used as a last resort. Although still invasive and risky, surgeries are often suggested over these other treatments as they are less detrimental to healthy tissues and have fewer side effects. If the affected region is localized, they can also be an easier and safer way to effectively eliminate the cancer cells. Choroidal melanoma treatments and varying rates of success as this is a rather aggressive and fast spreading cancer that often goes undetected for too long.

Immunotherapy drugs are being tested, but currently pembrolizumab (Keytruda) and ipilmumad (Yervoy) are heavily immplemented. Brachytherapy (Plaque therapy) is when doctors plant seeds of radioactive material close to the cancer. The planted pellets are left for 4 to 7 days, but effects won’t be observed for months. Stereotactic radiosurgery and proton beam radiation therapy are options. Special machines are needed to perform these to both create protons or carry out the radiosurgeries. A gamma knife shoots beams at many different angles during a single session. Cyberknife or Clinac used computer controlled radiation which rotate in a 180 degrees circular motion over multiple sessions. Nanomedicine is being experimented with, so nanobots may be closer than we think.

How does chemotherapy and radiation work?

This is not the kind of therapy where you lay on a couch of a psychoanalyst and discuss your feelings for hours. (Although you may find psychological and psychiatric intervention a healthy way to address mental issues you have as a result of the diagnosis). Instead, it is specially designed chemical interventions aiming to kill cancer cells.

This component of cancer that makes it difficult to treat, detect, and research is the fact that it is your cells doing it. It’s a bit confusing to wrap your mind around, but essentially cancer is when cells enterally replicate. Replication through mitosis, the natural way single celled eukaryotes divide and reproduce, is expected will cells. They are generally programmed to do this a number of times depending on the brain region. They do this to disappear when they’ve done their job and replace themselves. Instead of doing this when needed, cancerous cells do it out of control in an unnatural and ineffective manner. The excessive duplication leads to exponentially growing populations of cells which can disrupt cell function and ultimately kill you. Aside from them that, they are genetically identical to your healthy cells.

Researchers have taken this component of the condition and tailored chemo and other aggressive interventions to attack that. While they can successfully kill cancer cells, all diving cells can be interfered with. This means healthy cells will fall victim to the treatment as well. Cells prone to a lot of replacement (such as in the hair, skin, and nails) will be attacked during the treatment. This is why the stereotype cancer patient is bald or has discolored skin.

Will I go blind?

While visual loss is considered a more advanced symptom, it is a likely possibility. Your eye is being attacked, however, if you catch it early enough, should not be a chief concern unless left untreated. Certain treatments generally associated with end stage characteristics may involve damaging the eye in order to preserve the rest of your life.

A glass prosthetic or eyepatch is better than a gravestone. Try not to let aesthetic compromise your mortality. In these cases, an eye removal (or removing extensive amounts of tissues) will result in partial or complete blindness.

How are the stages of choroidal melanoma defined?

The staging of cancer is defined by the spread. According to the American Joint Committee on Cancer (AJCC), doctors generally use the TNC approach to decide the sage of cancer. T, for tumor, evaluates the size of the mass as well as the location. N, node, determines if it has spread to the lymph nodes yet and if so, the number of infected regions. Finally, M, metastasis, measures whether or not cancer has spread to other parts of the body and if so, how much has it covered. Staging can be gauged clinically (through physical examinations and imaging techniques) or through pathological means (through surgical procedures). What the physician used can often be determined by a lowercase c or p written on the medical documents. Overall, pathological staging is invasive and comes with more risks, but offers a more accurate estimation and prognosis.

Choroidal melanoma prognosis

The prognosis of choroidal melanoma varies between patients. Complications due to expansion to vital organs are the main concern. If it is caught in the eye before it manages to take a trip elsewhere and treated effectively while still contained, your outlook will be brighter. If you only notice it at stage three or four where it’s managed to attack an important organ, it may already be too late.

 

 

Article References:

  1. https://www.ohsu.edu/xd/health/services/casey-eye/clinical-services/specialty-services/oncology/chorodial-melanoma.cfm
  2. https://www.webmd.com/cancer/chemotherapy-what-to-expect
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5228280/
  4. https://www.touchophthalmology.com/2012/03/15/current-methods-for-the-diagnosis-and-treatment-of-choroidal-melanoma/

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