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Uveal melanoma

If you are diagnosed with a tumour in the eye, melanoma (uveal melanoma, choroidal melanoma), there are several efficient treatment options to choose from. Choice of the right treatment method depends on each particular situation. In order to offer the most efficient and safest treatment method that keeps the functions of the eye, our specialists must evaluate the localization of the disease, tumour in the eye, previous examinations and treatments.

Radiosurgery Centre Sigulda  offers treatment of uveal melanoma with the last generation robot CyberKnife  M6. Treatment of uveal melanoma with radiosurgery does not involve surgical intervention and blood loss.

Treatment of tumours in head with CyberKnife® M6 Step by step

How can we help if you are diagnosed with the uveal melanoma?

  • Since establishment of the Radiosurgery Centre Sigulda (2015) our clinic offers the world's most advanced non-invasive eye tumour treatment method with the Cyberknife® M6 robotic radiation delivery system;
  • CyberKnife® M6 radiosurgery ensures 85% of growth control of a tumour as well as minimal side effects;
  • Our team consists of experienced, highly qualified specialists (neurosurgeon, neuro radiologist, radiation oncologist, medical oncologist as well as ophthalmologist) specialising in diagnosing and treating of tumours affecting eye functions;
  • Each individual case is assessed by the specialist team — within the framework of the board of specialised doctors;
  • Our specialists work according to the guidelines of the professional associations on the basis of recent clinical trials and experience of the leading European clinics, in line with a tailor-made protocol for uveal melanoma treatment;
  • Results of patients treated during two years’ period completely correspond to the results of the leading CyberKnife centres in Europe both in terms of efficiency and safety.

The main task of our specialists is to offer diagnostics and treatment method that is most suitable for you. Ask here and our specialists will help you to understand your situation and find the best solution in your case.

Treatment of uveal melanoma with CyberKnife — 3 years before and after

Treatment methods in case of the uveal melanoma

Several methods or their combinations are used to treat the uveal melanoma:

  • transpupillary thermotherapy;
  • brachytherapy;
  • removal of eyeball (enucleation);
  • radiosurgery.
Uveal melanoma treatment tactics in case of small tumours

Transpupillary thermotherapy must be used in case of small-sized melanomas (3mm). During this therapy temperature of the tumour is gradually increased by means of a laser thus killing cancer cells and slowing down growth of the tumour.

Uveal melanoma treatment with brachytherapy

Brachytherapy – a method where a radioactive iodine or ruthenium plate is stitched to the sclera according to localisation of the tumour. It remains there from few days to 2 weeks and is removed afterwards. This method is used if the tumour is 3-8 mm in size. The method is not efficient in case of large tumours or tumours located close to the optic nerves.

Uveal melanoma treatment with radiosurgery

Radiosurgery is a non-invasive, painless method, applicable to tumours of various localisations and sizes. Before the preparatory procedure of the therapy and before the very treatment itself, medicines are administered into the eye muscle (retrobulbar immobilisation) to render the eyeball motionless. Planning of the procedure is followed by the therapy with the robotic radiosurgery system CyberKnife. It usually takes one therapy session after which the patient can go back to his or her routine schedule. Goal of the therapy is to stop tumour from growing and make it inactive, as well as to keep the functions of the eye. In 35% of the cases the sight does not deteriorate, and in some cases it even improves. Treatment efficiency ratio is 85%. In order to attain the ultimate effect, it is important to use the most cutting-edge diagnostic examinations when preparing and planning the radiosurgery: 3 Tesla magnetic resonance imaging and at least 64 slice computed tomography scan, because in radiosurgery it is possible to radiate the tumour to a precision of a millimetre.

Removal of the eyeball (enucleation)

If the applied methods are not efficient or the tumour has been detected in later stages, the eyeball must be removed (enucleation), however efforts must be made to preserve the eye, if possible. Nonetheless, if it is necessary to remove the eye, a surgery must be performed after the removal to prepare the eye cavity for ocular prosthesis. Very good quality ocular prostheses are manufactured in Valtera protēžu laboratorija.

Treatment of the uveal melanoma with the robotic system CyberKnife

Step one: Consultation and assessment of treatment options

Possible therapy tactics, side effects and course of the therapy are explained in a consultation. Image data from previous analyses and diagnostic radiology are demonstrated and explained, as well as therapy plan is drawn up.

Step two: Tumour board
Step three: Topometry
Step four: Drawing up of individual treatment plan
Step five: Radiosurgery procedure with CyberKnife
Step six: Post-treatment

Eye tumour — uveal melanoma

Melanoma

Melanoma is a malignant tumour developing from cells — melanocytes that produce pigmentation called melanin. These cells are mostly found in skin, but can be located also in eyes, ears, gastrointestinal tract, central nervous system and mucous membranes of mouth and genitals.

Uveal melanoma is the most frequent malignant tumour, and it grows in the soft layers of the eye (iris, ciliary body and choroid). Usually the uveal melanoma is located only in one eye, but in rare cases can be found in both eyes.

Facts about uveal melanoma
  • 6-10 new cases in a year per 1 million inhabitants;
  • Most often in 50-70-year-old individuals;
  • People living in the Northern Europe, having pale skin and freckles that has difficulty in tanning or that does not tan at all are subject to increased melanoma risk;
  • Light eye colour (blue, green etc.);
  • Benign tumours in the eye structures can facilitate growth of the uveal melanoma.
Location
  • Most often in choroid ~80%;
  • In ciliary body ~15%;
  • Most rarely in iris ~5%.
Symptoms and complaints

Uveal melanoma can exist for a long time without causing any symptoms or complaints. Most often it is detected when examined by an ophthalmologist or when any of the following symptoms have appeared:

  • Brownish spot in the white part of the eye;
  • Foggy vision;
  • Loss or deterioration of vision;
  • Defects of the field of vision;
  • Feeling of pressure in the eye;
  • Pain.
Diagnostics

Diagnosis can be proven with the following methods:

  • During the fundoscopy an ophthalmologist can notice a foggy mass;
  • Ultrasonography or fluorescein angiography can prove tumour of the choroid;
  • Biomicroscopy and goniomicroscopy is used in diagnostics of the iris and ciliary body (painless method, during which the structures of the eye can be assessed);
  • Optical coherence tomography is a non-invasive method of imaging diagnostics, which allows a precise, detailed and fast examination of the iris, optic nerve and frontal structures of the eye: cornea, anterior chamber corner, sclera, iris, conjunctiva.

Radiosurgery Centre Sigulda specialists

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