Dr. Ann Musika Completes ECF Fellowship

From Uganda to Israel, and Back Home Again

Hailing from Kampala, Uganda, Dr. Ann Musika has completed her 6-month ophthalmic oncology fellowship training sponsored by the Eye Cancer Foundation.

From Left: Dr. Ann Musika, Dr. Alezam, Dr. Didi Fabian, and Dr. Vicktoria Vishnevska-Dai

For the past six months, Dr. Musika has trained at Sheba Medical Centre at the Goldschleger Eye Institute under supervision of the director of the ocular oncology unit, Dr. Vicktoria Dai. Her training included all aspects of eye cancer care––from diagnosis, to treatment, to intravitreal injections for radiation retinopathy. Additionally, she took part in various research studies at Goldschleger’s ophthalmology department.

The Eye Cancer Foundation places an emphasis world-class training as well as practical and applicable training. So while Dr. Musika learned all aspects of eye cancer treatment practiced at Goldschleger’s, she specifically focused on treatments and techniques that would be just as readily available to her in Kampala.

Dr. Ann Musika (second from the left) alongside Senior ocular oncologists (Presenters) with after the ocular oncology training at the University of Sienna Italy on December 6th-7th, 2018

“It is with great pleasure that I express my sincere gratitude

to you for the great support that you offered me…all this wouldn’t have been possible without your generous support. The knowledge and skills acquired from this training I hope to apply to improve the quality of care for our ocular oncology patients in my nation. I am forever grateful.”

Prior to Dr. Musika, there were no fellowship-trained eye cancer specialists in Uganda. Consequently, patients with eye cancer suffered not only from their disease, but also from a lack of specialized care. However, now upon the completion of her training, Dr. Musika intends to return to Uganda and provide her nation with much-needed specialty care.

 

To Learn More about the Eye Cancer Foundation, its mission, and fellowship opportunities, visit the website at www.eyecancercure.com.


Day 4: Live From the ISOO 2019!

Day 4 at the ISOO: Retinoblastoma

Every two years, eye cancer specialists worldwide convene at the International Society of Ocular Oncology Conference in order to review latest research and encourage international collaboration within the field of ophthalmic oncology.

For details on the ISOO Biennial Conference, read more here.


Preventing Retinoblastoma

Dr. Helen Dimaras opened with her talk on clinically preventable retinoblastoma, having analyzed the frequency of unfavorable outcomes such as death, metastasis, enucleation, EBRT, and how we can avoid such outcomes. Looking at data retrospectively allows physicians to “review how patients do and improve practice by looking at the past, reducing errors, and improving documentation and precision of care.”

In high-income nations, frequency of poor outcomes is low, and we need to work on expanding such rates abroad. Not only this, but a comment from the audience emphasized the significance of this study’s call to action: even just one child who succumbs to retinoblastoma is a child lost, and such outcomes need to be taken very seriously. We need to avoid misdiagnosis and under-treatment as much we humanly can to ensure that unfavorable outcomes do not happen in the future.


“Chemoplaques”

Dr. Brenda Gallie presented an interesting study regarding a device named “chemoplaques” in Chemoplaque (sustained-release topotecan episcleral device) for retinoblastoma: Opportunity for rapid clinical evaluation of toxicity and efficacy to support safe eye salvage. The devise works through continuous exposure via diffusion, and has thus far produced promising results. By day 28, most of the studied tumors had gone away, and many were gone even earlier, by day 18.


International Fellowship Training Guidelines

Forming Plans for Future Fellowships

In an auxiliary lecture hall, many of us gathered to discuss training fellows all over the world in order to create and develop international treatment centers that will allow greater access to eye cancer care in underdeveloped countries and underserved areas. Sound familiar? As this is one of the primary missions of The Eye Cancer Foundation, Chairman of the ECF, Dr. Finger gave a lecture and lead the discussion.

Dr. Finger with fellows trained by Dr. Honavar in Hyderabad, India. From left: Dr. Sumeet Lahane, Dr. Paul Finger, Dr. Puneet Jain, Dr. Mrithika Sen, Dr. Ankit Tomar, and Dr.

So what is the plan of action? Flexible fellowships with candidates sent from the ophthalmic society of the unserved or underserved region. Being underserved locations, we must be open to 3-month long fellowships, since the physician is needed in their country to give care. 12-month fellowships oftentimes are unfeasible. We must also make a collaborative effort to increase funding for such programs. Dr. Finger says “It has been my experience that funding can come from unexpected places. All you need to do is discuss this wonderful work we are doing and relate how we need help. It is a blessing to allow others to share in the accomplishment of saving children’s sight and life.”

Full video of Dr. Finger’s Lecture Here!

International Fellowship Training Guidelines Meeting Attendees

 


Day 3: Live From the ISOO 2019!

Day 3 at the ISOO: Melanoma, Other Intraocular Cancers, and Basic Retinoblastoma Science

Every two years, eye cancer specialists worldwide convene at the International Society of Ocular Oncology Conference in order to review latest research and encourage international collaboration within the field of ophthalmic oncology.

For details on the ISOO Biennial Conference, read more here.


Dr. Puneet Jain presenting his iris varix poster

Dr. Puneet Jain returned to give us some insight on iris varix by presenting his paper Iris varix: 10-year experience with 28 eyes, published alongside Dr. Paul Finger during his Eye Cancer Foundation fellowship. The study began with the intention to more clearly define iris varix, consistent characteristics, imaging findings, and note any consistent change that might occur with observation. The results showed that iris varix is “primarily located in the inferotemporal quadrant, not associated with dysmorphic pupillary findings, progression, secondary glaucoma, or malignancy.” Essentially, “iris varices were benign vasculopathies with no associated ocular or vision-related morbidity.”


Dr. Ekaterina Semenova’s poster presentation

Why are some cases naturally suppressed by the immune system? Dr. Ekaterina Semenova raised the question, noting five cases in which choroidal melanoma in the patient had spontaneously regressed in her paper Spontaneously Regressed and Apparently Dormant Choroidal Melanomas, also published alongside Dr. Finger. She opened up discussion to the audience, though consensus was that this would be an interesting topic for future research in order to determine the cause. Now that such cases have been documented, we have this data to look back on and, hopefully, make additions to.


Dr. Abhilasha Maheshwari (left) and Dr. Paul Finger (right) after another successful poster presentation!

Finger’s Slotted Plaques was recognized in Dr. Abhilasha Maheshwari presentation, A 12-Year Study of Slotted Eye Plaque Radiation for Choroidal Melanoma: Near, Touching, or Surrounding the Optic Nerve. Over a decade’s worth of data was analyzed and slotted plaques were found to be very effective and resulted in good patient outcomed for patients whose tumor lies close to the optic nerve. These plaques offer more proper positioning of the plaque, allowing radiation to the entire melanoma plus a 2-3 mm margin. Dr. Maheshwari concluded that even after 12 years, “slotted plaque radiation therapy resulted in high rates of local tumor control and vision and eye retention.”


That’s all for today’s ECF highlights! Day 4 will be fully dedicated to retinoblastoma. Stay tuned!

 

To help sponsor fellowships and fellow research, donate to The Eye Cancer Foundation at www.eyecancercure.com/donate.


The ECF Establishes the First Eye Pathologist in Jordan

Prior to involvement of The Eye Cancer Foundation (ECF), Jordan had no practicing eye cancer specialists. We trained Dr. Yacoub Yousef and he established the first eye cancer referral center at The King Hussein Cancer Center in Amman. After years of building this center, Dr. Yousef has trained many eye cancer specialists for the surrounding countries and has offered life and vision-sparing treatments for patients throughout the Middle East. Finally, with a place to go, patients requiring eye treatment inundated these hospitals. With more and more patients needing eye cancer services, Jordan and the Middle East needed a specialist in eye pathology.

In response to this need, The ECF supported Dr. Jakub Khzouz’s fellowship in ophthalmic pathology and oncology with Dr. Sarah Coupland at the Royal Liverpool Hospital in Liverpool, England. Dr. Khzouz has so far spent one year learning modern methods of ophthalmic pathology (adult and pediatric), as well as the diagnosis and treatment of eye cancers.  

Dr. Khzouz reports that his exposure to Eye and general Pathology with Dr. Coupland at  Liverpool Hospital’s pathology laboratory was significantly different from his prior experience in Jordan. He learned that eye cancer specimens should be handled by trained eye pathology specialists. “Proper sample grossing and detailed reporting are important for staging and aid management,”says Dr. Khzouz. He intends to reassess prior pathology reports, stating that “once back in Jordan, my first project will be to review all the retinoblastoma cases archived in our pathology laboratory, independently report and stage them according to the latest 8th edition AJCC-TNM system, and then compare that with the original reports.” Such will be important for research purposes, as well as defining the impact and importance of fellowship-training with respect to complicated pathologies.

Our fellows have even greater plans for the future of eye cancer treatment in Jordan. Dr. Khzouz intends topartner with the first eye cancer specialist in Jordan, ECF Fellow Dr. Yacoub Yousef. “I have discussed with my colleague Yacoub, and by working together we will improve the quality of the King Hussein Ocular Tumor Service and reach out to other laboratories and countries to perform molecular and genetic testing for eye cancer patients.”

Through our fellowship programs, The Eye Cancer Foundation has sought to provide unserved and underserved countries with the best quality fellowship education and training from some of the most experienced specialists in the world. We motivate our fellows to bring new techniques and advancements to their home countries so that access to optimal eye cancer treatment becomes universal. We will continue to support our fellows, Dr. Yousef and Dr. Khzouz and now offer Jordan two fellowship-trained eye cancer specialists who are dedicated to saving sight, saving life and “paying it forward” by teaching fellows from other middle eastern countries.

However, our goal is not yet complete. Many more countries are in great need, and we hope to place at least one eye cancer specialist in each country. Click here to donate to our cause.

 


World Cancer Day 2019

For nearly 20 years, the Union for International Cancer Control has brought the world together  in a unified front against cancer. World Cancer Day aims to “unite the cancer community to reduce the global cancer burden, promote greater equity, and integrate cancer control into the world health and development agenda” (worldcancerday.org).

The Eye Cancer Foundation’s goals closely align with those put forth by World Cancer Day. Life-saving diagnostic techniques and treatment methods for cancer should be accessible to everyone throughout the world. This is the exact reason why the ECF has emphasized and supported the placement of fellowship-trained cancer specialists in unserved and underserved countries for the past 20 years. While we continue researching and innovating for more precise treatment, we also want interventions available in order to halt the preventable deaths of children with retinoblastoma and patients with cancers of the eye and orbit.

“We believe that access to life-saving cancer diagnosis, treatment, and care should be equal for all – no matter where you live, what your income, your ethnicity or gender…We believe that individuals, together can create change.” – worldcancerday.org

This coming World Cancer Day, consider supporting and raising awareness for eye cancer, a rare cancer variety in critical need of worldwide acknowledgement.


More about World Cancer Day: https://www.worldcancerday.org/

Donate to the ECF: https://eyecancercure.com/donate


New ECF Graduates Bring Their Skills to Egypt and India

Saving the Underserved in Egypt and India…

We at The Eye Cancer Foundation are pleased to celebrate the graduation of our two most recent recent fellows: Dr. Puneet Jain from India and Dr. Moanes Morkos from Egypt. In traditional ECF manner, both fellows return to their country with goals to care for eye cancer patients, advocate for patients, improve treatment and training. They will present their ECF sponsored research work at eye meetings in their countries and around the world.

Having successfully completed their training, Dr. Jain and Dr. Morkos now join the ranks of over forty fellows trained and sponsored by the ECF. Not only have we reached the goal of our 2020 Campaign––to train 20 eye cancer specialists in 20 unserved and underserved countries by the year 2020––we have doubled it.

With the support of our donors, we have taken on and answered many previously unsolved questions about eye tumor diagnosis and treatment  this year. We hope that this momentum does not decline, but rather accelerate, and bring us to a future where ocular melanoma, retinoblastoma and eye cancer deaths do not exist.

To become a patron, simply give a gift to The Eye Cancer Foundation. You can sponsor fellows like Dr. Jain and Dr. Morkos, buy prosthetic eyes for retinoblastoma children, or aid in any of our numerous goals for a clearer, brighter future.

Next stop: the rest of the world!

Donate Now!


ECF Fellow Presents: How to Save Eyes in Cairo, Egypt

Dr. Abhilasha Maheshwari (above) presents ECF research at Ophthalmic Oncology Meet

November 22nd Cairo, Egypt:

November 22nd Cairo, Egypt: Physician scholars came together for The 2nd Middle East Ophthalmic Oncology & Pediatric Retina Meeting. Organized by Dr. Ihab Othman, the meeting fostered discussion of various topics in ocular oncology.

The Eye Cancer Foundation (ECF) fellow, Dr. Abhilasha Maheshwari, shared recent findings of ECF supported research. She first presented her research with her mentor and ECF-chair Dr. Paul T. Finger. The article, titled Regression Patterns of Choroidal Melanoma After Palladium-103 (103Pd) Plaque Brachytherapy, shows how choroidal melanomas regress after 103Pd plaque radiation therapy.  Initially discovered as effective ocular cancer treatment by Dr. Finger in 1990, 103-Pd ophthalmic plaques have since been scientifically proven to be more gentle and effective than its precursor, 125-I. [See our results after 103Pd plaque therapy for choroidal melanomas on our website!] Results showed the tumors became darker, decreased in thickness, and there was a reduction or complete elimination of the tumor vascularity.

Dr. Maheshwari continued her presentation on choroidal melanoma by discussing patients whose tumors were located very close to the optic nerve. This talk, “A 12-Year Study of Slotted Palladium-103 (103Pd) Radiation Therapy for Choroidal Melanoma: Near, Touching, or Surrounding the Optic Nerve, discusses how using specially designed plaques created by Dr. Finger, even melanomas that surround the optic nerve can be treated with eye and vision sparing radiation therapy (instead of removing the eye). Dr. Maheshwari’s results showed > 98% tumor control, while most had relative preservation their sight and eye.

The Eye Cancer Foundation takes great pride supporting research that improves patient care. Our fellows are given travel grants to spread the word around the world. As we spread knowledge of these unique findings and improved treatments, we also spread hope for those who would alternatively lose both sight and life.

 


 

To donate to the ECF and help sponsor fellowships, research, and cancer treatments, click here!

Read Dr. Finger and Dr. Chagule’s paper here.

Read Dr. Finger and Dr. Maheshwari’s paper here.


Trailblazing Eye Cancer Studies Presented at AAO 2017

 

As you may have heard in our previous blog, the American Academy of Ophthalmology (AAO) 2017 Meeting in New Orleans, Louisiana was attended by noteworthy fellowship alumni from the Eye Cancer Foundation, as well as founder and executive director of the ECF, Dr. Paul T. Finger. Held from November 11th to 14th, AAO took place the day following the 2017 AAOOP Annual Meeting, where oral presentations were given by ECF Fellows Dr. Sonal Chaugule and Dr. Abhilasha Maheshwari.

Dr. Chagule spoke on her research regarding the efficiency of intravitreal steroids to treat radiation side-effects, while Dr. Maheshwari spoke on a 12-year study of patients treated with slotted plaque radiation therapy. To read more on AOOP 2017 presentations from these ECF fellows, click here.

At AAO 2017, hosted at the Ernest N. Morial Convention Center in New Orleans, Dr. Sonal Chaugule, Dr. Ekatrina Semenova, and Dr. Nicole Scripsema presented ECF-sponsored research conducted under the guidance of Dr. Paul T. Finger at the New York Eye Cancer Center and at New York Eye and Ear Infirmary.

Dr. Sonal, pictured below along Dr. Finger, presented two studies, the first titled “Regression patterns of Iris Melanoma after Palladium-103 Plaque Brachytherapy”. This study takes into account 50 iris melanoma patients who were closely evaluated following plaque brachytherapy with Palladium-103 as treatment. The results of this study underscored Palladium-103 as effective treatment for iris melanoma. After incisive evaluation, patients showed decreases in tumor size, tumor pigmentation, and more. These findings are particularly important to iris melanoma patients, who endure a rare condition in the already-rare family of cancers (iris melanoma patients are only 2-3% of eye cancer cases). To read more on this paper and its implications, click here.

Dr. Chaugule’s second presentation concerned her paper most-recently published in the Indian Journal of Opthalmology. Titled “Primary Topical Chemotherapy for Giant Ocular Surface Squamous Neoplasia”, this paper examines and reports the outcomes of using topical chemotherapy eye drops (such as 5-Flurouracil and/or Interferon alpha-2b) to treat giant ocular surface squamous neoplasia. The paper was featured in a past blog post — to read more on the study, which evaluated 10 patients with stage T3 tumors, click here.

Details from AAO do not stop here! Stay tuned for more exciting news on the work ECF Fellows make towards eye cancer research by keeping eyecancer.com in your bookmarks!


AAO Newsletter Features Paper Published by ECF Fellow

From the summer of 2016 to 2017, Dr. Sonal S. Chaugule gained a wealth of knowledge as an Eye Cancer Foundation (ECF) fellow under the tutelage of Dr. Paul T. Finger at the NYECC. From shadowing Dr. Finger’s surgeries at the New York Eye and Ear Infirmary, to speaking at the Second Eye Cancer Working Day in March 2017, Dr. Chaugule has since returned to India, using the knowledge she has gained as tools to continue in the footsteps of her mentors. Her efforts manifest in her paper, in collaboration with Dr. J. Park and Dr. Paul Finger, being published by the American Academy of Ophthalmology.

Featured in the headlines of the AAO Newsletter, the paper was first published by the Indian Journal of Ophthalmology in December 2017, and discusses the effectiveness and safety of topical chemotherapy as sole treatment for giant ocular surface squamous neoplasia (OSSN). Ten patients (3 female, 7 male) with biopsy-confirmed giant OSSN were treated with topical chemotherapy drops (interferon alpha 2b and/or 5 flurouracil 1%). Then, patients were monitored for changes in tumor response, vision, recurrence of disease, metastasis, and treatment complications.  

Pictured below are samples from the paper, revealing slit-lamp photographs of patients afflicted with OSSN before treatment (A, C) and after treatment (B, D). Pre-treatment for both patients (A, C) and post-treatment (B, D) reveal complete tumor regression after treatment via topical chemistry therapy drops. You may note that there is no evidence of opacity, or haziness, to the cornea in the after photos.

Results found that there was no evidence of vision-limiting complications due to treatment by chemotherapy drops — no thinning of the sclera (the white of the eye), no cloudiness in the cornea, and no stem cell deficiency. Noteworthily, there were no tumor recurrences, and none of these 10 patients required additional treatment for their giant OSSN such as surgical excision or cryotherapy. For all patients in this study, there was tumor regression, concluding to researchers that topical chemotherapy drops were not only safe, but effective as treatment for giant OSSN. To read the published study in full, click here.

 

The ECF offers fellowships to doctors from unserved and underserved countries, providing specialized training in the treatment of retinoblastoma and other eye cancers. Once they complete their training, ECF fellows commit to return home to create eye cancer treatment programs. Dr. Chaugule has begun oncology services at HV Desai Eye Hospital in Pune, India, a vital center for eye cancer research and patient treatment, serving a wide population of not only Indians, but also those from the neighboring countries of Pakistan, Bangladesh, and Nepal.   

Through its  2020 Campaign, The Eye Cancer Foundation plans to multiply this success story across the world. With your help, we can train 20 eye cancer specialists to work in 20 countries by 2020.

Our immediate 2020 Campaign goal is to save the lives of 1,000 children by 2020. But that’s only the beginning. Our ability to train doctors and supply them with the equipment they need to properly diagnose and treat retinoblastoma is only limited by the generosity of our donors.

You can become part of the cure with a one-time or recurring donation to The Eye Cancer Foundation. Click HERE to donate today.


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