Podcasts from Dr. Finger!

Announcing the Essential Eye Cancer Podcast Page with Dr. Paul Finger! Dr. Finger has been working hard to give you this latest addition to the New York Eye Cancer website. For those of you who are auditory learners, these new Podcasts are where you can find your questions answered regarding Dr. Finger’s treatments, techniques and medical suggestions. Dr. Finger is an internationally recognized eye cancer specialist who offers excellence in ophthalmic oncology care and this information reflects his research, teaching, and experience caring for patients over the last 35 years. He has authored over 300 scientific articles, invented new methods for eye cancer diagnosis and treatment and always strives for excellence in his patient’s care. 

Dr. Finger's podcasts

The first PodCast posted on the page is about Dr. Finger’s anti-VEGF therapy. In 2006, Dr. Finger was the first to find that anti-VEGF intraocular injections can suppress radiation damage to the eye and thus save vision. However, like most medications for chronic disease, these drugs are typically given every 4-6 weeks! Click here to listen on Apple Podcasts! Other major podcast links are also available on our Podcast page. To read along, you can also open our brochure page to find the anti-VEGF brochures or click here. Following the debut of this first podcast, other topics will be posted to the podcast page every Monday. Be sure to check back each week to listen to a new podcast! 

 

Eye Cancer Cluster in Raleigh, North Carolina

A recent article was just published in an online magazine called “Southerly” about a possible correlation between cancer incidence in Huntersville, North Carolina and industrial pollution. This relationship was scrutinized upon learning that several high school kids in a school by Lake Norman were diagnosed with ocular cancer. This prompted the residents to look for a correlation, and their current findings were found to be interesting. So far, there have been 20 cases of ocular melanoma in Huntersville within a population of 56 thousand people. Usually, ocular melanoma is found in 6 per million people. 

Soon, suspicions rose that the industrial pollution below the town could be related to energy development. However, finding a definitive cause for the incidence of cancer across many younger individuals proved more than difficult. Nevertheless, initiatives to fund research started outpouring from citizens. Doctors from Columbia University started to run tests on tumors of patients while the Huntersville Mayor has asked the town for help in funding more research. This research would show whether coal ash or heavy metals could be tied to these cancer clusters.          

In fact, there are many sites around North Carolina that are Superfund sites or industrial facilities, which are required by federal and state governments to test for pollutants. However, there are currently no standards for this testing when communities around the sites begin to develop schools, commercial buildings, and eventually neighborhoods. 

Nonetheless, it is clear that this town must discover answers to this heartbreaking incidence among high school children.

Annual Ophthalmic Oncology Lectureship

At the 41st Annual Tulane Eye Alumni Day at the Renaissance New Orleans Pere Marquette Hotel, Dr. Finger lectured about how and why his important innovations came to life. In the lecture, he discusses his early work on plaque microwave hyperthermia and TRT for intraocular tumors, pd-103 plaque radiation therapy, the slotted plaque, the amniotic membrane buffer technique, epicorneal plaques, and anti-VEGF therapy for radiation maculopathy.

As Dr. Finger presented these innovations in chronological order, thanking his mentors along the way, he provides data to support the success of these creations. As an ophthalmic oncologist and specialist in ophthalmic radiation therapy, Dr. Finger’s inventions have not only paved way for safer radiation therapy practice and reduced vision loss in patients suffering from eye cancer, but also significantly increased patient comfort.

Select Innovations Discussed:

  • Pd-103 Plaque Radiation Therapy:
      • Ophthalmic plaque radiation therapy is used as treatment for choroidal melanoma. The first plaques incorporated radioactive material Cobalt-60 and later Ruthenium-106 and Iodine-125. However, palladium-103 became available for the first time treatment of intraocular tumors.
      • Pd-103 had more advantages than Iodine-125. For example, while in both cases the eye tumor is destroyed, palladium-103 radiation is absorbed faster than iodine-125. This difference relatively spares and thus preserves critical normal intraocular tissues used for seeing and preserving the treated eye.
  • Amniotic Membrane Buffer Technique:
      • By placing an amniotic membrane on top of the cornea and below the gold plaque during treatment of iris melanoma, Dr. Finger was typically able to reduce patient pain from 9/10 to 2/10. In addition, the cornea had less surgical irritation. All this was done for patient care while effectively curing the cancer.
  • Slotted Radiation Plaques: Peripapillary. Juxtapapillary, Circumpapillary melanomas:
    • Only Fingers’ Slotted Plaques will allow melanomas near, touching, or covering the optic nerve to be completely irradiated. The slotted plaque was created to overcomes orbital optic nerve obstruction which prevents round and notched plaques from encircling these melanomas. That is why, Dr. Finger created a slot in the plaque big enough to accommodate the optic nerve sheath (typically 6mm wide). Sliding the plaque posterior to the optic nerve obstruction normalizes plaque position to completely surround the tumor.
  • Anti-VEGF suppresses radiation vasculopathy(retinopathy and optic neuropathy):
    • Originally described by Dr. Finger. Intraocular anti-VEGF injections have allowed patients to retain their vision after radiation treatment causes retinal and optic nerve side effects. In a study done by Dr. Finger, it was found that, after a decade, 80% of patients treated with anti-VEGF therapy were within 2 lines of pre-irradiation visual acuity.

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 Treatment Alert!

Patients who have had treatment for a choroidal melanoma with radiation plaque brachytherapy will sometimes go on to develop retinal problems secondary to the radiation exposure which was needed to sterilize their tumor. This is called radiation retinopathy. These retinal problems can manifest as an increased thickness of the retina and/or intraretinal and subretinal fluid (fluid inside the retina and underneath the retina, respectively). If left untreated, this can lead to permanent loss of vision.

Fortunately, Dr. Finger had discovered that radiation retinopathy is treatable with periodic injections into the eye of anti-VEGF drugs, such as Avastin, Eylea, and Lucentis. These eye injections are already very commonly used to treat eye conditions, such as neovascular (“wet”) macular degeneration. In fact, the administration of these eye injections is now the most common surgical procedure in the United States.

There is now a new anti-VEGF drug called brolucizumab, also known as RTH258, which is currently in Phase III clinical trials. This novel drug is a tiny humanized single-chain antibody fragment. This type of fragment is thought to have improved tissue penetration, and therefore, improved drug delivery due to its small size. Trials thus far have shown brolucizumab to be superior in the treatment of wet macular degeneration, compared to Eylea. Patients presented with decreased retinal thickness, intraretinal fluid, and subretinal fluid — the same signs we treat in radiation retinopathy at The New York Eye Cancer Center! Interestingly, patients maintained these improved results even with a longer dosing interval of every 12 weeks. Most importantly, potential adverse reactions were comparable in both the brolucizumab and Eylea groups. Pending the results of more trials and FDA approval, this drug may be available for use in 2019.

To stay updated on all the latest eye cancer research, please keep our website, eyecancer.com in your bookmarks!

NGO in India Promotes World Retinoblastoma Awareness Week

Retinoblastoma (RB) is the most common eye cancer in children, affecting approximately 8,000 of them each year. In developed countries like the United States, the survival rate reaches beyond an astounding 96%, with early diagnosis and treatment being key to saving a patient’s life and sight. However, this incidence rate is higher in developing countries, where most of the children succumb to metastatic retinoblastoma. In areas where children and families have no means of travel to treatment centers far away from them, these afflicted children often endure their disease untreated until there is very little hope for them left. Because no child or family should have to suffer these losses, especially due to the simple inability to reach proper care, The Eye Cancer Foundation has launched the 2020 Campaign, a campaign dedicated to training ophthalmic oncologists to serve in underprivileged countries.

One such underprivileged area is India, a country populated by over 1.32 billion people and counting, where 1,500 of the global 8,000 retinoblastoma cases are diagnosed every year. However, the reality persists that many cases of retinoblastoma go undetected or unreported in India, and awareness for the disease is abysmally low in rural areas. Motivated by India’s need to increase awareness and treatment for this disease, The Eye Cancer Foundation has sponsored fellowships for three doctors from India to train with Dr. Paul T. Finger at The New York Eye Cancer Center over the last year alone — Dr. Sonal S. Chaugule, Dr. Abhilasha Maheshwari, and Dr. Puneet Jain.

After the successful completion of her NYECC-ECF fellowship in Summer 2017, Dr. Chaugule returned to her native Maharashtra, India. She currently employs her expertise in retinoblastoma care by consulting at HV Desai Eye Hospital, a critical center for eye cancer patients in Pune, India. Her continued efforts to raise awareness in this vastly unrecognized disease have led to her medical advice being featured across Indian news media. According to Dr. Chaugule in The Indian Express, “Awareness about retinoblastoma is low and early detection is crucial to give the best chance of saving the child’s life, eye, and vision. Early detection and proper treatment will ensure 95% of the children diagnosed with RB are saved from death, 90% have their eye intact and 85% have their vision protected.

Unfortunately, in India, a child is taken to an eye specialist only when there is any notable problem, which makes treatment of RB at a later stage much harder,” she said.

Dr. Chaugule suggests that systemized screening of the eye for any abnormality in infants and toddlers should be made mandatory. Additionally, it is crucial that all doctors and healthcare professionals, whether they be eye cancer specialists or not, ought to be deeply sensitized to this disease’s magnitude.

In response to India’s growing need for retinoblastoma care, The Iksha Foundation, a non-governmental organization based in Benglauru, has accelerated their programs to raise awareness for the disease so that children may be diagnosed early enough to save their livees. Founder and trustee at the Iksha Foundation, Thanmaya Bekkalale, says, “We only know the reported cases of retinoblastoma — there are numerous cases that go unreported. The need of the hour is to spread individual and societal awareness about retinoblastoma and promote early detection as it is documented that every day, four children are born with eye cancer in India, and one of them is facing death as a result of diagnosis at an advanced stage, or not diagnosed at all.”

To raise awareness, May 13th through 19th were observed as World Retinoblastoma Awareness Week. The Iksha Foundation will hold awareness programs, ensuring that their various stakeholders will understand that early diagnosis is crucial to saving the lives of children throughout India.

Read the article published in The Indian Express by Dr. Chaugule and her colleagues at HV Desai Eye Hospital here.

To stay up-to-date on the latest news in eye cancer, please keep our website, eyecancer.com, in your bookmarks.

The NYECC Results Page: Introducing the Latest Eye Cancer Directory

In our previous blog, we unveiled Dr. Finger’s Results page, the first public database of its kind to report a doctor’s treatment outcomes. With the power of the world-wide-web at our fingertips, it is now easier than ever to browse for healthcare options. Search engines, with the simple press of a button, are able to provide patients with a virtually infinite list of specialists available to them locally, regionally, even internationally.

So, shouldn’t it be just as easy to know how successful these specialists are? How can patients choose the best doctor without knowing their past performance? These questions motivated the creation of Dr. Finger’s Results page, a launch that was met with glowing approval from across both patient and scientific communities. And now, this page is more comprehensive than ever!

Understanding the Report

Choroidal melanoma, iris-ciliary body melanoma, and squamous conjunctival malignancy are three of the most common conditions treated at The New York Eye Cancer Center. Once treated for these select diseases (whether through plaque radiation, chemotherapy, cryotherapy, and so on), patients are routinely seen at NYECC in follow-up visits, where they are monitored for any changes in tumor activity and quality of life.

Starting from December 1, 2017, each NYECC patient seen in these follow-up visits is anonymously entered in our Result’s page database — information that becomes immediately accessible on our website. These results are updated weekly, and with Dr. Finger’s practice spanning over 30 years, the database will continue to grow moving forward.

For each disease, we report on:

– Patients Entered: The number of patients included in these results, which grows with every week once patients are seen by Dr. Finger in follow-up.
– Visual Acuity: The average and median (most common) visual acuity, or eye chart test score, after finishing treatment.
– Local Tumor Destruction: The percentage of patients whose tumors are successfully eliminated through treatment.
– Initial Eye Removal: The percentage of patients who have undergone enucleation (eye removal) surgery prior to being treated by Dr. Finger at NYECC.
– Metastases: The percentage of patients whose tumors have spread to other organs after treatment.
– Average Follow Up: Number of years after treatment before additional treatments are required.

The data, located on our Results page and observable through an interactive table, reports on patients treated only by Dr. Finger. Patient data is strictly confidential, HIPPA-compliant and, once again, anonymous.

What’s New

Our Results page has a new look! Rather than having to observe all reports at once, we have implemented a ‘choose your results’ feature. This cancer directory allows you to choose which of these three diseases you would like to observe. Choroidal Melanoma, Iris Ciliary Body Melanoma, Squamous Conjunctival Malignancy — each of these reports now has its own page and table. These pages will be a source of information specialized to each disease; the result is a streamlined, organized process for eye cancer patients across the world. Here is a shortcut to the directory you can find on our page:

Choose your cancer below to view results:

 

Choroidal Melanoma »

 

Iris Ciliary Body Melanoma »

 

Squamous Conjunctival Malignancy »

 

The launch of our results page is the first step, and we encourage other centers to join us in this effort. The Eye Cancer Foundation will offer assistance to any center or solo practitioner in setting up a page akin to the new NYECC Results page.

Let’s hold ourselves accountable to our outcomes and empower patients to make their life-changing choice of eye cancer specialist based on visible results.

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!

Melanoma 101: How Skin Cancer Can Impact the Eye

Right alongside cancers of the breast and lung, skin cancer exists as a well-known cancer afflicting U.S. Americans. The history of cancer study has lead to the identification of over 200 types of the disease, and skin cancer is the most commonly diagnosed of them, affecting more than 1 million Americans a year. Information on this type of cancer has been widely disseminated to the American public, from a fleet of dedicated websites, to news articles, and more, to the extent that most American adults realize that skin cancer can often arise from dangerous exposure to ultraviolet (UV) sunlight. But did you know that skin cancer and eye cancer, a lesser-known type of cancer, are closely linked? Indeed, skin cancer can negatively affect the eyes — take seventy-year-old John McPartland for example, who understood this well.

In 2001, McPartland, a lifetime lover of outdoor activity, noticed a freckle on his eyelid. Determined to find answers, he consulted with many doctors until finally meeting with Dr. Paul T. Finger, who diagnosed McPartland with conjunctival melanoma. A melanoma is a particular type of skin cancer; it affects nearly 70,000 people, and is found on the melanocyte cells of the skin. Melanocyte cells are responsible for the production of brown skin pigment — melanin, Because these pigment-producing cells are afflicted, melanomas commonly begin as pigmented, odd-looking freckles like McPartland’s. The conjunctiva is a delicate, clear membrane covering the inside of the eyelids and the white (sclera) of the eye. McPartland’s diagnosis was deadly.

“I just thought I should check it out and see if it is anything,” McPartland said, “and fortunately I did … As far as I’m concerned, [Dr. Finger] saved my life.”

About 2,400 patients are diagnosed with conjunctival melanoma every year, often in part due to the same UV light that causes skin damage. Those who work outdoors, play sports and/or frequent beaches are most vulnerable to eye cancer. Having light blue eyes and a fair complexion increases vulnerability, due to a lack of melanin (brown pigment) production that protects us from harmful sun exposure. Those who have a family or personal history of skin cancer are also vulnerable. For these people, Dr. Finger recommends that they “should have an eye exam, and then every six months thereafter.”

“Certain drugs also increase UV toxicity” Dr. Finger additionally cautions. “Patients who take chlorothiazides, sulfonamides, tetracycline, phenothiazins, psoralens, and allopurinol should be extra cautious about sunlight.”

A 2008 Fox News article highlights Dr. Finger’s experience with McPartland, along with his advice for optimizing eye health that he continues to recommend to his patients today. While the importance of wearing hats and using sunblock to protect the skin has long been stressed to the American public, Dr. Finger says people should approach this thinking to the eyes as well. The best way one can optimize eye health on their own? Using UV-blocking sunglasses!

“Think of sunglasses as sunblock for your eyes”, Dr. Finger says. He advises that sunglasses with 100% UV protection offer optimal prevention of sun damage to the eye.

 

Cancer is certainly a difficult reality to endure for many people, but there are ways one can help to protect themselves against the disease. By doing something as simple as wearing UV-blocking sunglass, you can take charge of your health today.

Stay tuned for more stories at eyecancer.com by keeping our website in your bookmarks!

Patient Stories

"Very well treated by Dr. Finger. He explained everything I needed to know about my issue with detail and attention, putting me at ease and giving me confidence to handle this problem for the rest of my life.”
– N.N.

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