Free at Last!

New Radiation Instructions for Eye Plaque Patients 2018

Based on published guidelines from United States Nuclear Regulatory Commission (NRC), The New York Eye Cancer Center and its affiliate New York Eye and Ear Infirmary of Mt. Sinai have agreed that patients undergoing low energy (iodine-125 or palladium-103) eye plaque radiation therapy for intraocular melanoma are allowed to proceed with their lives as usual.

Before this change, eye plaque patients were required to almost quarantine themselves. They had to remain at home, maintain a distance of 6-feet from others, and no pregnant women or children were allowed to visit.

With the new changes, patients can use public transportation. We ended most of the radiation exposure precautions and restrictions (i.e. you may go to the park, restaurants, grocery stores…etc.). However, it is recommended that patients stay at home as much as possible and that they do not engage in activities that could dislodge the implant and/or seeds. As before, the patient’s body fluids, clothing, and utensils ARE NOT radioactive and can be handled by others safely. We ask that the patient sleep alone and in a separate room away from anyone under the age of eighteen.

Dr. Finger says it’s about time: “With the radiation implants I use, eye cancer patients typically receive only a small fraction of the radiation given to patients undergoing implant radiation for other cancers, where patients are sent home on the day of implant.”

Though a few rules remain, they new radiation instructions are not nearly as strict. Free at last, patients can feel the sunlight, do their own shopping, and enjoy the company of their loved ones.

 

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A New Support Group for Eye Cancer Patients is Available!

Stress and anxiety following treatment for choroidal melanoma have been well recognized among patients and studied among doctors. In fact, The NIH-funded Collaborative Ocular Melanoma Study reported on 209 patients with medium-sized melanoma treated with either brachytherapy or enucleation. In this sub-study, their goal was to compare the quality of life between treatment groups using questionnaires.

After questioning patients, researchers found that those undergoing radiation therapy had better quality of life outcomes related to their vision, such as driving, near activities, and binocular vision. After three to five years post-treatment, this benefit did decline, paralleling a decline in vision for the brachytherapy-treatment group (this, of course, predates the advent of vision-sparing anti-VEGF therapy).

However, in the scientific article published for the study, researchers state that “certain patients treated with brachytherapy, particularly those with pre-existing symptoms of anxiety, may suffer from increased risk of anxiety as compared with patients treated with enucleation during follow-up (Archives of Ophthalmology).”

At The New York Eye Cancer Center, we are currently participating in a study evaluating patient reported outcomes after plaque brachytherapy for choroidal melanoma. The more we understand a patient’s reception of plaque brachytherapy and the effect their treatment has had on their lives, the more we can specialize our care for each individual. We strive to offer compassion and understand what our patients are going through on a personal and psychological level. In an effort to help patients deal with their stress and anxiety, The New York Eye Cancer Center has begun to host a support group specifically for eye cancer patients and survivors. Please join Karen Campbell, a Licensed Clinical Social Worker (LCSW), who will facilitate this group. Sponsored by The Eye Cancer Foundation, this group therapy session will be held on Friday, October 13, 2017 at 1:30 pm at The New York Eye Cancer Center. Join us to have your voice heard among peers who understand what you are going through!

For your convenience, please consider downloading this flyer for the Support Group that contains all necessary information. We will host more sessions in the future, so in order to stay tuned for announcements on upcoming dates, please check back on eyecancer.com regularly!

 

New Study Highlights Promising Treatment for Patients with Iris Melanoma

A new study by Dr. Sonal Chaugule and Dr. Paul Finger has identified a promising treatment for patients diagnosed with iris melanoma. This is a first study describing regression characteristics in published literature.

Uveal melanoma is the most common primary intraocular malignancy in adults. Iris melanoma is the rarest cancer in this family, making up only 2% to 3% of cases. However, recent studies have found that biopsy-proven iris melanomas can spread outside the eye in up to 11% of cases. These findingsIris melanoma support the treatment of iris melanomas.

In the past, most patients with melanoma of the iris were treated by removal of the tumor along with the surrounding iris. Though the tumor is removed, the surgical procedure usually leaves a giant pupil with a non-functional iris sphincter and symptoms of glare.

“After part of the iris is removed, it is like having one pupil constantly dilated, even in the sun,” Dr. Finger said.

In their new study Chaugule and Dr. Finger describe patterns of tumor regression and side effects after iris-sparing treatment for iris melanoma using palladium-103 (103Pd) plaque brachytherapy. At the New York Eye Cancer Center, plaque brachytherapy has been found to be a conservative treatment modality with low local recurrence rate. Treatment with plaque radiation to sterilize the melanoma eliminates the need to open the eye, remove the tumor and make the pupil abnormally large.

Dr. Chaugule sought to examine and document the patterns of change after plaque radiation therapy for iris melanoma. The study included 50 patients with iris melanoma who underwent 103Pd plaque brachytherapy with at least 6 months of follow-up. Pre-treatment and post-treatment tumor morphology, gonioscopy and high frequency ultrasound imaging was studied and analysed.

In this study, palladium (103Pd) plaque brachytherapy of iris melanomas showed dissappearance of blood vessels within the tumor,, darkening of tumor surface, and decreased tumor thickness. With 100% local and systemic control at a mean duration of 5.2 years, the study shows this to be a safe and effective pupil sparing treatment.

You can click here to download and read the full study.

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"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.”
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