The treatment options for eye cancer depend on the type, size, and location of the cancer, as well as the individual’s overall health and preferences. Some of the most common treatment options for eye cancer include:
- Radiation therapy
- Surgery
- Laser therapy
- Immunotherapy
- Targeted therapy
- Chemotherapy
- Cryotherapy
These are further discussed below.
Radiation therapy
Radiation therapy is one of the most common treatments for eye cancer.
- Brachytherapy: Brachytherapy, or internal radiation therapy, is the most common treatment for eye melanomas. For treatment, your provider will implant a tiny disc near the tumor that releases radiation to kill cancer cells.
- External beam radiation therapy (EBRT): With EBRT, a machine that never touches your body directs radiation toward a tumor. Techniques include stereotactic surgery, which directs high doses of radiation toward your tumor in one treatment session. Proton beam radiation therapy is another option. This is a newer form of radiation therapy that delivers precise, high doses of radiation toward tumors. As the equipment is very expensive to maintain, it isn’t available everywhere.
Surgery
Surgery is a common treatment option, especially for small tumors that haven’t spread beyond your eyeball. Procedures include:
- Iridectomy: Removes part of your iris. Providers commonly use this procedure when treating small melanomas.
- Iridocyclectomy: Removes part of your iris and ciliary body. Providers commonly use this procedure when treating small melanomas.
- Transscleral resection: Removes melanomas in your choroid or ciliary body.
- Enucleation: Removes your eyeball. You may need this surgery for large tumors or when there’s no way to preserve your vision with treatment. Afterward, you’ll get an artificial eyeball that matches your remaining eye. Your healthcare team will work with you closely to fit you with a replacement that looks and moves like your eye.
- Orbital exenteration: Removes your entire eyeball and some of the surrounding tissue. Your provider may recommend this procedure if the cancer’s spread into structures surrounding your eyeball. As with enucleation, you’ll get an artificial eyeball implant afterward.
Laser therapy
Laser therapy uses heat to destroy eye cancer. The most common type is transpupillary thermotherapy (TTT). During the procedure, infrared light delivers concentrated heat toward the tumor, destroying cancer cells. Providers may use this on its own or after brachytherapy to prevent cancer from returning (recurring).
Immunotherapy
Immunotherapy treatments help your immune system identify and destroy cancer cells more effectively. In certain instances, providers use the immunotherapy drug tebentafusp to treat uveal melanoma. Immunotherapy is a common treatment for cancer that’s spread or that providers can’t surgically remove.
Targeted therapy
Targeted therapy drugs target specific weaknesses in cancer cells, destroying them. You may be eligible for targeted therapy treatments if cancer cells contain a BRAF gene mutation (change). Currently, this mutation is more common in skin melanomas, but this treatment may be beneficial in people with eye melanomas, too.
Chemotherapy
Chemotherapy isn’t a common treatment for eye cancer, but your healthcare provider may recommend it if your cancer hasn’t responded to other treatments or if it spreads to other areas.
Cryotherapy
Cryotherapy uses extreme cold to destroy cancer cells. It is often used for small tumors on the eyelid or in the conjunctiva.
The choice of treatment depends on several factors, including the type and stage of the cancer, the patient’s general health, and the potential side effects of the treatment. A multidisciplinary team of specialists, including an ophthalmologist, a medical oncologist, and a radiation oncologist, will work together to determine the best course of treatment for each individual.