Retinoblastoma - Pictures, Treatment, Causes, Stages, Symptoms
What is Retinoblastoma?
This is a form of cancer of the eye that starts in your retina. This is the lining on the inside of the eye that is very sensitive. It primarily affects children although it can rarely happen in adults. The retina is very important to vision as it sends a signal to your brain through your optic nerve which is where those signals will be seen as an image. In the retina there is nerve tissue that can sense the light at it comes through the front of the eye. This type of cancer although rare is a common form of cancer that affects a child’s eye. It can happen in just both eyes or just one of them and usually affects children under the age of six. Most commonly it is diagnosed in children between one and two years of age. In the United States it can affect approximately four hundred children each year. Most children who have this medical condition are born with it.
There are three stages of retinoblastoma, which are:
- Intraocular Retinoblastoma - this is the initial stage when the cancerous tumor makes its presence but has not spread to other part of your eye. In this stage there are five grades from A to E. Which grade it is depends on how much damage the eye has and the size of the tumor. At this stage the tissue has not be affected since the tumor is just forming.
- Extraocular Retinoblastoma - at this stage the tumor has spread to surrounding areas and damaged the tissue. If not treated at this stage it can travel to other parts beyond your eye.
- Recurrent Retinoblastoma - at this stage the cancer returns even after treatment. This can happen when it spreads to other parts beyond your eye or within the eye itself.
- In the center circle of your eye, which is called the "pupil", you may notice a white color when the light is shown in your eye like taking a flash photograph.
- The eyes may appear to be looking in different directions and do not align up.
- There could be redness, pain, and swelling of the eye(s).
- Crossed eyes called "strabismus".
- Double vision.
- There could be a different colored iris in each eye
- Blurred vision
- Pupils may remain dilated
- Having a cat eye effect called "leukocoria".
The cause of retinoblastoma is when the nerve cells found in your retina develop mutations that are genetic. These genetic mutations cause the nerve cells to grow continually and multiply. When these cells accumulate into a mass they form a tumor. These mutant cells can go farther into your eye and also into nearby structures. They can also metastasize, or spread, to different areas of your body including your spine and brain. At this time in many of the cases of retinoblastoma it is not known just what causes this genetic mutation. Over half of the cases of retinoblastoma will develop in a child where there is no eye cancer in the family. It is also possible for a child to inherit these genetic mutations from the parents. The mutated genes that increase your risk of developing other cancers, including retinoblastoma, will usually be passed to the children from the parents.
When the cause of retinoblastoma is hereditary, the children inherit it in an "autosomal dominant pattern". This is the type of pattern where only one, not both, of the parents needs one copy of the gene mutation in order for the child to develop an increased chance of developing retinoblastoma. If just one of the parents carries the mutated gene then there is a fifty percent chance that the child will get the mutated gene. Children that have the inherited type of retinoblastoma will usually get the disease at an early age and will usually happen in both of the eyes instead of just one of the eyes.
The treatment that a physician chooses to use depends on where the tumor is located and the size of the tumor and if it has spread beyond your eye. The physician will also take in consideration what the parent’s preference is and the health of the child. If possible the physician will usually try to preserve their vision
- A physician may opt to use cryotherapy, laser surgery, radiation therapy, or thermotherapy to treat small tumors and also to help treat the remaining cancer cells after chemotherapy.
- To treat large tumors they may also use radiation therapy which can be external beam radiation or internal radiation (brachytherapy). When they use "external beam radiation" the high powered beams used on the tumor come from a machine that is outside your body. With "internal radiation" the device that delivers the treatment is placed either in the tumor or near the tumor.
- If it has spread beyond your eye they may have to use chemotherapy, which can be taken in the form of a pill or they can do it through your blood vessels.
- If the tumor does not respond to other treatments the physician may have to do a procedure called "enucleation" which is the removal of the eye. In some cases the physician may use this procedure as the first treatment.