Thermotherapy/Laser Therapy

Thermotherapy uses heat to destroy cancer cells. It may be given using a laser, ultrasound, microwaves, or infrared radiation. Laser therapy uses a powerful beam of light to kill cancer cells. Another form of thermotherapy is photocoagulation, in which your doctor uses a laser to destroy blood vessels that lead to the tumor, cutting off its supply of nutrients. These procedures may be used to treat small retinoblastomas. It is often used after chemotherapy to kill any remaining cancer cells.

Cryotherapy

Your doctor may recommend cryotherapy to freeze and destroy small, peripheral tumors. Your doctor places a probe on the surface of the eye and uses it to freeze the outer wall of the eye. This freeze penetrates the outer wall and kills the tumor inside the eye.

Chemotherapy

Chemotherapy is the use of drugs to target rapidly growing cells in an effort to destroy cancer cells. There are various ways of administering chemotherapy to the eye. Chemotherapy is usually administered intravenously and targets the entire body, but the doctor may also administer chemotherapy intra-arterially, periocularly, or intravitreally to treat retinoblastoma. In intra-arterial chemotherapy, the doctor inserts a catheter into the patient’s groin and guides it to the eye through the arteries. The doctor then injects the chemotherapy medication directly into the eye. In periocular chemotherapy, the doctor injects the chemotherapy drug into the tissues around the eye. In intravitreal chemotherapy, the doctor injects the medication directly into the eye.

High-dose Chemotherapy & Stem-cell Transplantation

This procedure allows patients to receive extra-large doses of chemotherapy. These high doses destroy normal cells in the blood and bone marrow, as well as cancer cells. After chemotherapy, the patient receives his own blood-forming stem cells that help the body form new, healthy blood cells.

Radiation Therapy

Radiation therapy uses waves of high-energy rays to target and kill cancer cells. Doctors commonly use a form of internal radiation therapy called plaque radiation therapy for tumors of the eye. Your doctor will attach radioactive pellets to a disk (or plaque) and place the disk on the wall of your child's eye near the primary tumor. The plaque is usually made of gold, which helps prevent radiation damage to nearby healthy tissues. The plaque will be held in place with temporary stitches and left in place for four to five days. This procedure may be referred to as Brachytherapy.

Proton Beam Radiation Therapy

Proton therapy is an advanced new type of radiation therapy that uses “protons” rather than X-ray “photons” to deliver radiation to the tumor. Proton therapy can target tumors much more precisely and with higher amounts of radiation than conventional radiotherapy, resulting in less damage to healthy tissue and fewer side-effects. Doctors can control the proton beam so that most of the radiation is deposited directly at the tumor site, and healthy tissues are spared as the beam moves through the body.

• Please see Understanding Proton Therapy to learn more.

Enucleation

For larger, more advanced tumors, your doctor may need to remove the entire eye. If the eye is removed, your doctor will order a prosthetic (artificial) eye. The doctor will first insert an implant into the eye socket and attach it to the eye muscles. The doctor will then insert the prosthesis, which is painted to match your child's eye color. The implant allows the prosthesis to move normally.

Clinical Trials

Clinical trials allow patients to try a new treatment before it is available to the general public. In some cases, this may be a new drug that has not been used in humans before, or it may be a drug or drug combination that is not currently used for that specific type of cancer. Early phase clinical trials are often used to test side effects of a drug or drug combination, while later phase clinical trials are used to see how effective a new treatment might be for a certain type of cancer. Clinical trials allow doctors and researchers to improve the treatment of cancers with possibly more effective therapies. A clinical trial may be a new, groundbreaking drug or it may have no effect. It is important to talk with your doctor about the pros and cons of clinical trials for your particular situation. Speak to you doctor about clinical trials sponsored by the Children's Oncology Group.