Melanoma of the skin is a well-known disease, especially in a sunny country like ours. Most of the cases are the result of overexposure to the sun at a young age, which manifests itself in adulthood, and is relatively easily identifiable. Ocular melanoma, on the other hand, is a rare and more difficult disease, which hides inside the eye and cannot be noticed immediately.
The symptoms of the disease include various disturbances in the field of vision, difficulty focusing the vision, double vision, blurred vision and a variety of other similar problems, which in most cases will not necessarily be associated with ocular melanoma, but an ophthalmologist who performs an examination will identify a suspicious finding. In fact, in many cases the disease will be discovered during a routine examination at an ophthalmologist, and it is the thickness of the finding in the eye that will predict its chance of spreading.
“A few years ago, my wife was diagnosed with cutaneous melanoma. We knew there was treatment and that it was a well-known disease, so when the doctor diagnosed me with melanoma as well, we were surprised by the chilling coincidence. But when he explained to me the difference between cutaneous melanoma and ocular melanoma, I froze. I felt like an ice bucket had been dumped on my head It turns out that these are two completely different diseases, and in my case, I paid a heavy price when I underwent surgery to remove the eye.” According to Yossi Levy, from the Sharon region, who was recently diagnosed with the disease.
In case the diagnosis is made in the early stage, the treatment will be focused, and will include inserting an instrument into the eye that spreads radiation around the tumor, for several days. Only some of the cases will be discovered when the disease is in a more advanced stage inside the eye and the patients will undergo surgery to remove the eye in its entirety, which of course means complete vision loss.
Dr. Ronan Stoff, senior oncologist at the Ella Institute for Melanoma and Immuno-Oncology, Sheba Tel Hashomer Hospital, explains that it is important to stop the disease before it reaches the liver: “For a reason that is not yet known, the biology of the disease tends to reach the liver, so that is where the medical follow-up will be focused. When the disease has left the eye and migrated to the liver, it is considered a generalized cancer, in an advanced stage, and hence early detection is of great importance.”
Unlike cutaneous melanoma, in the case of ocular melanoma, the therapeutic options are limited, and they are only effective for some patients. However, this year the FDA approved a new drug, submitted to the current health basket, based on a unique mechanism that attaches the cells of the immune system to the melanoma cells in order for the immune system to attack the disease. Its advantage is that it can improve the fight against the disease, and perhaps even prolong the lives of the patients and their quality of life, since it is a potentially fatal disease.