This story is part of a series on the current progression in Regenerative Medicine. This piece is part of a series dedicated to the eye and improvements in restoring vision. 


In 1999, I defined regenerative medicine as the collection of interventions that restore tissues and organs damaged by disease, injured by trauma, or worn by time to normal function. I include a full spectrum of chemical, gene, and protein-based medicines, cell-based therapies, and biomechanical interventions that achieve that goal.


The significance of eye health cannot be overstated, yet it often takes a backseat in our daily concerns. Unfortunately, ocular conditions such as eye melanoma are not discussed as frequently as they should be despite their potentially devastating consequences. It is a rare but serious form of cancer that can occur at any age, and it poses a silent threat to our vision and overall well-being. It may not be visible to the naked eye, but it is a formidable foe that warrants our attention and vigilance.


Unfortunately, it’s not just the elderly grappling with such challenges – individuals across various age brackets must stay vigilant. Eye melanoma, like many health issues that affect the eyes, often escapes early detection due to its subtle onset, emphasizing the necessity for regular screenings and a discerning eye on any visual changes.


More Details about Cancer in the Eye 


Eye melanoma is a cancerous growth that originates in the cells responsible for producing pigments in the eye. Although rare, it is diagnosed in about 2,500 new cases annually in the United States


Melanoma of the eye can occur in different parts of the eye, including the uvea, iris, ciliary body, conjunctiva, and eyelids. Uveal melanoma is a cancer that is relatively rare but deadly and usually affects Caucasians. It is the most common primary intraocular tumor found in adults, with tumors primarily located in the choroid, followed by the ciliary body and iris. 


It is a severe condition with few or no symptoms until it has progressed significantly. However, some common signs include changes in vision, eye pain, poor vision in one eye, bulging eyes, and a noticeable spot on the iris that increases in size over time. Detecting it early is crucial for successful treatment and recovery. This can be done through a comprehensive eye exam, including imaging tests like ultrasound and biopsy.


Current Treatments for Melanoma of the Eye


The treatment options available vary depending on several factors, including the size and location of the cancer. Common treatments for small melanomas include surgery, laser, and radiation therapy. 


Surgery involves removing the tumor and surrounding tissue. At the same time, laser treatment and radiation therapy use high-energy beams to destroy the cancer cells. It’s important to note that these treatments can be expensive. The cost of treatment depends on various factors, such as the type of treatment, the extent of the cancer, and the location of the treatment center.


When it comes to treating medium melanomas, a few options are available. Radiation therapy and surgery are two of the most common treatments. Radiation therapy uses high-energy radiation to eliminate cancer cells, while surgery involves removing the tumor and the surrounding tissue. The decision on which treatment to use will depend on various factors, such as the size and location of the cancer.


For bigger melanomas, surgery and radiation therapy are usually the preferred treatment options. In some cases, complete eye removal (known as enucleation) may be necessary to prevent the cancer from spreading. Enucleation is a surgical procedure that involves removing the entire eye and is typically recommended only when other treatment methods have not worked.


There are alternative treatments available for eye melanoma, including photodynamic therapy and immunotherapy. Photodynamic therapy employs a specially designed light-sensitive drug that a laser activates to destroy cancer cells. On the other hand, immunotherapy is a treatment that aids the body’s natural defense system in fighting against cancer.


Clinical Trials for Eye Melanoma


Researchers are currently investigating various treatments for this condition through clinical trials. One promising treatment option is immunotherapy, which involves using the body’s immune system to fight cancer cells. Certain drugs, such as Tebentafusp and IMCgp100, have shown significant potential in treating advanced eye melanomas in some patients. These medications are designed to target specific proteins present on the surface of cancer cells and stimulate an immune response against them.


Checkpoint inhibitors are another type of immunotherapy being studied for their effectiveness in treating eye melanoma. These drugs block specific proteins on cancer cells, preventing immune cells from attacking them. Nivolumab and pembrolizumab are two checkpoint inhibitors currently being studied for their potential in treating eye melanoma.


Another type of treatment that has shown success in treating patients with uveal melanoma is targeted therapy with Selumetinib. This drug is designed to target a specific genetic mutation that is found in many uveal melanomas. By blocking the activity of this mutation, Selumetinib can slow or stop the growth of cancer cells.


Although eye melanoma is a rare disease and has limited treatment options, recent advancements in treatment have shown promise for improving patient outcomes. Researchers are exploring new and innovative ways to treat this disease, including immunotherapy, targeted therapy, and ongoing clinical trials. It is essential to continue to explore these treatments and expand access to care for those affected by eye melanoma. 

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