Treatment options for eye cancer

The treatments used for eye cancer are surgery, radiotherapy and chemotherapy. The treatment you have will depend on

• The type of eye cancer you have
• The size of your tumour and how far it has grown or spread (the stage)
• Your general health
• Your age and level of fitness

As with many types of cancer, the earlier your cancer is diagnosed, the easier it is to get it under control and possibly cure it. When planning your treatment, your doctors will try their hardest to save as much of your sight as they can.

There is detailed information about surgery, radiotherapy and chemotherapy for eye cancer in this section of CancerHelp UK.

Most people with eye cancers are referred to a specialist centre for their treatment. These centres provide a range of treatments and offer the one most suitable for you. For some types of eye cancer there may be only one treatment that is suitable for you. Or there may be several that are possible for you to have. The eye surgeon and the specialist nurse will explain your treatment choices in detail. They will talk through the potential benefits and complications of each before a final decision is made. Occasionally, it may help to get a second opinion from another eye cancer specialist.

Treatment for eye melanoma is surgery or radiotherapy or both.

Whether you have surgery or radiotherapy depends on

• Where the tumour is
• The size of the tumour and
• How much it is affecting your sight

If the tumour is already preventing you from seeing out of the eye, you will probably have surgery to remove the eye. This operation is called an enucleation. But if you can still see with that eye, your doctor may try to keep the sight and decide to

• Remove just the tumour or
• Give you radiotherapy

It is important to ask your doctor questions – as many as you need to. Together you can decide which treatment is best for you.

It can come as quite a shock if you need to have surgery to remove your eye. You will need time to come to terms with this change. But as long as you have sight in one eye, it may not make much difference to what you can and can’t do. You may still be able to drive, for instance. It may help to know that many people who have had this surgery rate their quality of life as highly as people who have kept their eye.

There is information about how to cope with changes to your sight in the living with eye cancer section.

This type of cancer can be so slow growing that you don’t need treatment, especially if you don’t have any symptoms. But your doctor will give you regular check ups to make sure the cancer is not getting bigger. If the tumour is growing, or if it is causing symptoms, you will normally have one of the following operations to

• Remove the iris (iridectomy)
• Remove the iris and the tissues around the clear layer covering the front of the eye (the cornea) – this operation is called an iridotrabeculectomy
• Remove the iris and the ciliary body (the muscle that focuses the eye) – this operation is called a iridocyclectomy
• Remove the whole eye (enucleation)

For some iris melanomas your doctor may suggest radiotherapy.

If melanoma of the choroid or ciliary body is not getting bigger you may not need treatment straight away. You will have regular check ups to make sure the tumour has not started to grow.

If you do need treatment, for small melanomas you may have one of the following

• Radiotherapy
• Surgery to remove just the tumour
• Surgery to remove the whole eye (enucleation)

For medium sized melanomas you may have one of the above treatments or radiotherapy, followed by surgery to remove the eye.

Surgery or radiotherapy are the treatments for large melanomas. If you need surgery, this will usually mean removing the eye (enucleation).

If your tumour has spread outside the eye, to the optic nerve or the eye socket, it is called an extraocular melanoma. You may hear your doctor call this extraocular extension. It is a more advanced stage and you will probably need surgery to remove your eye. This operation is called enucleation. You may need further surgery to the eye socket to make sure all the cancer is gone. You might have radiotherapy as well.

If the cancer has come back in your eyeball (intraocular) you will most likely have surgery to remove your eye (enucleation). You may also have radiotherapy after surgery to kill off any cancer cells left behind.

If the cancer has come back outside your eyeball (extraocular melanoma) you may have chemotherapy or biological therapy or both. Clinical trials are looking at how helpful biological therapy may be in treating melanoma of the eye. You can find information about biological therapies for eye melanoma on the eye cancer research page.

Doctors call lymphoma of the eye intraocular lymphoma. They treat intraocular lymphoma in a similar way as other types of non Hodgkin’s lymphoma. You may have radiotherapy, chemotherapy or both. For some types of non Hodgkin's lymphoma biological therapy may be used. You are not likely to have surgery to treat intraocular lymphoma.

Radiotherapy to treat intraocular lymphoma

To treat lymphoma of the eye your doctor may suggest you have external radiotherapy to your eye and brain. This can get rid of the cancer in the eye and also helps to stop it come back in the brain or spinal cord. There is more about radiotherapy to treat intraocular lymphoma and its possible side effects in the radiotherapy for eye cancer section.

Chemotherapy to treat intraocular lymphoma

Most people with lymphoma of the eye will have chemotherapy. You may have chemotherapy injected into the fluid around your spinal cord (intrathecal chemotherapy). You might have this treatment along with radiotherapy. There is more about chemotherapy for intraocular lymphoma in the chemotherapy for eye cancer section of CancerHelp UK.