What are the main methods of treating cancer of the retina and what determines the choice of treatment.
When planning a treatment, the following features of the tumor process are taken into account:
- One-way or two-way process;
- How much vision is saved and how is it saved;
- The optic nerve is involved in the tumor or the process is localized only inside the eyeball;
- Is the spread of the process to orbit and central nervous system,
- Are there distant metastases?
In order to achieve the best effect, a combination of several treatment methods is often used, the sequence of which is determined on a case-by-case basis.
Conservative methods for retinoblastoma treatment.
Physicians always seek to preserve vision and eyes, but this is possible only with small tumor sizes and the absence of metastases. The most commonly used are:
- Cryotherapy - local action on the tumor at low temperatures when the tumor process is damaged by the anterior part of the retina,
- Photocoagulation - the destruction of a tumor with a laser in the case of damage by the tumor process of the posterior part of the retina.
Operative methods of retinoblastoma treatment.
- Enucleation - removal of the eyeball and maximal - optic nerve. This is the most common type of surgery in this type of tumor, and it gives the best results. After 1.5-2 months after surgery, it is possible to prosthetics.
- Occentration of the orbit is an enucleation with the removal of all within, and the near-orbital tissues (muscle, age, lacrimal gland, etc.), this operation is more crippling than enucleation, and it is shown during non-ulnar spread of the tumor process.
Radiation therapy with retinoblastoma.
Radiation therapy is often performed when vision preservation is possible. Retinoblastomas are sensitive to radiation therapy, it is believed that it cures 75% of tumors in the correct selection of patients, and when combined with cryotherapy, the percentage of treatment is even higher. But this method is limited in children with hereditary retinoblastoma when there are several tumor nodes.
Unlike surgical and radiotherapy, which are cured in 80-90% of cases, chemotherapy is most often used in extending the process beyond the eye's eye and in the presence of metastases, since retinoblastoma is very sensitive to the effects of some cytostatics. Here, too, different techniques have been developed, based on complementing the combination of several anticancer drugs, as well as taking into account some of their side effects.
In recent years, in connection with the improvement of diagnosis and retinoblast detection in the early stages of development, patients' treatment with photocoagulation, cryotherapy and radiotherapy has improved.
Prevention of retinoblastoma
As the main method of prevention, genetic research is currently being used, especially in families where cases of disease and retinoblast treatment have been reported in the past.