Ocular tumors

Ocular tumors including melanomas of the eye, choroidal hemangiomas, conjunctival tumors, benign eye disease, and other eye tumors are treated at UCSF. Proton ocular therapy is a specialized treatment at UCSF using a dedicated proton eye beam specifically developed for ocular patients. External beam radiation, intensity-modulated radiation, stereotactic radiosurgery, radioactive plaque therapy, and stereotactic radiation therapy are specialty areas at UCSF and may also be used for ocular cases.

For more information on appropriate alternatives for eye tumor treatments or to schedule an appointment, please contact us by phone at (415) 353-9807 or by email at OcularRadOncNP@ucsf.edu

Ocular Melanoma (Melanomas of the Eye)

Ocular tumor visible in fundus photograph

Ocular melanoma is the most common primary adult tumor of the eye. Though it is a rare disease, UCSF’s dedicated Ocular Melanoma and Ocular Tumors Proton Therapy Program has successfully treated and followed thousands of eye patients since 1978. Proton therapy (charged subatomic particles) is considered the “gold standard of care” for the treatment of ocular melanoma.

“Ocular melanoma,” “uveal melanoma,” or “choroidal melanoma” are often used interchangeably. The terms describe melanomas, which arise from the eye, and can occur in the iris, ciliary body and/or choroidal regions of the eye. Melanomas are cancers that arise from specific types of pigmented (colored) cells in the body. Melanomas of the eye are rare.

There are three main areas in the eye where melanomas arise:

• the iris
• the ciliary body
• the choroid

Together, these three regions of the eye are called the “uvea.” The choroid is the layer in which most eye melanomas arise. The choroid sits between the retina (nerve layer that is light sensitive in the back of the eye) and the sclera (white outer layer of the eye).

Risk factors for developing ocular melanoma can include being of Caucasian ethnicity, having light-colored eyes, having engaged in welding, having a history of sun burn or snow burn, and being of older age.

Diagnosis

Patients can present symptoms such as visual field loss, visual blurriness, flashing lights, floaters, pressure changes, or other eye changes. Some patients may not experience any symptoms or the tumor may be found on a routine eye exam.

If a patient is noted to have symptoms and/or found to have suspicious findings on the exam, he/she should be seen by an ophthalmologist or retinal specialist for further study. This may include, dilated clinical exam, ultrasound, fundus photography, imaging studies, and other analysis.

Treatment

Examples of special collimators for the shaping of proton beams based on the unique shapes of patients’ tumors

Proton therapy, which is a kind of particle radiation therapy, is considered the “gold standard of care” for ocular melanomas, the most common primary malignant adult cancer of the eye, as well as for other ocular tumors. UCSF is one of only two long-standing major proton ocular centers in the United States with a dedicated beam-line for such rare diseases of the eye, treating patients since the 1970s. Patients often travel from outside of California or from outside of the USA to receive care at UCSF.

UCSF Radiation Oncology is part of the UCSF Comprehensive Cancer Center, a member of the National Comprehensive Cancer Network; an alliance of 26 of the world’s leading cancer centers. The UCSF Ocular Tumor Proton Radiation Program is one of a very select group of programs across the nation and world, that offer proton therapy for uveal melanoma and that have long-term clinical and technical expertise in treating this cancer.

Meaningful clinical, radiation planning and treatment delivery research and development for proton/particle therapy for cancer has been pioneered and implemented at UCSF. A list of highlighted research articles from the Ocular Tumor Proton Radiation Program is available.

An example of the significant long term benefits in terms of ocular tumor control as well as preserving the eye with particle therapy was studied by the Director of the Ocular Tumor Proton Therapy Program, Kavita K. Mishra, MD, MPH: Long-term Results of the UCSF-LBNL Randomized Trial: Charged Particle With Helium Ion Versus Iodine-125 Plaque Therapy for Choroidal and Ciliary Body Melanoma

Ocular Tumor Radiation Program

For further information on malignant and benign ocular tumors, please contact us by phone at (415) 353-9807 or by email at OcularRadOncNP@ucsf.edu