Retinoblastoma treatment depends on the tumor and whether the cancer has spread to other areas, among other factors. The Eye M.D. will aim to preserve vision whenever possible.
Chemotherapy is a drug treatment that uses chemicals to kill cancer cells by traveling throughout the body. Chemotherapy may help shrink a tumor in children with retinoblastoma so that another form of treatment can be used to treat the remaining cancer cells. Chemotherapy may also be used to treat cancer that has spread outside the eyeball or to other areas of the body.
Radiation therapy uses high-energy beams, such as X-rays, to kill cancer cells. Radiation therapy may be internally delivered, where a small disk of radioactive material is stitched either in or near the tumor and left in place for a period of time to radiate the tumor. For advanced retinoblastoma, external beam radiation delivers high-powered beams of radiation to the tumor from a large machine outside of the body.
Laser therapy (laser photocoagulation)
A laser may be used to destroy blood vessels that nourish the tumor, with the goal of killing the cancer cells.
Cold treatments (cryotherapy)
With cryotherapy, an extremely cold substance (such as liquid nitrogen) is used to freeze cancer cells. Once the cells freeze, the substance is removed and the cells are then allowed to thaw. This process of freezing and thawing is repeated multiple times with the result that the cancerous cells die.
Heat treatments (thermotherapy)
With thermotherapy, extreme heat is directed at cancer cells with microwaves, lasers or ultrasound devices to kill the cells.
Surgery to remove the eyeball (enucleaction) may be needed to treat retinoblastoma if the tumor has grown too much to be effectively treated through other means. This may help keep the cancer from spreading to other areas of the body.
After the eyeball is removed, the surgeon places an eye implant in the eye socket and attaches eye muscles to it. Eventually the eye muscles will move the implanted eyeball just as they did with the natural eye. However, the implanted eyeball cannot see.
Several weeks after surgery, a custom-made artificial eye can be created that sits behind the eyelids and clips onto the eye implant. The artificial eye sits over the eye implant and can be made to match the healthy eye.
Removing an eye will affect vision, though most children will adapt to the loss of an eye over time.