Melanoma is a kind of cancer that develops in the melanocytes, which are the cells that give your skin and tissues their color.
Melanocytes in the uvea of your eye are where uveal melanoma begins to grow. The tissue layer known as the uvea is made up of the
- ciliary body, a ring of muscle that changes the shape of your vision lens
- choroid, which contains blood vessels
- iris, the colored part of your eye
When uveal melanoma begins in the iris, the prognosis is frequently the best. This is because cancers in this area are frequently found and treated early.
Treatment is effective for uveal melanoma when it is discovered before it spreads to other bodily tissues. However, if the disease spreads to your liver or other organs, your prognosis usually gets worse.
What is uveal melanoma?
Although eye melanoma is a very uncommon cancer, it is the most prevalent primary eye malignancy in people. When eye cancer is primary, it begins in the eye rather than moving to other tissues.
About one out of every 200,000 adults will acquire eye melanoma. Compared to cutaneous melanoma, the fifth most prevalent cancer in the US for both men and women, it is far less common.
Uveal melanoma is a type of melanoma that begins in the uvea. About 90% of uveal melanoma cases begin in the choroid. Your iris or ciliary body is where the other 10% of cases begin.
The conjunctiva, the thin, transparent covering that covers your eye white, is another place where ocular melanoma can begin. Conjunctival melanoma is the name for melanoma that begins here.
What are the symptoms of uveal melanoma?
In the early stages of uveal melanoma, about 30% of patients show no symptoms. When symptoms do show up, they frequently consist of:
- blurry vision
- double vision
- distorted vision
- some level of vision loss
- seeing flashing lights
- eye irritation or pain
- feeling like something is in your eye
- eye redness
- bulging eye
- change in pupil shape (the pupil is the opening in the center of the iris)
- increased pressure in the eye
The location and size of the melanoma tumor may affect the symptoms you experience. For instance, a black spot may grow on the iris of persons who have melanoma.
It's critical to consult an ophthalmologist whenever you observe changes in your eyesight. To identify the source of your symptoms, the doctor could prescribe several tests. You might undergo diagnostic procedures like the following if they detect cancer:
- slit lamp biomicroscopy
- indirect ophthalmoscopy
- ocular ultrasound
- fluorescein angiography
- fundus photography
- optical coherence tomography (OCT)
- fine needle aspiration biopsy
- MRI
What causes uveal melanoma?
Although the precise etiology of uveal melanoma is unknown, several variables probably contribute to the disease, as is the case with most cancers. Among the known risk factors for uveal melanoma are:
- light-colored eyes and fair skin
- dysplastic nevus syndrome (atypical mole syndrome)
- atypical or common cutaneous nevi (unusual moles or eye freckles)
- family history of BAP1 cancer predisposition syndrome
- age (most cases are diagnosed in people ages 60 and older)
Whether exposure to ultraviolet (UV) radiation raises the risk of uveal melanoma is unclear. If it does, it is believed to play a less important role than cutaneous melanoma.
Research indicates that around 98% of uveal melanoma occurrences occur in Caucasian individuals. Caucasians are diagnosed with eye melanoma eight to ten times more frequently than those of African heritage.
Is uveal melanoma curable?
Cancer still has no known cure. However, if your cancer remains completely remission-free for five years, doctors consider it cured. When an illness is in remission, its symptoms are no longer present.
When uveal melanoma is treated, many patients experience total remission, particularly if the cancer has not progressed to other tissues.
The following are the most popular therapies for uveal melanoma:
- Conservative care means keeping a watchful eye on the cancer without administering any specific treatment.
- radiation therapy
- laser therapies such as:
- transpupillary thermotherapy
- laser photocoagulation
- surgery, which could include excising the eye or the tumor
- Immunotherapy medications for patients with metastatic cancer, such as darovasertib or tebentafusp-tebn
Can you prevent uveal melanoma?Family history is one of the many risk factors for uveal melanoma that cannot be controlled or avoided.Although it's unclear whether exposure to UV radiation increases the risk of uveal melanoma, it's still a good idea to protect your eyes from the sun to maintain the health of your eyes in general.
What is the outlook for people with uveal melanoma?
When uveal melanoma is identified and treated early on, its prognosis is at its best.
When reporting cancer survival, doctors frequently utilize 5-year relative survival rates. This statistic shows the proportion of persons who survive five years after being diagnosed with certain cancer as opposed to those who do not.
From 2012 to 2018, the following were the 5-year relative survival rates for eye melanoma in the US:
| Stage | 5-year relative survival rate |
|---|---|
| Localized (no spread) | 85% |
| Regional (spread to nearby tissues) | 67% |
| Distant (spread to distant tissues) | 16% |
| All stages combined | 81% |
Up to 50% of patients with eye melanoma have the disease spread to other organs. We refer to this as metastatic melanoma.
The prognosis usually deteriorates when metastatic eye melanomas travel to the liver, which happens in around 80% of cases. It may spread to other places, such as your:
- lungs
- skin
- soft tissues
- bone
Two to three years after the initial diagnosis, or perhaps decades later, the spread to various areas may take place.
When uvea melanoma originates in your iris, your chances of recovery are often the best. Since iris melanoma is typically discovered early, it seldom spreads to other body areas.
Takeaway
The most prevalent primary eye cancer in adults is uveal melanoma. It grows in the uvea, which is the middle layer of your eye's pigmented cells.
The prognosis for uveal melanoma is improved by early detection and treatment. Compared to cancer that begins in other areas of the eye, melanoma that begins in the iris typically has a better prognosis.
Think about seeing an eye doctor regularly, particularly if you experience symptoms like blurred or distorted vision or notice changes in your vision.
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