Retinoblastoma (patient information): Difference between revisions

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{{Template:Retinoblastoma (patient information)}}
{{Template:Retinoblastoma (patient information)}}
'''For the WikiDoc page for this topic, click [[Retinoblastoma|here]]'''
'''For the WikiDoc page for this topic, click [[Retinoblastoma|here]]'''
{{CMG}};  '''Associate Editor(s)-In-Chief:''' Jinhui Wu, M.D,{{JC}}, {{Sahar}}
{{CMG}};  '''Associate Editor(s)-In-Chief:''' Jinhui Wu, M.D,{{JC}}, {{Sahar}}
==Overview==
==Overview==
Retinoblastoma is a cancerous tumor in the eyes. It usually occurs in children under 3 years. Epidemiological data suggest that the development of retinoblastoma is related to heredity. Usual symptoms include [[strabismus]],  white or pink pupil when shining, [[vision problems]], eye pain, etc. Ultrasound, computed tomography (CT) scan and magnetic resonance imaging (MRI) may help diagnosis. Treatments involve [[surgery]], [[radiation therapy]], [[chemotherapy]], laser therapy, cryotherapy, thermotherapy, or high dose chemotherapy and stem cell transplant.
Retinoblastoma is [[eye cancer]]. It originates from the [[Retina|inner layer of the eye]], [[retina]] and usually occurs in children under 3 years.
 
==What are the symptoms of Retinoblastoma?==
==What are the symptoms of Retinoblastoma?==
Retinoblastomas are usually found in infants or children.  
Retinoblastomas are usually found in infants or children.  
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:*[[Eye swelling]]  
:*[[Eye swelling]]  
Other health problems may also cause these [[symptoms]]. Only a [[pediatrician]] can tell for sure. A person with any of these [[symptoms]] should tell the doctor so that the problems can be [[Diagnosis|diagnosed]] and treated as early as possible.
Other health problems may also cause these [[symptoms]]. Only a [[pediatrician]] can tell for sure. A person with any of these [[symptoms]] should tell the doctor so that the problems can be [[Diagnosis|diagnosed]] and treated as early as possible.
==What causes Retinoblastoma?==
==What causes Retinoblastoma?==
*Retinoblastoma is caused by a [[mutation]] in a gene controlling [[cell]] division of [[retinal]] cells, causing these [[cells]] to grow out of control and become a pile of [[cells]] ([[tumor]]).
*Retinoblastoma is caused by a [[mutation]] in a gene controlling [[cell]] division of [[retinal]] cells, causing these [[cells]] to grow out of control and become a pile of [[cells]] ([[tumor]]).
Line 25: Line 20:
*In a little over half of the cases, this [[mutation]] develops in a child whose family has never had [[eye cancer]].
*In a little over half of the cases, this [[mutation]] develops in a child whose family has never had [[eye cancer]].
*After the development of the [[tumor]] within the [[Eyeball|eye globe]], it also may invade the nearby structures or even spread to further sites of the body.  
*After the development of the [[tumor]] within the [[Eyeball|eye globe]], it also may invade the nearby structures or even spread to further sites of the body.  
==Who is at highest risk?==
==Who is at highest risk?==
*Those who have a [[mutation]] in the [[RB1]] [[gene]] are at risk of [[tumor]] development.
*Those who have a [[mutation]] in the [[RB1]] [[gene]] are at risk of [[tumor]] development.
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*This method causes the [[tumor]] to shrink, so other treatment forms treat the remaining [[tumor]] (if any).
*This method causes the [[tumor]] to shrink, so other treatment forms treat the remaining [[tumor]] (if any).
*This treatment can decrease the need for the eye [[surgery]].
*This treatment can decrease the need for the eye [[surgery]].
*It may also be used in case of spread of tumor outside the eye globe and other sites of the body.
*It may also be used in case of spread of [[tumor]] outside the eye globe and other sites of the body.
*intra-arterial chemotherapy, a new type of chemotherapy, transfer the chemical drug directly to the tumor via a tiny tube (catheter) in the eye artery.
*intra-arterial [[chemotherapy]], a new type of [[chemotherapy]], transfer the chemical drug directly to the tumor via a tiny tube (catheter) in the eye artery.
*Intravitreal chemotherapy is also used for retinoblastoma that has spread within the eye via direct injection of the chemical drug into the eye.
*[[Intravitreal]] [[chemotherapy]] is also used for retinoblastoma that has spread within the eye via direct injection of the chemical drug into the eye.
**This method is usually used when the tumor is resistant to other types of treatment.
**This method is usually used when the [[tumor]] is resistant to other types of treatment.
'''Radiation therapy''' which kills cancerous cells using high energy beams such as X-ray and protons.<br>
'''[[Radiation therapy]]''' which kills [[Cancer|cancerous]] cells using high energy beams such as [[X-ray]] and protons.<br>
Radiotherapy categorized into two categories:
Radiotherapy categorized into two categories:
*Internal radiation (brachytherapy) which the device is within or in the close distance of the tumor temporarily.
*[[Brachytherapy|Internal radiation]] ([[brachytherapy]]) which the device is within or in the close distance of the [[tumor]] temporarily.
**This method uses a small disk which is stitched in place and left for a few days while it radiates the beam to the retinoblastoma tumor.
**This method uses a small disk which is stitched in place and left for a few days while it radiates the beam to the retinoblastoma tumor.
**This method reduces the risk that treatment will affect healthy eye tissue due to the placement of the device near the affected eye.
**This method reduces the risk that treatment will affect healthy eye tissue due to the placement of the device near the affected eye.
*External beam radiation. External beam radiation uses high-powered beams to radiate the tumor from a large machine outside of the body.
*[[External beam radiotherapy|External beam radiation]] which uses high-powered beams to radiate the tumor from a large machine outside of the body.
**This method can cause side effects due to simultaneous radiation of other parts of the body such as the brain so, external beam radiation is typically reserved for children with advanced retinoblastoma and those for whom were resistant to other forms of treatment.<br>
**This method can cause [[side effects]] due to simultaneous [[radiation]] of other parts of the body such as the [[brain]] so, [[External beam radiotherapy|external beam radiation]] is typically reserved for children with advanced retinoblastoma and those for whom were resistant to other forms of treatment.<br>
'''Laser therapy (laser photocoagulation)''' which uses a laser to destroy blood vessels supplying the tumor with oxygen and nutrients.
'''[[Laser therapy]] ([[laser photocoagulation]])''' which uses a [[laser]] to destroy [[blood vessels]] supplying the [[tumor]] with [[oxygen]] and nutrients.
'''Cold treatments (cryotherapy)''' which uses extreme cold to kill cancerous cells.
'''Surgery''' removes the tumor which is too large to be treated by other methods.  
'''[[Cryotherapy|Cold treatments]] ([[cryotherapy]])''' which uses extreme cold to kill [[cancerous]] [[cells]].
*It decreases the risk of spread of the tumot to the nearby structures.
*Surgical methods for retinoblastoma include:
'''[[Surgery]]''' removes the [[tumor]] which is too large to be treated by other methods.  
**Surgery to remove the affected eye (enucleation) as well as a portion of the optic nerve, which extends from the back of the eye into the brain
*It decreases the risk of spread of the [[tumor]] to the nearby structures.
**Surgery to place an eye implant which replaces the empty space of the eyeball by a special ball — made of plastic or other materials — in the eye socket and connects the muscles that control eye movement to the implant.
*[[Surgical]] methods for retinoblastoma include:
**[[Surgery]] to remove the affected eye ([[enucleation]]) as well as a portion of the [[optic nerve]], which extends from the back of the eye into the [[brain]]
**[[Surgery]] to place an eye implant which replaces the empty space of the [[eyeball]] by a special ball — made of plastic or other materials — in the eye socket and connects the [[muscles]] that control eye movement to the implant.
**Fitting an artificial eye which involves the placement of a custom-made artificial eye that can be made to match your child's healthy eye.
**Fitting an artificial eye which involves the placement of a custom-made artificial eye that can be made to match your child's healthy eye.
*Surgery may be complicated by side effects such as infection and bleeding.
*[[Surgery]] may be complicated by [[side effects]] such as [[infection]] and [[bleeding]].  
 
 
Patients with retinoblastoma have many treatment options. The selection depends on the stage of the tumor. The options are [[surgery]], [[radiation therapy]], [[chemotherapy]], laser therapy, cryotherapy, thermotherapy, or high dose chemotherapy and stem cell transplant. Before treatment starts, ask your health care team about possible side effects and how treatment may change your normal activities. Because cancer treatments often damage healthy cells and tissues, side effects are common. [[Side effect]] may not be the same for each person, and they may change from one treatment session to the next.
:*[[Surgery]]: The surgery is called enucleation. During the surgery, an orbital implant is also put in to take the place of the eyeball.
:*[[Radiation therapy]]: This is a cancer treatment to kill cancer cells or keep them from growing by using high-energy x-rays or other types of radiation.
:*[[Chemotherapy]]: The treatment is to use drugs to stop the growth of cancer cells either by killing the cells or by stopping them from dividing.
:*Laser therapy: This treatment uses laser beams to destroy the tumors and the blood vessels that supply them. It is effective only for smaller tumors. 
:*Cryotherapy: Cryotherapy uses a very cool, small probe to kill the retinoblastoma cells by freezing them. It is only effective for a relatively single small tumor.
:*Thermotherapy: Thermotherapy uses infrared waves to treat retinoblastoma.
:*High dose chemotherapy and stem cell transplant: This treatment is used to treat children with retinoblastoma that has spread.
 
==Where to find medical care for Retinoblastoma?==
==Where to find medical care for Retinoblastoma?==
[http://maps.google.com/maps?f=q&amp;hl=en&amp;geocode=&amp;q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|retinoblastoma}}}}&amp;sll=37.0625,-95.677068&amp;sspn=65.008093,112.148438&amp;ie=UTF8&amp;ll=37.0625,-95.677068&amp;spn=91.690419,149.414063&amp;z=2&amp;source=embed Directions to Hospitals Treating retinoblastoma]
[http://maps.google.com/maps?f=q&amp;hl=en&amp;geocode=&amp;q={{urlencode:{{#if:{{{1|}}}|{{{1}}}|retinoblastoma}}}}&amp;sll=37.0625,-95.677068&amp;sspn=65.008093,112.148438&amp;ie=UTF8&amp;ll=37.0625,-95.677068&amp;spn=91.690419,149.414063&amp;z=2&amp;source=embed Directions to Hospitals Treating retinoblastoma]
==Prevention of Retinoblastoma==
==Prevention of Retinoblastoma==
*Because retinoblastoma is caused by a [[genetic]] [[mutation]], it remains unpreventable. But it is very important to detect [[cancer]] early and get the most effective treatment.
*Because retinoblastoma is caused by a [[genetic]] [[mutation]], it remains unpreventable. But it is very important to detect [[cancer]] early and get the most effective treatment.
*In the inheritable form of the [[disease]], however, other children of the family should be [[Screening|screened]] using [[genetic analysis]] for the presence of the [[mutation]], so eye exam can start at an early age and [[diagnose]] the [[tumor]] when it is [[Surgery|surgically]] removable.
*In the inheritable form of the [[disease]], however, other children of the family should be [[Screening|screened]] using [[genetic analysis]] for the presence of the [[mutation]], so eye exam can start at an early age and [[diagnose]] the [[tumor]] when it is [[Surgery|surgically]] removable.
==What to expect (Outlook/Prognosis)?==
==What to expect (Outlook/Prognosis)?==
The [[prognosis]] of retinoblastoma depends on the following:
The [[prognosis]] of retinoblastoma depends on the following:
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:*The stage of [[cancer]]: the size of the [[tumor]], whether [[cancer]] has spread  
:*The stage of [[cancer]]: the size of the [[tumor]], whether [[cancer]] has spread  
:*The child’s general health
:*The child’s general health
==Possible complications==
==Possible complications==
*Invasion of the [[tumor]] to the nearby structure
*Invasion of the [[tumor]] to the nearby structure

Latest revision as of 20:40, 2 May 2019

Retinoblastoma

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Retinoblastoma?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

Retinoblastoma On the Web

Ongoing Trials at Clinical Trials.gov

Images of Retinoblastoma

Videos on Retinoblastoma

FDA on Retinoblastoma

CDC on Retinoblastoma

Retinoblastoma in the news

Blogs on Retinoblastoma

Directions to Hospitals Treating Retinoblastoma

Risk calculators and risk factors for Retinoblastoma

For the WikiDoc page for this topic, click here Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Jinhui Wu, M.D,Jyostna Chouturi, M.B.B.S [2], Sahar Memar Montazerin, M.D.[3]

Overview

Retinoblastoma is eye cancer. It originates from the inner layer of the eye, retina and usually occurs in children under 3 years.

What are the symptoms of Retinoblastoma?

Retinoblastomas are usually found in infants or children.

Other health problems may also cause these symptoms. Only a pediatrician can tell for sure. A person with any of these symptoms should tell the doctor so that the problems can be diagnosed and treated as early as possible.

What causes Retinoblastoma?

  • Retinoblastoma is caused by a mutation in a gene controlling cell division of retinal cells, causing these cells to grow out of control and become a pile of cells (tumor).
  • It is not clear what causes the mutation, but in some cases, children can inherit the mutation from their parents (Familial form).
  • In a little over half of the cases, this mutation develops in a child whose family has never had eye cancer.
  • After the development of the tumor within the eye globe, it also may invade the nearby structures or even spread to further sites of the body.

Who is at highest risk?

  • Those who have a mutation in the RB1 gene are at risk of tumor development.
  • A person with a family history of members of retinoblastoma in a parent, sibling, or first/second-degree relative is also at risk.

Diagnosis

The following methods are used to diagnose the tumor:

When to seek urgent medical care?

  • Call your health care provider if you notice any change in your child'eye that concerns you.
  • If you have a family history of retinoblastoma ask your primary care provider when to start eye exam in your child.

Treatment options

Treatment differs depending on the following factors:

  • Size of the tumor
  • Location of the tumor
  • Spread of the tumor to the structures other than the eye
  • Overall health status of the affected child
  • The parents' preferences

Available treatment options are:
Chemotherapy which kills the cancerous cells using chemical drugs.

  • It can be prescribed in pill form or through the blood vessels.
  • This method causes the tumor to shrink, so other treatment forms treat the remaining tumor (if any).
  • This treatment can decrease the need for the eye surgery.
  • It may also be used in case of spread of tumor outside the eye globe and other sites of the body.
  • intra-arterial chemotherapy, a new type of chemotherapy, transfer the chemical drug directly to the tumor via a tiny tube (catheter) in the eye artery.
  • Intravitreal chemotherapy is also used for retinoblastoma that has spread within the eye via direct injection of the chemical drug into the eye.
    • This method is usually used when the tumor is resistant to other types of treatment.

Radiation therapy which kills cancerous cells using high energy beams such as X-ray and protons.
Radiotherapy categorized into two categories:

  • Internal radiation (brachytherapy) which the device is within or in the close distance of the tumor temporarily.
    • This method uses a small disk which is stitched in place and left for a few days while it radiates the beam to the retinoblastoma tumor.
    • This method reduces the risk that treatment will affect healthy eye tissue due to the placement of the device near the affected eye.
  • External beam radiation which uses high-powered beams to radiate the tumor from a large machine outside of the body.
    • This method can cause side effects due to simultaneous radiation of other parts of the body such as the brain so, external beam radiation is typically reserved for children with advanced retinoblastoma and those for whom were resistant to other forms of treatment.

Laser therapy (laser photocoagulation) which uses a laser to destroy blood vessels supplying the tumor with oxygen and nutrients.

Cold treatments (cryotherapy) which uses extreme cold to kill cancerous cells.

Surgery removes the tumor which is too large to be treated by other methods.

  • It decreases the risk of spread of the tumor to the nearby structures.
  • Surgical methods for retinoblastoma include:
    • Surgery to remove the affected eye (enucleation) as well as a portion of the optic nerve, which extends from the back of the eye into the brain
    • Surgery to place an eye implant which replaces the empty space of the eyeball by a special ball — made of plastic or other materials — in the eye socket and connects the muscles that control eye movement to the implant.
    • Fitting an artificial eye which involves the placement of a custom-made artificial eye that can be made to match your child's healthy eye.
  • Surgery may be complicated by side effects such as infection and bleeding.

Where to find medical care for Retinoblastoma?

Directions to Hospitals Treating retinoblastoma

Prevention of Retinoblastoma

  • Because retinoblastoma is caused by a genetic mutation, it remains unpreventable. But it is very important to detect cancer early and get the most effective treatment.
  • In the inheritable form of the disease, however, other children of the family should be screened using genetic analysis for the presence of the mutation, so eye exam can start at an early age and diagnose the tumor when it is surgically removable.

What to expect (Outlook/Prognosis)?

The prognosis of retinoblastoma depends on the following:

  • Whether or not the tumor can be removed by surgery.
  • The stage of cancer: the size of the tumor, whether cancer has spread
  • The child’s general health

Possible complications