Uveal melanoma secondary prevention

Revision as of 15:24, 27 October 2015 by Simrat Sarai (talk | contribs)
Jump to navigation Jump to search

Uveal melanoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Uveal melanoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Uveal melanoma secondary prevention On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Uveal melanoma secondary prevention

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Uveal melanoma secondary prevention

CDC on Uveal melanoma secondary prevention

Uveal melanoma secondary prevention in the news

Blogs on Uveal melanoma secondary prevention

to Hospitals Treating Uveal melanoma

Risk calculators and risk factors for Uveal melanoma secondary prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Secondary prevention strategies following uveal melanoma include [strategy 1], [strategy 2], and [strategy 3].

Secondary Prevention

Currently, there is no consensus regarding type or frequency of scans following diagnosis and treatment of the primary eye tumor. Of the 50% of patients who develop metastatic disease, more than 90% of patients will develop liver metastases. As such, the majority of surveillance techniques are focused on the liver. These include abdominal magnetic resonance imaging (MRI), abdominal ultrasound and liver function tests.

Regardless of treatment, monitoring for metastasis should be performed regularly and patient compliance with follow-up should be stressed. Regular dilated fundus examination, liver function test, and CT or right upper quadrant ultrasound assessing liver metastasis is the follow-up performed by most ophthalmologists. The frequency of follow-up is recommended to be based on the demonstrated risk of the tumor, as discussed below, with visits every 3-4 months suggested for patient’s with the highest risk tumors. Uveal melanoma metastases may present years after the primary tumour has been treated. A patient who receives treatment (e.g. brachytherapy, EBRT, or enucleation) can still get metastases from the tumour cells that escaped from the eye to the body PRIOR to treatment.Almost 50% of patients with uveal melanoma will develop metastases within 15 years of being initially diagnosed. 2% of patients at the time of initial uveal melanoma diagnosis would show an evidence of metastases. A diagnosis of uveal melanoma metastasis has a very poor prognosis and, unfortunately, has a high rate of mortality. There are several approaches to surveillance for metastases. Because metastases usually occur in the liver and in the lung, tests that are performed are focused on these organs. These tests are performed every 6-12 months and can continue for many years or decades. However, there are no standard guidelines or approachesfor surveillance as there is no clear consensus amongst experts. • Blood tests – to determine how the liver is functioning. • Imaging tests – ultrasound to monitor the liver and a chest X-ray to monitor the lung. Some people receive Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) scans. • Physical exam – to detect issues. • Recently, gene studies, by a needle biopsy from the tumour before treatment, can predict with high accuracy the potential to develop metastases eventually.

References