I have Ocular Melanoma. Never heard of it? Well, don’t feel bad because most people haven’t. While it is the most common kind of eye cancer it is still considered a rare cancer. Only 5-6 people per million-per year get this type of cancer. Wow! I guess I should feel pretty special to be a part of this elite group. We are affectionately known as “Ommies” around the world.
My tumor is called Choroidal Melanoma because it is located in the Choroid layer of the eye. This layer is smashed between the sclera (the white part of the eye) and the retina layer. My tumor is located in the very back of the eyeball near the entrance of the optic nerve and close to the fovea, which is the center of vision. My tumor is 11.58 mm in diameter, which is similar in size to a big cheerio and is 2.06 mm thick. The thickness pushes inward toward the retina not outward toward the sclera. Below is a good diagram that shows different areas that tumors can be located.
Photo credit: https://www.mayoclinic.org/diseases-conditions/eye-melanoma/symptoms-causes/syc-20372371
Today, I met my radiation oncologist in preparation for my eye surgery in 16 days. Dr. Maggass spent over an hour with me and Rick describing plaque radiation treatment which will be the method we use to blast my tumor. I will be getting a beautiful gold disk filled with radiation seeds sewn to the back of my eyeball for 7 days.
I “get” to have that in my eye?
Dr. Maggass will use pictures, ultrasounds, and CT scans of my eye to send measurements to a physicist in California who will create my personalized plaque. He will determine the number of radiation seeds, the strength of the seeds and how long I will have to wear the plaque based on the size and location of my tumor. The goal is to destroy the tumor without delivering too much radiation to my macula, optic nerve, and fovea. This will offer me the best chance of keeping my vision over time. Radiation is delivered continuously while the plaque is in place. As soon as it is removed I will no longer have any radioactivity left in my body.
During surgery, Dr. Kurli and Dr. Maggass will rotate my eyeball as far as possible in order to place the plaque over my tumor in the back of the eye. If they can rotate the eye far enough they may not need to cut any muscles. They will also have a better opportunity of doing a biopsy of the tumor. When surgery is complete the gold plaque will not be visible because it will be toward the back of the eye socket. They will make the plaque 2 mm larger than the actual diameter of my tumor to catch any stray cancer cells. The picture below is a sample disk that will be similar in size to the piece I will have in my eye.
Because radiation can come out through the front of the eyeball, I will wear a lead patch if I am near people. I need to stay at least 6 feet away from Rick and the girls which will be very difficult and I imagine I will feel very lonely. Thank goodness for Facetime! Dr. Maggass discussed some possible side effects. I may lose my eyelashes and I will experience some double vision and blurring that should improve with time. Long term, I may have blurring, dimming, partial veils, light bursts, black spots or total vision loss. Time will tell. I am sure the vision issues will be unsettling at first but eventually will become my new normal. He said the radiation often causes a cataract within 6-18 months post surgery and that will need to be treated. I may also experience some extra headaches and feel tired from the radiation. Each OM patient’s experience is different based on their individual tumor so it is difficult to pinpoint exactly what my long term vision effects will be.
Still curious and want to know more? Are you science-minded and interested in the human body? Below is a video of plaque surgery. WARNING! This video is graphic and may not be comfortable for some viewers.
I am not looking forward to this surgery, but I am not scared of it.
I am taking a positive approach to this difficult time in my life. I “GET” to have this surgery so I can blast this thing out of my body. I “GET” to have this surgery so I can reduce the chances cancer will metastasize to other areas of my body. I “GET” to be isolated from my family to heal safely so I can be with Rick and see my girls grow up.