When three-year-old Shami had a fungal mass bulging out of his right eye, his parents rushed him to hospital. They did not realize that the white reflection in his right eye, which first appeared when he was five months old, was the root of this blindness problem. Siddiksha’s parents noticed a squint in his right eye when he was three years old, but thought it was a natural condition and never consulted a doctor. Neither parent realized that a white aberration or reflection was an early sign of retinoblastoma, or eye cancer, which is being found more and more in children.
“Retinoblastoma is the most common eye cancer in children, with an estimated 1,500 to 2,000 children affected each year, accounting for almost a quarter of the global disease burden. But with timely diagnosis and prompt treatment, more than 95 percent of these children are cured,” says Dr. Sima Das, Chief of Oculoplasty and Oncology Services, Department of Medical Education in Charge, Dr. Charity Eye Hospital. Shroff. She treated both children. Shami had to undergo multiple cycles of chemotherapy, surgery, radiotherapy and laser therapy. Siddiksha had to lose an eye while she underwent enucleation surgery. After four weeks, she was fitted with a custom eye prosthesis so that she could resume her routine activities. Unfortunately,
How often does retinoblastoma affect children Retinoblastoma is the most common eye cancer among children that affects the retina. About one in 15,000-18,000 children is likely to be affected by it. Children with a family history of this cancer or an affected sibling have a 50 percent chance of getting retinoblastoma.
What age group is most likely to get it?
In general, children under the age of five are the most vulnerable. Rarely does this affect older children. It is unusual to find this cancer in adults.
How can it be cured?
With prompt and early diagnosis, it is possible to treat this cancer completely. If left untreated, this cancer can become fatal. In the early stages, this cancer is usually treated with lasers and chemotherapy, saving the lives, eyes, and vision of most children. Advanced stages need intensive treatments such as surgery. Unfortunately, this involves removal of the eye with vision loss. Newer treatment modalities, such as intra-arterial chemotherapy and plaque brachytherapy, can save the eye in children whose cancer is at an advanced stage.
What are the stages?
Retinoblastoma usually begins as a small tumor on the retina and grows in size quickly enough to damage the eye and vision if left undetected. In the early stages, the tumor remains confined to the eye and can be completely treated. If left untreated, the tumor can spread to other parts of the body, such as the brain, bones, and lymph nodes.
Can you explain the care protocol?
An eye doctor can easily diagnose retinoblastoma through a routine retinal exam. The earliest symptom of this cancer is a white glow in the eye and any child with a white reflection in the pupil should see a specialist. Sometimes squinting or decreased vision can also be early signs. Retinoblastoma is treated by an eye cancer specialist, who can perform a detailed exam under anesthesia. Other investigations such as MRIs and ultrasounds are also performed. Children who need chemotherapy will be evaluated by a pediatric oncologist. Surgery is recommended in advanced stages in addition to intra-arterial chemotherapy and plaque brachytherapy.
How would you explain this cancer to a layman?
A white shine or reflection in a child’s eye is usually the first sign of this cancer. Sometimes this white reflection can be seen in photographs. In the early stages, this cancer may be asymptomatic except for this white glow. Therefore, parents or caregivers should contact an ophthalmologist immediately. This cancer is completely curable if detected early. Even after completing treatment, regular check-up with eye cancer specialist is necessary to prevent recurrence. The chances of the tumor coming back are greatly reduced as the child gets older.