of radiation needed. The radiation dose is calculated by a radiation oncologist (cancer doctor) who will explain exactly how and where the radiation will be given and any potential short- and long-term side effects that may occur. External beam radiation therapy can injure the entire eye and portions of the orbit (the bone around the eye). Because children with retinoblastoma who require external beam radiation therapy are usually 1–5 years of age and are still growing, the radiation can stunt the growth of the orbit. SURGERY Surgery is indicated for the treatment of retinoblastoma if the tumor is large enough to interfere with useful vision of the affected eye, or if all other forms of treatment (chemotherapy, radiation, and focal treatments) have been unsuccessful in killing the cancer. If surgery is necessary, the entire globe (the eyeball, which resembles a marble) is removed by the ophthalmologist in the operating room. This operation is called enucleation and is performed as a day surgery procedure. During the procedure, the ophthalmologist places a temporary implant called a conformer inside the orbit once the globe has been removed. The implant looks like part of a small golf ball and permanently takes the place of the globe because it maintains the shape of the eye. Your child will be unaware that the conformer is in place; it cannot be removed, other than by surgery, and is not visible. After the surgery, your child’s eyelids may be bruised and swollen for several days, but these local side effects will go away. Within 6–8 weeks after surgery, your child will be fitted with a prosthetic eye, which resembles a large contact lens. A special art- ist called an occularist will make your child’s prosthetic eye by fitting the prosthetic eye and painting it to match your child’s remaining eye. It will be placed inside of the eye socket between the eyelids and, if fitted properly, should not come out easily. The prosthetic eye will look almost as natural as the remaining eye, except it will not move as much from side to side or up and down.
n HOW LONG WILL MY CHILD’S THERAPY LAST? The length of your child’s therapy depends on the type and stage of your child’s tumor at the time of diagnosis. Usually, the treatment is given for several months. Follow-up blood tests and check-ups between and following treatments generally are done in the clinic or doctor’s office. Your child will require annual or semian- nual checkups throughout his or her entire life.
n WHAT NEW METHODS OF TREATMENT ARE THERE? Most of the advances in the treatment of childhood cancer have been made through a process known as clinical trials. In many clinical trials, the best known (standard therapy) treatment for a particular cancer is compared with a new (experimental therapy) treatment that is believed to be at least as good as, and possibly better than, the standard treatment. Clinical trials allow providers to determine whether promis- ing new treatments are safe and effective. Participation in clinical trials is voluntary. Because clinical trials involve research with new treatment plans, all of the risks cannot be known ahead of time, and unknown side effects may occur. However, children who participate in clinical trials can be among the first to benefit
7
Powered by FlippingBook