World Retinoblastoma Awareness Week: Doctor reveals symptoms, precautions and treatment

World Retinoblastoma Awareness Week: Doctor reveals symptoms, precautions and treatment
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Retinoblastoma is the most common eye cancer in children which as per the reports, affects 1 in 18,000 children every year across the world and in India, more than 1500-2000 children are affected by the disease every year as there has been a gradual increase in the number over the past few years. It arises from the retina of the eye that is responsible for visual perception.

Most common among infants and young children, in the majority of Retinoblastoma cases, it occurs in one eye (unilateral retinoblastoma), whereas in some instances, both eyes can be affected (bilateral retinoblastoma). The cancer has the risk of spreading to the brain through the optic nerve of the eye and through the blood to the whole body. 

Health experts insist that misconceptions surrounding the disease along with late diagnosis are the biggest reasons why we come across advanced cases in India which reduce the chances of survival. Otherwise, it is a completely curable eye cancer if detected early and treated the right way.

Risk factors of Retinoblastoma for children:

In an interview with HT Lifestyle, Dr Fairooz P Manjandavida, Consultant at HORUS Specialty Eye Care in Bangalore, Specialist of Ophthalmic Plastic Surgery, Orbital Surgery and Ocular Oncology and Medical Adviser for Entod Pharmaceuticals, revealed, “Some variations in the genes or genetic mutation is considered to be the risk factor for retinoblastoma. In about 40 per cent of cases, the genetic form is responsible for this type of cancer and always affects very young children, especially those who are 1 year old or younger.”

She added, “The gene responsible for this rare form of cancer is known as RB1. When retinoblastoma occurs in both the eyes, the genetic condition happens to be the link. Rarely, does the genetic form result in damage to only 1 eye. Despite that, only 10-20 per cent of children with the disease have a family history associated with retinoblastoma. Another risk factor for this form of cancer is the young age. The majority of children diagnosed with the disease are below the age of five years, and several of them are even infants. Though children of every race can develop this condition, the ones from the underserved communities face the worst outcomes due to inadequate healthcare facilities.”

She said that scientists are also studying various possible links to the disease like environmental factors and paternal and maternal factors.

Signs and symptoms:

As the disease is most prevalent in young children and infants, Dr Fairooz P Manjandavida said that the symptoms goes unnoticed. However, she list some signs that one may look out for:

1. White Pupillary Reflex – In normal scenarios, the pupil looks red when light is focused on it, however in eyes with retinoblastoma, the pupil mostly appears white especially during flash photograph. This is indeed the white tumour that is hiding inside.

2. Squint eye – The eye can be seen as squinting, turned inwards or outwards

3. Redness and pain

4. Affected eyes can appear bigger

5. Vision loss

6. Bulging of the eyes

7. Bleeding in the front of the eye

8. Shrunken eye ball

Precautions and treatment:

According to Dr Fairooz P Manjandavida, “Preventing retinoblastoma is not possible but children who have a family history of the disease must be taken for regular eye exams from birth. This way the disease can be detected early and the chances of survival significantly increase.”

She highlighted that the treatments vary according to the stage of the disease and the common treatments include:

1. Cryotherapy – In this technique, the tumour is destroyed by applying ice and freezing it.

2. Laser therapy – Laser therapy techniques include thermotherapy. Doctors use lasers to destroy cancer tumours with heat.

3. Chemotherapy – Chemotherapy drugs are injected through the vein or artery. It is the mildest of the chemotherapy and children tolerate it well. Advancement in treatment modalities recently also includes injecting chemotherapy drugs directly into the arteries supplying the tumour. And, also injections into the eyes.

4. Radiation – Radiation therapy can kill the cancer cells and prevent them from multiplying. For effective treatment, a provider may also recommend a type of radiation therapy called radioactive plaque therapy, where the radiation device is directly applied on top of the eye to treat the tumour.

Dr Fairooz P Manjandavida said, “Retinoblastoma is a curable childhood eye cancer. It is important to detect it early by the parents and grandparents. White reflex in the eye should be considered as retinoblastoma until proven otherwise. Avoid misdiagnosis and delay by the paediatricians, physicians and general ophthalmologists. Referring the patients to the retinoblastoma specialists and treatment centres, makes it possible to give appropriate care thereby improving the outcome. With the recent advances in the treatment we are able to save many lives, eyes and vision.”

 

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