Retinoblastoma is a malignant tumor in the retina of a child’s eye. While it’s not common to find hospitals that specialize in this rare cancer, the pediatric ophthalmology specialists at the University of Michigan Kellogg Eye Center do, diagnosing and treating retinoblastoma using the latest treatment options, as well as discovering new treatments and therapies to comprehensively care for our patients. These ophthalmologists work in tandem with Kellogg’s newest service: the Orbital and Ocular Oncology Service.
Most often, retinoblastoma is diagnosed early in life, often by a pediatrician examining a child who notes a “white pupil” known as leukocoria – a white pupil due to reflection of light off a tumor located behind the lens of the eye. Sometimes a parent notices something is wrong when the white pupil is seen in a flash photograph. Retinoblastoma can occur randomly or it can be hereditary. When retinoblastoma occurs in only one eye, it is usually not hereditary. When the disease occurs in both eyes, it is always hereditary.
Once the symptom is noticed, the child is referred to a pediatric ophthalmology specialist at the Kellogg Eye Center. The ophthalmologist will perform a fundus examination, which means examining the interior lining of the eyeball that includes the retina. Once retinoblastoma is diagnosed, the pediatric ophthalmology specialist will order tests to determine the size of the tumor and whether it has spread to other parts of the body. Tests may include an MRI or CT scan, bone marrow test and/or a spinal tap. Our multidisciplinary program combines the efforts of Pediatric Ophthalmology, Ocular Oncology, Radiation Oncology, Hematology/Oncology and the Comprehensive Cancer Center.
Typically, the survival rate for a child with retinoblastoma is greater than 90 percent. The type of treatment given depends on the extent of the disease within the eye, whether the disease is in one or both eyes, and whether the disease has spread beyond the eye.
Treatment options consider both cure and preservation of sight, and include the following:
- Enucleation – surgery to remove the eye
- Cryotherapy – the use of extreme cold to destroy cancer cells
- Laser photocoagulation therapy – the use of laser light to destroy blood vessels that feed the tumor
- Radiation therapy – the use of high-energy radiation from x-rays and other sources to kill cancer cells and shrink tumors
- Chemotherapy – a systemic treatment where drugs enter the bloodstream, travel through the body, and kill cancer cells throughout the body
Cutting-edge clinical trials are available to patients who qualify through the Children’s Oncology Group.
Because of the hereditary factor, brothers and sisters of children with retinoblastoma should be examined to find out if they may develop the disease.
Retinoblastoma survivors can also pass this form of cancer on to their children. If your child has retinoblastoma, particularly the hereditary type, there is an increased chance that he or she may develop a second cancer in later years. We offer genetic counseling to answer all your questions about inherited diseases, providing comprehensive evaluation, education, and support.