Treatment
When a tumor is discovered in the eye there are currently a number of options available. We will list the current and possible future ones below:
Radiation
There are a number of radiation methods available to treat ocular melonma. The main purpose is to KILL the tumour with radiation.
Plaque Radiotherapy
Is where a small radioactive disk is place over the tumor. One can have 2 types of radioactive material, ruthenium and iodine. Iodine the stronger material is used for the bigger tumors >5mm.
Proton Beam Radiotherapy
This technology is used when plaque radiotherapy is not appropriate. A machine called a synchrotron or cyclotron speeds up the protons. The protons’ speed determines the energy level. High-energy protons travel deeper in the body than low-energy ones.The protons go to the targeted place in the body. There, they deposit the specific radiation dose in the tumor. With proton therapy, radiation does not go beyond the tumor. We link to a recent video diary of a proton beam patient from the BBC.
Stereotactic Radiotherapy
This treatment involves directing radiation at the tumour from several directions so as to maximise the dose of radiation within the tumour while minimising the radiation delivered to surrounding healthy tissues.
There is a better description of radiation treatments here The Liverpool Ocular Oncology Centre
Virus injections
MAR 2017
Eradicating cancer without damaging healthy tissue is the Holy Grail of cancer researchers.
Wills Eye Hospital in Philadelphia is testing a novel, light-activated drug designed to do just that in the eye, raising hopes for the first ocular melanoma treatment that would preserve patients’ vision. Sparing eyesight could encourage earlier detection and treatment, thus reducing the chance of metastases. You can read more about this new treatment here https://www.aao.org/headline/fda-fast-tracks-ocular-melanoma-treatment
Note,
Ocumelirl does NOT promote any treatment, we only report what we find in our travels for your information. Please at all times take appropriate qualified professional medical advice. However medical science is moving so fast that your Dr may not yet be aware of what is happening in other areas so It might be of benefit to point out whats new when you consult with him/her.
Enucleation
If the tumor is found to be too big for radiation or other treatment you Dr may decide to remove the whole eye. This operation is called an enucleation. The Royal Victoria Eye & Ear Hospital Dublin ( RVEEH ) have given kind permission republish their patient leaflet on enucliation. It is attached as a .pfd download below. We currently have 2013 version but will publish the newer updated one when it becomes available in the near future.
Looking after a false / prosthetic eye: Our very good friend Ian over in the UK has done a great YouTube video on how he cleans his eye. He has kindly given us permission to embed it into our website below. People have found it very useful.
Leaving Ireland for treatment
Ireland as we all now know is not in a good place to be when it comes to being sick. We are a small county with many problems. When it come to rare cancers patients are in a serious situation. On a positive side cures & improvents are happening every day but they tend to be in foreign centres of excellence. Based on our experience we hope to share our knowledge of getting treatmet abroad.
Did you know;
Your GP can refer you to a foreign consultant with appropriate ability for you particular ailment. This is possible even if you local Irish consultant is not working out as you had hoped.
Treatment Abroad Scheme (TAS) HSE
HSE TREATMENT ABROAD SCHEME (TAS) is restricted to covering treatments not available here in Ireland.
The Treatment Abroad Scheme (TAS), is governed by EU Regulation 1408/71, as per the procedures set out in EU Regulation 574/72, and in accordance with Department of Health and Children Guidelines.(HSE). A patient can apply for the TAS if a recommended treatment is not available in Ireland. It is in essence a funding application that can only be made by an Irish consultant on the patient’s behalf. It may or may not be granted. The application form is not available online. You must contact the TAS office and they will either e mail or post it to you.
Tips to assist you in making an application;
If you think you may be eligible to apply for TAS - E mail their offices at treatmentabroadscheme@hse.ie and request an application form along with guidance documents on how to complete.
There are different officers depending on where you live
- Dublin, Kildare, Wicklow 056 778 4059
- Cork, Kerry, Carlow, Kilkenny, South Tipperary, Wexford, Waterford, Meath 056 778 4593
- Galway, Donegal, Leitrim, Mayo, Roscommon, Sligo, Cavan, Monaghan, Louth 056 778 4554
- Clare, Limerick, North Tipperary 056 778 4579
- Laois, Longford, Offaly, Westmeath 056 778 4548
TIP: Find out who the TAS officer is that will be dealing with your application and ask for his/her e mail address. When communicating with your TAS officer always copy any communication to treatmentabroadscheme@hse.ie so other staff can follow up on the process should your officer be on leave at any stage otherwise you will find the application slows down.
PATIENT CONSENT – COMMUNICATING WITH THE TAS OFFICE ON BEHALF OF THE PATIENT
Patient consent is not referred to in the guidance docs but know that should you be applying on behalf of the patient you should advise the officer from the outset – ask does the office require written consent for you to act on the patient’s behalf. Some officers do request written consent, some do not. You do not want anything slowing down so find out from the start what exactly is needed.
WARNING TAS will only accept an application from your consultant within 2 weeks of you having seen him/her so there is a timing issue.
There are 2 sections to the application – one to be completed by the patient and the other to be completed by the consultant (you cannot be referred by your G.P.)
Sometimes a decision to refer will depend on the outcome of a scan or other treatments however there is no harm in being ready to go. So to speed up the process it is possible to complete the patient section of the form (its short, –not much to it but just ensure you have it signed and dated or it will be returned. When you next meet the consultant you can give him/her the form (with your section completed). He/she can then complete the consultant section and send it off to the relevant officer at TAS with a copy of the referral letter to the treating consultant.
Remember the TAS office will not begin the process of application until all documentation is received at the same time – they will return the application form for example if it is sent in without the consultants referral letter or if there is a signature missing or a date missing – so to recap, your consultant will forward to TAS the following;
- Patient section
- Consultant’s section (ensure it is signed and not PP’d or it will be returned)
- a copy of the referral letter he/she sent to the treating consultant.
It can be helpful and speed things up if you read and are therefore aware of the referring consultant guidelines (this is important as it can be returned for a number of reasons – such as no signature, name and address of treating consultant not noted on the referral form)
It is best to communicate with your consultant before the application is sent and definitely check in with TAS by e mail to see if it is received. Again you can e mail or phone their offices. Always best to e mail if at all possible so that a record can be kept.
Remember your consultant can e mail the application form and follow up with the signed original in the post
FORMS
The application form is not available online. You must either e mail the TAS office at treatmentabroadcheme@hse.ie or phone their main number on and request the for
The TAS office have up to 20 days to respond to your application and you will receive a response by post. Travel expenses can be also claimed for both you and a travelling carer so hold onto to your airline receipts and your boarding passes. There can be a lenghty delay in processing your refund.
If you have private insurance cover or the means to go abroad you can use your Irish GP OR Consultant to make a referral. However for the TAS sheme it must be your Irish consultant and the treatment must NOT be available here.
Hope this helps you on your journey.