FILE Eye cancer, causes & treatments

As an organ, the eye is not immune to cancer. Its complexity means that malignant tumors can affect and develop across several structures of the eye. Eye cancer, while relatively rare, is poorly understood and, consequently, poorly detected. Particular vigilance is warranted when certain symptoms are present. Certain behaviors can also contribute to its development.

Through this file, we will try to learn more about eye cancer , its causes, and ways to treat it.

Eye cancer: not one, but several

Malignant eye tumors can affect the entire structure of the eye , including the eyelids, conjunctiva, orbit and its adnexa, and the eye itself. While most remain rare, they are quite serious and must be treated very quickly.

The most common eye cancer in adults is called uveal melanoma (or uveal melanoma). There are approximately 600 new cases annually in France. The tumor appears in melanocytes, the cells that produce melanin, the pigment responsible for the color of the eyes , but also of the skin and hair. Ocular melanoma arises inside the eyeball.

In terms of symptoms, there are two main ones that should alert you: the appearance of phosphenes (light signs always located in the same place) sometimes accompanied by black dots and the sudden drop in the amplitude or visual field.

If caught early, it can be treated with radiotherapy or brachytherapy . If it is too late to treat the tumor, the eyeball can then be removed. Finally, this cancer is likely to cause metastases, often to the liver, which makes it particularly dangerous for other organs.

Another cancer, a little less common but affecting around 300 people per year, is called intraocular lymphoma . There are also a few warning signs that should prompt the patient to seek medical help quickly. This is particularly true when there is a gradual decline in visual acuity, blurred vision, or persistent redness or inflammation.

Treatment is possible and will depend on the diagnosis. In fact, lymphoma is most often linked to cerebral lymphoma.

In children, there is an eye cancer called retinoblastoma . This cancer affects the cells of the retina. It only affects children because the tumor attacks the retina when it is not fully formed. This is why the vast majority of these cases affect children under 3 years old.

Camera screening!

There are approximately 50 children affected by retinoblastoma each year in France. In its bilateral form (if it affects both eyes), it is most often a genetic mutation. The latter can be hereditary , and parents may also have this same mutation.

If this is the case, a fundus examination should be performed immediately after the child's birth. However, due to a lack of information, identifiable symptoms may be overlooked. Two of these are fairly easy to recognize. These are unilateral early strabismus and leukocoria , a white or silvery reflection in the pupil.

If in doubt, leukocoria can be detected using a simple camera. Photographs should be taken from different angles, with a flash, and without any red-eye correction. If one eye is red and one with a silvery sheen, a doctor should consult a doctor.

Other rarer tumors

Lesser-known tumors can affect the eye and its surroundings. These include eyelid tumors, which are actually basal cell carcinomas, the most common skin cancer. There is also squamous cell carcinoma , which is rarer and more aggressive and can also affect the eyelids.

Finally, the orbit and conjunctiva can also be affected by tumors, melanomas, and lymphomas. All are quite rare but relatively serious. Therefore, early and appropriate treatment is essential.

Known risk factors for eye cancer…

Several factors can be linked to eye cancer. Age, in particular, is one of them. The average age of those diagnosed is 55. Eye cancer is much rarer in children, although some cases have been observed, and in people over 70.

Skin and eye color are also proven risk factors. People with light skin and light eyes are more likely to be affected than those with darker skin and eyes. There is no proven link, however, with gender. This cancer can affect both men and women.

Some medical histories are favorable for introcular melanoma. These include people who have had a nevus of Ota , a hyperpigmentation of the eye or the skin around it. A Nevi , a congenital malformation of the skin, produced by excess pigmentation or a dysplastic nevus syndrome, moles of a particular shape and color.

As we have seen, eye cancer can also be caused by family history, particularly by the mutation of the BAP1 gene. This mutation can also be the cause of other cancers, such as kidney cancer.

People infected with HIV are more likely to develop lymphoma of the eye and squamous cell carcinoma of the conjunctiva.

Finally, it should be noted that a profession is very risky. In fact, the welder's job offers a higher than average risk of developing eye cancer, particularly intraocular melanoma . Exposure to ultraviolet rays increases this risk, and this activity has been classified as a definite carcinogen for eye cancer.

…and suspected

Other behaviors, such as tanning, whether artificial or natural, are suspected of increasing the risk of certain eye cancers. Ultraviolet rays from tanning beds and sunlamps can damage the eyes and promote basal cell and squamous cell carcinomas. High exposure to sunlight can pose a similar risk.

Finally, it has been discovered that some industrial workers exposed to products such as polychlorinated biphenyls (or PCBs) may have an increased risk of developing eye cancer. This may also be the case for airline workers , pilots and commercial flight crews at the front of the line, who are exposed to high levels of ultraviolet radiation.

These conclusions remain to be confirmed, however.

Sources: Le Figaro , cancer-environnement.fr/