FILE Eye cancer, causes & treatments

As an organ, the eye is not spared from cancer. Its complexity means that malignant tumors can involve and take shape through several structures of the eye. Eye cancer, although rather rare, is relatively poorly understood and, consequently, poorly detected. Faced with certain symptoms, you should be particularly vigilant. Certain behaviors can also encourage it.

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

Eye cancer: not one, but several

Malignant tumors of the eye can affect the entire constitution of the eye , including the eyelids, the conjunctiva, the orbit and its annexes and the eye itself. Although most remain rare, they are rather serious and must be treated very quickly.

The most common eye cancer in adults is called uveal melanoma (or uveal melanoma). There are around 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 starts inside the eyeball.

As for the symptoms, there are two main ones which 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 amplitude or visual field.

If caught in time, it can be treated via 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 which affects around 300 people per year, is called intraocular lymphoma . A few warning signs should, here too, lead the patient to consult quickly. Particularly when we notice a progressive decline in visual acuity, and blurred vision, or even redness or inflammation that lasts.

Treatment is possible and will depend on the diagnosis. Indeed, most often, lymphoma is 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 completely formed. This is why the vast majority of these cases concern children under 3 years old.

Camera screening!

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

If this is the case, a fundus examination should be carried out just after the birth of the child. But due to lack of information, identifiable symptoms can be overlooked. Two of them are quite easily recognizable. These are unilateral early strabismus and leukocoria , namely a white or silvery reflection at the level of the pupil.

If in doubt, it is possible to screen for leukocoria using a simple camera. Indeed, you have to take photos from different angles, with a flash, and without activating any red eye correction. If you notice a red eye and an eye with a silvery reflection, you should consult.

Other rarer tumors

More unknown tumors can affect the eye and its environment. Among them, eyelid tumors, which are actually basal cell carcinomas, that is to say the most common skin cancer. There is also squamous cell carcinoma , rarer and more aggressive, which can also affect the eyelids.

Finally, the orbit and conjunctiva can also be subject to 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 make it possible to make the link with eye cancer. Age, in particular, is one. The average age of people diagnosed is 55 years old. Eye cancer is much rarer in children, although we have seen that certain cases can exist, and in people over 70 years old.

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

Some medical history is favorable for intraocular melanoma. These are people who have experienced an Ota nevus , hyperpigmentation of the eye or the skin around it. A Névi , a congenital malformation of the skin, produced by excess pigmentation or dysplastic nevus syndrome, moles of particular shapes and colors.

As we have seen, eye cancer can also be caused by family history, and in particular by 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. Indeed, the profession of welder offers a higher than average risk of developing eye cancer, more particularly intraocular melanoma . Exposure to ultraviolet strengthens it 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. The sun's rays, in case of strong exposure, can cause an identical risk.

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

However, these conclusions remain to be confirmed.

Sources: Le Figaro , cancer-environnement.fr/