FILE Eye cancer, causes & treatments

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

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 tumors of the eye can affect the entire structure of the eye , including the eyelids, the conjunctiva, the 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 each year 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.

As for the 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 spots and the sudden drop in visual amplitude or 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 which affects about 300 people per year, is called intraocular lymphoma . Here too, a few warning signs should lead the patient to consult quickly. In particular, when there is a progressive decrease in visual acuity, and blurred vision, or even redness or inflammation that lasts.

Treatment is possible and will depend on the diagnosis. In fact, 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 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 can also have this same mutation.

If this is the case, an eye examination should be performed immediately after the child is born. However, due to lack of information, identifiable symptoms may be overlooked. Two of them are quite easily recognizable. These are unilateral early strabismus and leukocoria , i.e. a white or silvery reflection at the pupil.

If in doubt, leukocoria can be detected using a simple camera. In fact, you need to take pictures 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 a doctor.

Other rarer tumors

Lesser-known tumors can affect the eye and its environment. Among them, eyelid tumors, which are actually basal cell carcinomas, 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 affected by tumors, melanomas and lymphomas. All are quite rare but relatively serious. Therefore, early and appropriate management 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 years old. Eye cancer is much rarer in children, even if we have seen that some cases can exist, and in those over 70 years old.

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 are people who have had a nevus of Ota , 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 particular shape and color.

As we have seen, eye cancer can also be promoted by family history, and in particular 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. Indeed, the welder's profession offers a higher than average risk of being affected by eye cancer, more particularly intracocular melanoma . Exposure to ultraviolet rays reinforces 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 booths and sunlamps can damage the eyes and promote basal cell and squamous cell carcinomas. The sun's rays, in cases of high exposure, can cause an identical 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 could also be the case for professionals in the aviation sector , 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/