Retinoblastoma is a rare type of cancer found in the eye. In retinoblastoma, 1 or more tumors form in the retina. The retina is a layer of light-sensitive tissue that lines the back of the eye. It converts visual images into nerve impulses in the brain that allow us to see.
Retina of the Eye
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As with most cancers, early diagnosis and treatment lead to better outcomes.
During early stages of fetal development, fast-growing, immature cells called retinoblasts form. Later, these cells become retinal cells. In retinoblastoma, some of these cells quickly grow out of control. If cells keep dividing uncontrollably when new cells are not needed, a mass of tissue forms, called a growth or tumor. The cancer may grow along the optic nerve and reach the brain, or it may travel to other parts of the body.
It is not clear exactly what causes these problems in the cells, but it is probably a combination of genetics and environment.
Retinoblastoma is more common in children under 5 years old. Other factors that may increase your child's chance of retinoblastoma include:
Retinoblastoma usually forms only in 1 eye, but both eyes may have tumors. Symptoms are usually noticed by the parent or caregiver and may include, but are not limited to:
Normal Anatomy of the Eye
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The doctor will ask about symptoms and family medical history, and perform a physical exam. Many retinoblastomas are found during routine physical exams. If a tumor is suspected, your child will usually be referred to a specialist for a more complete eye exam. In children with a family history of the disease, eye exams often begin within 1-2 days of birth. Additional eye exams are scheduled at regular intervals thereafter.
Tests may include:
The physical exam combined with all of the test results, will help to determine the stage of cancer. Staging is used to guide your child's treatment plan. Like other cancers, retinoblastoma is staged from I-IV. Stage I is a very localized cancer, while stage IV indicates a spread to other parts of the body.
Treatment depends on the stage of the cancer. Treatment aims to cure the cancer and preserve sight.
Therapies may be used alone or in combination, and may include:
This involves surgical removal of the entire eye and as much of the optic nerve as possible. The optic nerve is the nerve leading from the eye to the brain that is responsible for vision. Surgery may be used for a large tumor in one eye.
This treatment involves the use of radiation to kill cancer cells and shrink tumors. Radiation may be:
Cryotherapy is the use of cold to freeze and destroy small tumors.
This treatment uses heat to kill cancer cells.
Lasers are used to destroy a small tumor.
Chemotherapy is the use of drugs to kill cancer cells. This treatment may be given in many forms including pill, injection, and through a catheter. The drugs enter the bloodstream and travel through the body killing mostly cancer cells, but also some healthy cells.
Genetic counseling and close monitoring and screening for people at risk for retinoblastoma can help prevent the disease or detect it early if it occurs.
Prevention and early detection techniques include:
American Cancer Society
National Cancer Institute
BC Cancer Agency
Cancer Care Ontario
Retinoblastoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 13, 2013. Accessed November 8, 2013.
Clinical Oncology. 2nd ed. Churchill Livingstone, Inc; 2000.
Nelson Textbook of Pediatrics. 16th ed. WB Saunders Co; 2000.
Ophthalmology. Mosby International Ltd; 1999.
Principles and Practice of Pediatric Oncology. 3rd ed. Lippincott-Raven Publishers; 1997.
Last reviewed December 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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