Retinoblastoma is a rare cancer that originates in the retina, the tissue in the back of the eye that converts light into visual information that is interpreted by the brain.
One retinoblastoma symptom in particular is finding itself in the spotlight. With a rise in social media use in recent years, retinoblastoma has attracted media attention for being a type of cancer that can sometimes be detected through photographs. Across the internet, news stories like this one abound in which friends or relatives have alerted parents to the potential risk of eye cancer after noticing that a child’s pupil appears white instead of red — a symptom called leukocoria — on photos posted to social media.
Fortunately, with proper diagnosis and treatment, 95 percent of children diagnosed with retinoblastoma can be cured. What’s more, a catheter-based treatment approach is now sparing patients from some of the side effects that can be expected from more traditional therapies.
At the Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, a technique called intra-arterial chemotherapy — which involves using a catheter to deliver highly-concentrated doses of chemotherapy directly to the ophthalmic artery of the affected eye — is frequently used to treat retinoblastoma.
A rare skill to treat a rare cancer
While standard intravenous chemotherapy can weaken the body’s immune system and lead to other side effects including anemia, hair loss, nausea and weight changes, delivering targeted chemotherapy directly to the affected area can circumvent many of these problems.
And in stark contrast to surgery, during which the entire eye and its optic nerve are removed, intra-arterial chemotherapy can spare the eye and potentially a child’s eyesight.
That being said, the surgical skill to perform intra-arterial chemotherapy is relatively rare in parallel with retinoblastoma’s own scarcity.
“The approach to catheterizing the infant cerebrovascular system is unique, and intra-arterial chemotherapy for retinoblastoma is most safely done at centers with a high volume of pediatric cases,” says Darren Orbach, MD, PhD, Chief of Neurointerventional Radiology at Boston Children’s Hospital, who performs intra-arterial chemotherapy for retinoblastoma patients. “Unfortunately, a relatively high rate of adverse events has been seen with this treatment when it is performed by practitioners who typically treat vascular conditions only in adults.”