Retinoblastoma Treatment Guidelines in Children

What is Retinoblastoma?

Retinoblastoma is an eye cancer that is typically seen in children, but can also be experienced by adults. Retinoblastoma attacks the eye retina or the retina located at the inner wall of the eye. Retinoblastoma can affect one or both eyes. Most of these diseases occur in children under 5 years old. Retinoblastoma Treatment must be done as soon as possible to avoid blindness in your children.

Retinoblastoma Treatment Guidelines

Causes of Retinoblastoma in Children

The human retina is formed by cells called retinoblas. Cancer occurs due to genetic mutations that make retinoblas continue to reproduce until tumors grow on the retina. This cancer can grow into all parts of the eye to spread to other body parts, such as the brain and spinal cord.
Retinoblastoma Treatment Guidelines


The risk factors of Retinoblastoma in Children

The occurrence of genetic mutations in Retinoblastoma disease is unknown in most cases, but it is possible that Children having this disease because it is derived from a parent. Retinoblastoma derived heresiter called retinoblastoma. Retinoblastoma this type usually affects both eyes and can thrive even from a very young age.

Retinoblastoma that is not caused by genetic mutations generally occurs by chance and only on one eye. While retinoblastoma in adults can also be triggered by diabetes or other eye diseases there is a history in the family health record.

Symptoms and complications of Retinoblastoma in Children

Common symptoms of retinoblastoma can be leukokoria, which are white on the pupil when exposed to the light. There can also be cross-eyed, swollen eyes and red eyes. Immediately see a doctor if a child's eye condition worsened, such as red eye are not improved.

This disease can cause blindness and other types of cancer in children who suffered from retinoblastoma. Cancer may recur in healthy eyes or other body parts. People with retinoblastoma will be advised to do regular eye health checks, before and after treatment to minimize the recurrence of retinoblastoma.

Diagnosis of Retinoblastoma in Children

A series of tests need to be done.  An eye specialist can provide a diagnosis of retinoblastoma patients. The doctor will use a special ophthalmoscope to see clearly, whether there is a tumor in the retina of the patient. The eye examination can be performed with anesthesia to get more accurate results.
The doctor also may recommend imaging tests to find out how many cancer cells that have spread and whether the cancer has spread to other body parts. Imaging tests suggested to detect cancer cells include an ultrasound, CT scan, and MRI. Your doctor may refer to a cancer specialist, genetic counselor, or the surgeon during the treatment process.

If you have a history of retinoblastoma, ask your doctor about when your child should begin to undergo regular eye examinations. However, children with retinoblastoma will more often have regular checkups and can last up to 5 years.

Retinoblastoma Stadium

Stages of retinoblastoma are distinguished by size, rate of spread, and location of the cancer. This stage will affect the type of treatment procedures. Retinoblastoma is diagnosed at an early stage will have a level of greater treatment success.

The stages of retinoblastoma deployment starting from when the cancer cells are found in one or both eyes and has not spread to tissues outside the eye. This stage is called intraocular retinoblastoma. The next condition is when the cancer has spread beyond the eye or other parts of the body. This condition means that the cancer has entered the stage of extraocular retinoblastoma.

Recurrent retinoblastoma occurs after treatment ended and Retinoblastoma happen again in the eyes of the patient or spread to other body parts.

Retinoblastoma Treatment Guidelines in Children

The doctor will look at the extent of the severity of the patient. Next will be determined whether the blindness is avoidable or the need for removal of the eye will be replaced with an artificial eye.

One way to treat Retinoblastoma is the use of laser therapy (laser photocoagulation). Therapeutic laser light can be used to destroy blood vessels that nourish the tumor and cause the death of cancer cells.

Other treatment options are with cryotherapy or cold therapy. This therapy uses very cold liquid nitrogen to freeze the cancer cells before it is removed. This freezing process and removal can be done several times during the maintenance procedure. This process is carried out until the cancer cells die.

In addition, there is a heat therapy which is the opposite of cold therapy. Termoterapi using ultrasonic waves, microwaves, or lasers to direct heat and kill cancer cells.

Chemotherapy drugs and radiation therapy (radiotherapy) may also include means used to kill cancer cells Retinoblastoma. If chemotherapy uses drugs to kill cancer cells, then radiation therapy uses X-ray radiation to do so. Internal radiation or brachytherapy using tools that are placed near the tumor to reduce the risk exposure of healthy tissue from radiation.

For patients with severe retinoblastoma, external radiation therapy can be done to provide greater exposure to radiation. Compared to internal therapy, the therapy can risk damaging healthy tissue.

Eye removal surgery is done when the tumor size was too large and / or tumor could not be treated with other treatments. Surgical removal of the eye consists of several stages beginning with the removal of the infected eye cancer called enucleation. After that, an artificial ball (implant) is installed and connected with the eye muscles. The muscle tissue will adapt to the eye tissue healing process as a child, so will the eyes of the implant can move like natural eye although he can not see. 

The new artificial eye will be installed a few weeks after the operation and put together implants eyes behind the eyelids. In addition to impacting the child's vision, this surgical procedure also has the side effect of bleeding and infection.

Children who are diagnosed with retinoblastoma must be addressed before the stage of cancer is difficult to treat and cause vision loss. Post-treatment tests and examinations should be undertaken continuously, especially for children with genetic mutations derivative.

Prevention of retinoblastoma in Children

While most cases of retinoblastoma not yet have a definite precautions, routine eye examinations that begins at birth can detect retinoblastoma faster.

Typically, regular visits to the pediatrician in the early years of a child is born, already includes an eye examination. The doctor will check for signs of degenerative disease including signs of tumors in the eye. Routine eye examinations for adults to do at least once a year to monitor the eye health and reduce the risk of cancer recurrence.

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