In the blink of an eye
Routine optometrist visit leads to discovery of ocular melanoma
Say “melanoma” and thoughts turn to skin cancer. But there is melanoma of the eye too — ocular melanoma — with at least four cases in Medicine Hat.
For Jim Tennant who was diagnosed in 2014 it has been life-changing.
There are no symptoms in the early stages. Tennant was having a routine eye examination that September. For years there had been a nevus, a freckle, on his right eye but it had not been cause for concern. This time his eye doctor said “hhm...”.
“It’s not what you want to hear from your eye doctor,” said Tennant.
The nevus had now changed shape and measured 2.8 mm.
Within a couple months Tennant was in Calgary for tests including an ultrasound on the eye. By then the melanoma measured 3.1 mm.
He was presented with three options: Do nothing if it is small, Undergo radiation — eye plaque brachytherapy — or have the eye removed if it can’t be treated, said Tennant. Removing the eye does not necessarily mean all the melanoma will be gone however.
Dr. Ezekiel Weis, opthalmologist, researcher and surgeon, helped Tennant determine that radiation was the best choice, and Weis would do a biopsy at the same time.
A month later the melanoma measured 3.5 mm. Under general anesthetic, what Tennant describes as a bottle top filled with radiation beads was positioned in the eye. When he awoke there was a rather large and protruding eye patch over his eye. He was required to stay near the hospital for a few days.
The “bottle top” was then removed surgically and the eye still covered.
An eye patch looms large for those diagnosed with ocular melanoma and in fact every May 20 has become known as “Eye-Patch-Day” to raise awareness of the disease. Even now Tennant still has days when there is a throbbing discomfort in his eye and he will wear an eye patch to give his eye some rest.
The good news is the radiation resulted in arresting the growth of the melanoma. At his most recent check-up there was really good news: The melanoma has flattened and there was no fluid in it.
“It feels really good,” said Tennant about this news.
There is about an 80 per cent chance of the melanoma not metastasizing for at least five years, said Tennant. If it does metastasize it is most likely to go to the liver.
The radiation treatment has resulted in some vision loss for Tennant.
The diagnosis has changed Tenant’s perspective on many things. He went from having a family doctor, an eye doctor and a dentist to now having eight specialists watching over him regularly. There is even a dermatologist who determines whether any skin lesion needs to be removed.
Tennant is passionate about reminding people to have regular eye exams regardless of any symptoms and to wear polarized sunglasses. He also says waiting for retirement to travel is not a good strategy. Travel while you are young enough and physically well enough to enjoy it.
In Canada, 150 cases of ocular melanoma are diagnosed each year. In the U.S. there are six cases for every million people each year, said Tennant. The condition is more prevalent in some regions but research is ongoing to determine why that is the case.
In research, Weis has been able to determine that those with freckles and moles on their skin are two to four times more likely to develop ocular melanoma.
There is a world-wide support group for those diagnosed with ocular melanoma, with about 934 members currently.