Uveal Melanoma

What is Uveal Melanoma?

Uveal melanoma is a rare type of cancer that occurs in the tissues of the eye.

Also called intraocular or ocular melanoma, this type of cancer occurs in only 5 people per million. But, it can resist treatment and spread quickly through the body.

Your eye has an outer, middle, and inner layer. Uveal melanoma starts in the middle layer of the eye.

The middle layer — called the uvea or uveal tract — includes the:

• Iris — the colored part of the eye.
• Ciliary body — tissues of muscle fibers found behind the iris.
• Choroid — the layer of blood vessels that brings oxygen and nutrients to the eye.

Uveal melanoma can occur in one or more of these areas of the eye’s middle layer.

Uveal Melanoma Causes and Risks

The cause of uveal melanoma is not yet known.

Some factors that may increase the risk of getting this type of cancer include:

• Having fair skin.
• Having freckles.
• Skin that burns easily and does not tan.
• Having blue or green eyes.
• Older age.

Uveal Melanoma Symptoms

Sometimes uveal melanoma doesn't show early signs or symptoms.

But when it does, symptoms of uveal melanoma can include:

• Blurred or changed vision.
• Floaters, or spots that drift in your vision.
• Flashes of light.
• A dark spot on the iris.
• Changes in pupil size or shape.
• Changes in position of the eyeball in the eye socket.

If you have any of these symptoms, contact your doctor to make an eye exam.

Diagnosing Uveal Melanoma

Doctors can diagnose uveal melanoma with or without symptoms at a routine eye exam. Your eye doctor may see signs of the disease when dilating the pupil.

Other than an eye exam, tests to help diagnose uveal melanoma include:

• Ultrasound
• X-ray
• Transillumination test, or light test
• Physical exam

Though rare for diagnosing uveal melanoma, your doctor may perform a biopsy of the cancer tissue to learn more about your prognosis.

After doctors diagnose uveal melanoma, you'll need more tests to learn if the cancer has spread.

Cancer can spread from the original spot in the eye through the lymph system or blood vessels. Metastatic tumors form in the other parts of the body where the cancer has spread.

Uveal melanoma of the ciliary body and choroid is more likely to spread than uveal melanoma of the iris.

Stages of Uveal Melanoma

Uveal melanoma of the iris does not have stages.

Uveal melanoma of the ciliary body and choroid has four stages:

• Stage I — the tumor is small and only in the choroid.
• Stage II — the tumor is larger than in stage I. It also may have spread to either the ciliary body or outside of the eyeball.
• Stage III — the tumor has grown larger than in stages I and II. It may have spread to either the ciliary body or the outside of the eyeball.
• Stage IV — the tumor has spread to:
  • One or more lymph nodes.
  • The eye socket.
  • Other organs, such as the liver, lung, bone, brain, or skin.

Uveal Melanoma Treatments

Treatment for uveal melanoma largely depends on the stage of the cancer and the location. There are no currently approved treatments once metastases develop.

The most common types of treatment include:

• Surgery
• Radiation therapy
• Laser light therapy
• Thermotherapy (heat therapy)
• Close monitoring

Surgery for uveal melanoma

Surgery is the most common treatment for uveal melanoma. Your surgeon will assess what technique is best for you based on the size and location of the tumor.

The goal of surgery is to try to save your vision, if possible.

If we must remove the eye and optic nerves, we’ll fit you for an artificial eye that closely matches your other eye.

Radiation treatment for uveal melanoma

Radiation therapy uses x-rays to destroy cancer cells. You might receive this treatment externally or internally.

• External radiation therapy uses a machine — such as the Gamma Knife^® — to send radiation into the body. Gamma Knife therapy uses gamma rays to precisely target cancer cells and can save the healthy cells around the cancer.
• Internal radiation therapy uses catheters to send the substance directly into the cancerous part of the body.

Close monitoring

Your doctor may choose to keep close track of the uveal melanoma without treatment if the tumor:

• Is small.
• Is not growing.
• Affects the only eye with vision.

He or she will take pictures of your eye over time to watch for any changes.

Why Choose UPMC Hillman Cancer Center for Uveal Melanoma Care?

At UPMC Hillman Cancer Center, our experts developed an innovative therapy called adoptive cell transfer. This treatment uses the body’s own immune cells to fight uveal melanoma.

Because our center has both clinical excellence and groundbreaking research, you have access to the latest techniques and cancer treatments.

View our uveal melanoma clinical trial.

Contact Us About Melanoma and Skin Cancer Care

To learn more about melanoma and skin cancer care or to make an appointment, you can:

• Call 412-647-2811.
• Contact a UPMC Hillman Cancer Center near you.