Retinoblastoma Cancer from Diagnosis to Treatment


What Is Retinoblastoma?

Retinoblastoma is a rare eye cancer that develops in the retina, the light-sensitive tissue at the back of the eye.

It mostly affects young children, usually before age 5, and can occur in one eye | unilateral or both eyes | bilateral.

Retinoblastoma is highly treatable, especially when detected early.


Types of Retinoblastoma

Hereditary
Caused by a mutation in the RB1 gene
Usually affects both eyes
Often diagnosed at younger ages | <1 year
Can cause multiple tumors in each eye
Higher risk of other cancers later in life

Non-Hereditary | Sporadic
No family history
Usually affects one eye | unilateral
Diagnosed slightly later | 1-3 years old


1. Signs and Symptoms

White reflection in the pupil | called leukocoria
  Appears as a white glow in photos taken with flash

Eye redness
Swelling around the eye
Strabismus | crossed eyes
Vision problems or poor tracking
Eye wandering or shaking | nystagmus
Pain in later stages


2. Causes and Risk Factors

Family history of retinoblastoma
Inherited RB1 mutation
Siblings of an affected child have higher risk
No lifestyle or environmental causes are known


3. Diagnostic Procedure

Medical History & Physical Exam
Detailed eye exam by a pediatric ophthalmologist
Often requires eye examination under anesthesia for young children

Imaging
Ultrasound:
Detects tumor inside the retina

MRI of the brain and orbits:
Determines size of tumor
Checks for optic nerve involvement
Identifies spread to brain or nearby tissues

CT scans are rarely used to avoid radiation exposure in young children.

Genetic Testing
Identifies RB1 gene mutation
Determines if cancer is hereditary or non-hereditary
Important for siblings & future pregnancies

Staging

Intraocular | within the eye:
Group A to E based on tumor size and location

Extraocular | outside the eye:
Spread to optic nerve
Spread to brain, bone marrow, or other organs


4. Treatment Options

Systemic Chemotherapy

Used to shrink tumors | chemoreduction.

Common drugs:
Carboplatin
Vincristine
Etoposide

After shrinking, smaller tumors can be treated with local therapies.

Local Chemotherapy

Intra-arterial Chemotherapy
Drug delivered directly into the ophthalmic artery
Very effective for medium-sized tumors

Intravitreal Chemotherapy
Drug injected into the eye for vitreous seeds

Laser Therapy | Photocoagulation

Burns and destroys small tumors
Often used after chemo to treat residual disease

Cryotherapy

Freezes and destroys small tumors near the outer retina

Radiation Therapy

Used when chemotherapy and local therapies are not enough.

External beam radiation:
Rare today due to side effects

Plaque brachytherapy:
Radiation seeds placed on the eye surface

Surgery | Enucleation

Removal of the affected eye
Done when vision cannot be saved or tumor is large
Prevents cancer spread
Prosthetic eye is placed afterward


5. Preferred Nutrition for Patients

Protein-rich foods:
eggs, fish, chicken, yogurt

Fruits & vegetables:
carrots, spinach, berries

Whole grains:
oats, brown rice

Healthy fats:
avocado, nuts, olive oil

Hydration:
water, soups, herbal drinks

Small, soft, frequent meals
to reduce discomfort.


6. Follow-Up and Monitoring

Regular eye exams
MRI scans | for hereditary cases
Checking for tumor recurrence
Screening for secondary cancers
Vision development assessment