New treatment helps get rid of rare eye cancer

A bump below your brow could be a symptom of a deadly eye cancer, but if you have it, your chances of survival just jumped.

The rare cancer forms in the gland that produces tears.

Ten year survival used to be 20% or less, but now, a new treatment has quadrupled those odds.

You could call 54-year-old Marilyn Nakama’s eye patch a badge of courage.

For the last several months, she has been fighting adenoid cystic carcinoma, a tumor growing deep inside her eye socket.

Instead of cutting open the skill to remove these tumors, Dr. David Tse at the University of Miami’s Bascom Palmer Eye Institute pioneered a new treatment. Using a catheter, he infused a high dose of chemotherapy into the artery that was feeding the tumor, much more than what could be delivered through the veins.

Dr. Tse says, "By putting a catheter into the artery that supplies the blood to the lacrimal gland, we could perfuse high concentrations of chemotherapy that the concentration normally would be lethal to the patient."

The procedure shrunk the tumor, making surgery to remove all cancer cells more effective. Though Marilyn lost her eye, she still feels lucky.

Marilyn says, "I had an MRI about two weeks ago, and they said I was cancer-free, so that's really, really good news."

Steve Downey was the first to undergo Dr. Tse’s experimental cancer procedure.

He says, "Short-term and long-term, he saved my life, I guess you could say."

Steve now wears a removable prosthesis matched to his eye and skin color.

"Just like taking out contacts in the morning, putting them in at night."

He never forgets what could have been. He is a grateful patient, looking forward to a long, cancer-free future.

Dr. Tse’s research is continuing, and he hopes that one day, he can eliminate this eye cancer without surgically removing the eye.

Less than half a dozen centers in the United States perform this innovative treatment, and patients come from all over the world to undergo the procedure at the University of Miami.


BACKGROUND: Adenoid cystic carcinoma of the lacrimal gland is the most deadly orbital tumor. The cancer arises from the cells within the lacrimal gland, which is a structure that produces tears. Orbital adenoid cystic carcinoma usually occurs in patients between 20 and 50 years old. When an adenoid cystic carcinoma of the lacrimal gland grows, it typically pushes the eye down, towards the nose and forward. It can cause bulging of the eye. Adenoid cystic carcinoma also invades local nerves, causing pain. Pain and bulging are the most common symptoms.

DIAGNOSIS: Doctors must perform a complete eye exam with a clinical history and ophthalmic exam to diagnose adenoid cystic carcinoma of the lacrimal gland. Other tests such as CAT scans, MRIs and ultrasounds are also helpful in determining the diagnosis of adenoid cystic carcinoma of the lacrimal gland.

TREATMENT: If possible, an adenoid cystic carcinoma should be completely removed. This surgery is often called a lateral orbitotomy. However, total removal is often impossible because of the tumor's size, shape and presence of invasion.

A NEW OPTION: David Tse, M.D., from the University of Miami Miller School of Medicine, is using a new treatment called intra-arterial cytoreductive chemotherapy. A catheter is inserted into a large artery in the groin and is advanced toward the artery in the eye socket that feeds the tumor. Infusion of chemotherapy through the artery allows the doctor to deliver a very high dose of chemo that cannot be given through the vein. As the chemotherapy goes through the tumor, the drug is absorbed by the cancer cells, and the drug dosage becomes much less after perfusing through the tumor mass. This delivery system causes the tumor to shrink. Once the tumor shrinks, surgery becomes more effective in removing all cancer cells within the socket. The 10-year survival rate for adenoid cystic carcinoma of the lacrimal gland is 20 percent. The new treatment protocol developed at the University of Miami improves survival to more than 80 percent.
(SOURCE: Dr. David Tse, University of Miami)

Omar Montejo, Media Relations
University of Miami Miller School of Medicine
(305) 243-5654

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