What is retinoblastoma?

Retinoblastoma is the most common eye cancer affecting young children, and the Department of Ophthalmology at the Advanced Eye Center since 1996 has been running a retinoblastoma clinic here three days a week.

The department is the main referral center for the whole of North India and the first point of contact for the majority of patients and they provide their services to Chandigarh, the states of Punjab, Haryana, Himachal, Uttarakhand and parts of UP, Rajasthan and J&K. The department offers all modern treatments to all patients, which include laser photocoagulation, cryotherapy, intravitreal chemotherapy, transpupillary thermotherapy, intravenous and intra-arterial chemotherapy.

As part of World Retinoblastoma Awareness Week (May 15-21), the Retinoblastoma Clinic conducts awareness lectures with the public, medical staff and physicians to spread awareness about the condition of the disease. Professor Usha Singh, Department of Ophthalmology, heads the retinoblastoma clinic and works in close collaboration with senior residents, pediatric oncologists and radiation specialists, interventional neuroradiologists, and social workers. The team answers some questions about retinoblastoma.

What is retinoblastoma?

It is the most common type of eye cancer (malignancy) in young children. It can occur in one or both eyes and may be hereditary or sporadic. It can be life-threatening and also blur vision if not treated in time and detected by White Reflex (WR) vision.

symptoms

White reflection in the eye: A pupil that appears white or yellow instead of red when light strikes it.

eye crossed: Cross eye, looking either toward the nose or toward the ear.

Double vision with or without WR. The eye may also be red or painful.

Burden of retinoblastoma disease

Approximately 1500-2000 children are diagnosed with retinoblastoma each year in India. The majority of these children belong to lower socioeconomic strata of society and about 60 percent of these patients have advanced disease at presentation. It is associated with lower treatment and survival rates due to lack of awareness, social stigma, poor access to care, high cost of treatment, lack of infrastructure, health professionals, quality treatment protocols, quality medications, prognosis and supportive care. PGI offers state-of-the-art treatment and works tirelessly to alleviate the suffering and financial problems of these children. The financial assistance comes from various HMOs, government schemes, government cancer funds in Punjab and Haryana, and NGOs. Cankids is a registered NGO under the Indian Cancer Society and under the Memorandum of Understanding between PGI and Cankids. The goal is to provide all children with the best treatment to combat this disease, regardless of their financial condition.

How is retinoblastoma detected?

Eye sonography and fundus examination are immediate outpatient procedures. Its prevalence is determined by magnetic resonance imaging (MRI) and systemic staging investigations (bone marrow biopsy, CSF, whole-body PET scan).

How is retinoblastoma treated?

Treating retinoblastoma requires a multidisciplinary approach and is led by a team of experts who specialize in the care of these children.

Treatment is planned after a complete clinical examination and disease classification (clustering and staging). Treatment is individual for each patient.

Chemotherapy can be given intravenously or intra-arterially and is given by a pediatric oncologist and is the most common method of treatment. This should be followed by topical treatment administered by an ophthalmologist using various methods.

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With response assessment and local tumor monitoring, a change in treatment modality is needed on a weekly to monthly basis until the tumor is under control.

After treatment is completed, further monitoring and follow-up is done to monitor disease recurrence and side effects of systemic therapy. These patients require lifelong follow-up and genetic counseling for parents.

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