What is a choroidal melanoma?
It is a tumour in the blood vessel layer of the eye. It is an uncommon tumour, and may sometimes be very difficult to diagnose. There are also other non-tumour conditions that may look like a choroidal melanoma. The uveal tract in the eye is made of the:
2. Ciliary body
A melanoma can occur in any of these structures, but the choroid is the most common one in which a melanoma occurs.
What are the treatment options?
You will undergo a complete history and eye assessment before the most appropriate treatment is discussed with you. There are 2 main treatment options:
1. Enucleation (removal of the eye)
2. It is the only unit in Southern Africa that has the expertise to design custom-made radioactive iodine plaques
How does the consultation and treatment process work?
This usually occurs on a Monday. We will set up an appointment time with you. The appointments will take all day please bring a snack with you. If you are flying to Cape Town, you do not need to stay over. you can fly in on a morning flight, and take the last evening flight back home.
You will meet the doctors in charge of your treatment: Dr Steven Lapere (ophthalmologist) at Melrose Eye Clinic, Dr Hamzah Mustak (ophthalmologist) at Groote Schuur Hospital and Dr Julie Wetter and her team (radiation oncologist) at Groote Schuur Hospital. You will undergo a standard ophthalmic examination, similar to the examination that was performed by your referring ophthalmologist.
You will also undergo an ultra-sound examination and photographs will be taken. Other examinations to determine the size of the tumour may also be performed. The treatment options will be discussed with you during this visit. If indicated, a date will be decided upon for plaque treatment. Your initial visit is a planning, visit, and treatment will not take place at this visit. Treatment usually takes place 3-4 weeks after this visit. Once this eye examination is complete, you will drive to Groote Schuur Hospital and be seen by Dr Wetter (radiation oncologist) and her team.
The planning of a custom-made radioactive eye plaque is a collaborative effort between the ophthalmologist, radiation oncologist, medical physicist, mould-room personnel and administrative personnel. Radioactive seeds are ordered for your treatment and placed within the plaque. There are many processes involved in designing and administering this treatment, and the plaque is custom-made to fit the dimensions of your tumour, hence it cannot all happen in one visit.
Your specific treatment, and the treatment dates will be discussed with you during this visit. The planning of a custom-made radioactive eye plaque is a collaborative effort between the ophthalmologist, radiation oncologist, medical physicist, mould-room personnel and administrative personnel. Radioactive seeds are ordered for your treatment and placed within the plaque. There are many processes involved in designing and administering this treatment, and the plaque is custom-made to fit the dimensions of your tumour, hence it cannot all happen in one visit. If an enucleation is required, no radioactive material is required for this, and arrangements can be discussed during your visit.
You will require a chest X-ray and liver ultrasound as part of your workup. If this has already been done, please bring the report with you. If this has not been done, we will arrange this during the consult.
Tumour marker testing by choroidal biopsy (performed during the surgery) is offered and will be discussed with you during the consultation. Please see the information leaflet on the specifics of this test.
Why must you come to Cape Town?
The Radiotherapy Department at Groote Schuur Hospital has been involved in the development of this treatment since 1974. It is the only unit in Southern Africa that has the expertise to design and monitor this type of plaque therapy.
It is important to remember the following:
1. Your initial consultation will take all of Monday; the final discussions only take place at about 16:00. Please do not book your return ticket before 18:00.
2. Surgery may be postponed due to unforeseen circumstances. It is exceptionally rare for this to occur, but please bear this in mind when booking transport.
3. Please bring all your medial reports, scans, your doctor’s referral letter and any lists of medication with you for the first consultation.