What is Uveal melanoma?

Uveal melanoma is a type of cancer that grows in the part of the eye that provides the pigment called melanin. Although it’s not a common form of cancer, it is the most common type affecting the eye.

Factors that can make someone at higher risk of developing uveal melanoma include:

  • Increasing age
  • Fair skin complexion
  • Having blue or light green eyes

Symptoms

Symptoms of uveal melanoma can vary for each person, but some common symptoms can include:

  • Blurry vision
  • Other visual changes
  • Spots in the vision, called floaters
  • Change in the size or shape of the pupil
  • Dark spot on the eye

Diagnosis

When uveal melanoma is suspected, a thorough eye examination will need to be done to help determine the cause of the symptoms. During an eye exam, specialized tests can be done to evaluate the eye and its structures to look for abnormalities. This cancer is often diagnosed without a biopsy, as sometimes a biopsy can be risky. However, a biopsy may be recommended. The stage or extent of cancer needs to be determined as well to help determine the exact treatment that will be best.

Imaging tests used to help determine the extent of melanoma can include CT scans, MRIs, and PET scans. Blood tests to evaluate blood cell counts, as well as kidney and liver function, is often done as well.

Treatment

The exact treatment for uveal melanoma will be determined once the diagnosis is made and the cancer stage is known.

Surgery may be recommended for uveal melanoma. This surgery can include removing the tumor and healthy tissue surrounding it or removing the entire eye.

Radiation therapy is a treatment that may be used as well. During radiation, high-energy beams are directed at the cancer cells to kill them. Sometimes small radiation plaques are implanted directly into the tumor to kill it.

For some, a type of treatment called watchful waiting is used. During this, no specific treatment is given. Exams are performed regularly to assess the melanoma and determine how quickly it is growing. It may not need treatment unless it grows to a certain size or is causing more significant visual problems.

If you’ve been diagnosed with uveal melanoma, be sure to talk to your cancer team about the specifics of your cancer. They can help you understand your diagnosis and how best to treat it.

This disease affects adults more commonly than children and can be life-threatening if not treated effectively. Because early detection is crucial for treatment success, it is essential to be aware of the signs and symptoms of this condition. If you or someone you know has been diagnosed with uveal melanoma, there are treatments available that can improve prognosis and quality of life.

The Little-known Cancer – Cancer of Unknown Primary (CUP)

CUP, also known as Cancer of unknown primary, is Cancer that has metastasized from another body part. The site where it began, also called the primary site, is unknown in this case.

Why CUP is a challenging cancer?

Cancer of unknown primary is often challenging because it tends to be aggressive and spreads to many body parts when found. Only 2 to 5% of CUP cancers are diagnosed in the U.S. In addition, because the origin of this type of Cancer is unknown, it often is challenging to choose the best treatment. CUPs are usually found in the lymph nodes, liver, lung, peritoneum (lining of the bowel), or bone, and thanks to better diagnostics and screening, they are becoming less common nowadays.

What are the primary causes?

Because the primary site of many of these cancers is unknown, it is hard to predict the primary cause. Even in cases where the primary location is found, the type of Cancer determines the possible risk factors.

Types of CUP cancers

Even when an Oncologists is unable to determine the initial site where the Cancer began, A further microscopic inspection of the cancer cells concludes the Cancer falling into one of the following categories:

  • Neuroendocrine carcinoma: These are cancers that begin in specialized cells called neuroendocrine cells and have traits similar to those of nerve cells and hormone-producing cells. Neuroendocrine tumors are rare and can occur anywhere in the body. Most of this happens in the lungs, appendix, small intestine, rectum, and pancreas.
  • Poorly differentiated carcinoma: Cancer cells are present in this type of CUP, but they do not have enough detail for an oncologist to decide the type of Cancer. Around 10% of these CUP cases are lymphoma, melanoma, or sarcoma.
  • Adenocarcinomas: In six of every ten cancers of unknown primary are adenocarcinomas, beginning in gland cells, with the primary sites in the lung, pancreas, breast, prostate, stomach, liver, or colon.
  • Squamous cell cancer: These cells are flat, similar to cells on the skin or linings of some organs

 

What are the Symptoms of Cancer of Unknown Primary?

While the Symptoms of Cancer of unknown primary (CUP) vary from person to person and depend on where Cancer has spread, patients often experience it.

  • Swollen lymph nodes that are not painful but firm.
  • Abdominal Mass that can be felt from the outside, often causing a feeling of fullness after a small meal
  • Shortness of breath
  • Pain in the chest or abdomen
  • Pain in the bones
  • Skin tumors
  • Fatigue or weakness
  • Lack of appetite or unexplained weight loss

 

How is CUP Diagnosed?

If an oncologist suspects Cancer of unknown primary, one or more of the following tests may be performed for an accurate diagnosis.

  1. Biopsy
    1. Fine needle aspiration (FNA)
    2. Core needle biopsy
    3. Excisional biopsy
    4. Incisional biopsy
    5. Bone marrow aspiration and biopsy
  2. Blood and urine tests
  3. Imaging tests, which may include
    1. X-rays
    2. CT or CAT computed axial tomography) scans
    3. MRI (magnetic resonance imaging) scans
    4. Ultrasound
    5. PET (positron emission tomography) scans
  4. Endoscopy
  5. Colonoscopy

 

What are the available Treatments?

  • Surgery
  • Chemotherapy
  • Radiation therapy
  • Brachytherapy
  • 3D-conformal radiation therapy
  • Intensity-modulated radiotherapy (IMRT)
  • Proton therapy
  • Targeted therapies

 

Finally, Cancer of unknown primary is rare, and it’s essential to be aware of the symptoms and see a doctor immediately if you experience any of them. With early diagnosis and treatment, many people with this type of Cancer can beat the disease successfully.

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