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Ocular Melanoma


   

Many patients envision the sterile environment of the laboratory and wonder how hours of looking through a microscope relates to their care.  The Ohio State Medical Center’s answer can be found at the new OSU Center for Clinical & Translational Science (CCTS).  The CCTS is a Medical Center-wide effort to fast track the breakthrough scientific findings from the labs to the clinics so patients can benefit from OSU’s top-tier research institute.

The Havener Eye Institute is on the forefront of this initiative with its dynamic, interdisciplinary ocular melanoma team working together to end this disease. In October 2009, the Havener Eye Institute was recognized as one of the leading centers for the treatment of ocular melanoma at the 1st Annual Ocular Melanoma Scientific Working Group.

The Havener Eye Institute has a long history of using a multi-disciplinary approach to the management of patients with ocular melanoma.  Patients are evaluated by ocular oncologists Frederick Davidorf and Colleen Cebulla, medical oncologists Thomas Olencki and Kari Kendra, radiation oncologist Douglas Martin, and human cancer geneticists Mohamed Abdel-Rahman and Robert Pilarski.  By pairing our researchers with our clinicians and consulting specialists from every field of oncology, the Havener Eye Institute is able to offer patients a more thorough approach to cancer care.

In the tradition of OSU’s medical pioneers, the ocular
oncologists at the Havener Eye Institute have always sought to improve diagnostic tools and treatments.  Until the late 1960s, patients diagnosed with ocular melanoma had no choice but to have their eye enucleated (surgically removed).  Then, under the leadership of the late William Havener, OSU Ophthalmology began the concept of “conservative management” of eye melanomas. Dr. Havener and Dr. Frank Batley, former head of Radiation Oncology, designed a radioactive eye ring, using brachytherapy (applying radiation directly to the cancer) to treat these tumors without enucleation.  OSU was one of the first hospitals in the U.S. to use brachytherapy for ocular melanoma, which is now the standard of care.

In 1980, Dr. Havener passed the management of patients with ocular melanoma to Dr. Frederick Davidorf who established the Ocular Oncology Division.  In 1985, The OSU Ocular Oncology Division participated in one of the National Eye Institute’s largest clinical trial to date. The Collaborative Ocular Melanoma Study (COMS) lasted over fifteen years and succeeded in proving that radiation treatment was just as effective in curing eye cancer as enucleation.

In addition to radiation, chemotherapy is also used to combat most cancers.  While radiation is used to target and destroy cancer cells, chemotherapy uses toxic compounds which kill cells.  Both methods have destructive side effects, and anyone who has witnessed the ravages of chemotherapy and radiation understand how difficult and traumatic these treatments can be.  In an effort to discover a less harsh therapy, Dr. Mohamed Abdel-Rahman and his collaborators are currently studying naturally occurring medicinal herbs to control the growth of melanoma cells. They had found several very promising, highly efficient and relatively non-toxic herbs that are able to alter the growth of cancer cells. It is their belief that these types of herbal medicines may be able to control the spread of cancer with minimal side effects to the patient.

The Ocular Oncology Division is also studying three different aspects of the genetics of ocular melanoma.  First, they are looking for markers that can identify patients with an aggressive form of the disease.  This will allow researchers to follow these patients more carefully, and in the future select these patients for any potential systemic treatment.  Secondly, they are pre-selecting patients who they believe will better respond to newly discovered treatments, and also decrease the toxicity of the medication.  Finally, they are attempting to identify the genetic markers that a small subset of patients and their family members have inherited, which predisposes them to ocular melanoma and other tumors. Recognizing these patients will help in the early management of not only the patient, but of at-risk family members.

The future of ocular melanoma care is in today’s laboratories.  From Dr. Mohamed Abdel-Rahman, cancer geneticist, to Dr. Colleen Cebulla, clinician and researcher, we are bringing the latest understanding of disease processes from the laboratory and applying them to clinical situations.  With experienced faculty and fresh ideas, the Havener Eye Institute is translating basic science into better patient care, every day.

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