A Kid’s Guide to Ophthalmic Artery Chemosurgery for Retinoblastoma

Boy undergoing eye examination by female doctor

At MSK, we have performed more than 15,000 examinations for retinoblastoma over the past 100 years.

Summary

It’s hard to know what treatment will be like when a child is diagnosed with retinoblastoma. We’ve created this photo guide so that you and your family can see what a young patient may experience at MSK.

Highlights
  • Some children who have retinoblastoma are good candidates for ophthalmic artery chemosurgery (OAC), which was developed at MSK to reduce the side effects of whole-body chemotherapy.
  • OAC works by threading a very thin tube through an artery in the leg so chemotherapy can reach the affected eye.
  • Children have anesthesia for the procedure, which usually takes one to two hours. A month later they are examined at MSK. Most children need three or four OAC procedures to cure their cancer.

MSK patient with family member

Retinoblastoma is an eye cancer that mostly affects young children. Your mom or dad may have noticed you had a symptom, like a crossed eye or one eye that looked different from the other. Your regular doctor may have told your parents to take you to an eye specialist at Memorial Sloan Kettering to figure out what’s going on. Many kids with those same symptoms come from all over the world to MSK.

Ophthalmic Oncologist, David Abramson

At MSK, you’ll meet David Abramson (above). He is an ophthalmic oncologist, which means he treats cancers of the eye. Dr. Abramson will give you a medicine to help you sleep while he gets a better look at your eyes. All you have to do is lie on the bed in your regular clothes while the nurses put something that looks like a scuba mask on you. They’ll tell you to count to ten, but you’ll probably only get to two or three before you fall asleep! Your mom and dad can stay in the room with you to make it less scary.

Dr. Abramson and nurse

Sometimes, after kids who get this test wake up, they find out they have retinoblastoma. That is scary to hear, but Dr. Abramson and his nurses are here to make you better. In fact, Dr. Abramson invented a special treatment just for kids with retinoblastoma that sends chemotherapy medicine directly to your eye, instead of having it swim around in your body. That’s good because the medicine can sometimes make kids feel sick, so using less of it is actually better. The treatment is called ophthalmic artery chemosurgery, and the team at MSK has more experience with this treatment than anywhere else in the world.

Ophthalmic oncologist David Abramson with a family and nurse
If you need to get this treatment, you’ll come back a few days later to see Dr. Abramson again. But this time, you’ll go to a hospital across the street from MSK. The two hospitals work together when a kid gets this kind of treatment.

Dr. Abramson will put you to sleep just like last time you were here so you won’t feel or remember anything. The medicine will go into an artery in your leg, and it will travel all the way up to your eye. The whole thing should take about two hours. When you wake up, you can hang out in the recovery room, and you can even go home or back to your hotel room later that day!

Follow-up visit with nurse after ophthalmic artery chemosurgery treatment

A month later you will need to come back to see Dr. Abramson for a checkup. Even when the treatment works really well, you will probably need to come back two or three more times for the same procedure to get rid of any extra cancer hiding in your eye. But the nice people at MSK will make sure you have a good time when you’re here. At MSK, you can play, eat snacks, and meet other kids just like you.

MSK Long-term follow up care

After all the treatments are done, you will continue to have checkups with Dr. Abramson, but you won’t need any more chemo. When you get older, you can move into MSK’s Long-Term Follow-Up care group with other big kids, so doctors can make sure you stay healthy as you grow up.

We are here to help you whenever you need us and are happy to answer any questions you may have about your experience.

Comments

After how many IAC does the stage D retinobladtoma starts shrinking and is calcified? I mean statistiacally? My son had his first 5mg dose of melphalan but the tumour didnt respond very well.

Dear Hajra, we’re sorry to hear about your son’s diagnosis. We recommend that you discuss this with his healthcare team. Thank you for your comment, and best wishes to you and your family.

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