My Personal Fight With Cancer

In January of 2007 I had made a visit to my primary ophthalmologist, eye doctor, for an eye exam. As his tech was going through the motions of the tests, I began to detect some concern in her actions and her verbal responses to some of my questions. She added a couple of extra tests that I had not had done before after disappearing to talk with the doc. She also took additional time with photos of which she took many. Once we were done, I sat in the exam chair and waited for the doc, all the time thinking and wondering what she had found.

Once the doc showed up, he reset his equipment and began to go through a few of the same tests which his assistant had just completed. He had an obvious concerned look on his face which, of course, began to concern me even more. He started to explain what it was he was seeing and showed me through the imaging connected to the instrument.

He explained that he was seeing a tumor of some kind on the back of my left eye. It was possible that the tumor was Malignant Choroidal Melanoma, he said, but he wanted a surgeon to look at it. Luckily I live in an area where there are many good and competent doctors and the appointment was set. The surgeon had received all of the information from my doc which he had reviewed prior to my appointment. He ran some additional test, including an ultrasound, and confirmed the results. He too was concerned that the tumor was a medium sized Malignant Choroidal Melanoma. Because of the sensitive nature of the location of the tumor, my local surgeon wanted to refer me to another surgeon, one of the world’s top specialists, who was located at the University of North Carolina Hospital at Chapel Hill.

This appointment involved more testing, more photos and another ultrasound. The ultrasound is used to enable the surgeon to measure the actual size of the tumor and it was at this point where it was confirmed as a medium sized tumor. My wife and eldest daughter were there with me as I was given the results of the exam and the options I had. “You have two options here”, he said. “We can treat the cancer with radiation therapy or remove the eye.” He explained both options in great detail and took all the time we needed to answer our questions. I say “our questions” because both my wife and daughter had questions as well as me. He wanted to give us time to consider the options and wasn’t expecting an answer right away. I considered my options and even though the radiation therapy was not as “guaranteed” as removing the eye, the latter would always be available as a last resort if the radiation was not successful. I just couldn’t deal with the thought of losing the eye, at least not without trying the radiation. He got his answer right there and then.

I won’t go into detail about removing the eye, it’s self explanatory, however, I do want to give some detail about the radiation therapy. This is a surgical procedure that contains all of the inherent risk of any surgery, anesthesia, intubation, ect. My procedure consisted of placing “Plaque” over the site of the tumor. The placement of Plaque is typical in this type of radiation therapy for this type of tumor. Plaque is like a very small saucer that, by medical standard, is to be about four millimeters in diameter larger than the tumor, my tumor was about seven millimeters. This saucer has several small, rice like pieces of radioactive iodine affixed to its inside which is faced to the tumor. The Plaque is then stitched in place, over the tumor and just under the outer layer of tissue which protects the eyeball itself. The strength of the Plaque and the duration of its presence are determined by the size of the tumor.

It is now the end of March and I have an appointment for the procedure set, the pre-surgery visit is out of the way, and I arrive the morning of. I’m prepped, rolled into the OR and it was only a few minutes when it was lights out for me. Even though great detail had been explained to me, it was still very strange waking up after the procedure only seeing out of one eye, a lead patch was over the other to contain any radiation which might “Leak” out of the eye. I was moved to a private room which was labeled with all sorts of radiation warnings on the door. I wished I had lived in the local area of the hospital because I possibly would have been able to be at home while the radiation did its thing, I was 170 miles from home.

It was uncomfortable at first and the first several hours were painful. Medication helped but not completely. There were eye drops that were needed every couple of hours at first to help keep infection from setting in, which actually continued for several months. The hospital monitored the radiation levels in the room twice a day and the four days spent there seemed like an eternity.

On the fourth day it was back to the OR to have the Plaque removed. Once completed, I again was moved back to my room for observation for a few hours and was ready to head home. However, this didn’t happen as had been planned. The pain this time was actually worse than the first and a little more pain med was administered. This slowed down my leaving by a couple of hours. I don’t remember most of the three hour drive home as I was still a little under the influence of the medications. No, I wasn’t driving! I stayed off the job for a total of about one month to recover, a patch over the eye for about two weeks. I made an emergency visit to the local surgeon I had seen after about one week at home because the eye had become “Angry”, as he put it. The pain had increased with some swelling and infection and he prescribed some additional medication to take care of that issue.

With time the eye has gotten better and it has now been seventeen months since the procedure. Sight in the eye is not the greatest, 20/60 on my last follow-up about eight month ago and my peripheral vision is good. My right eye compensates nicely for the low vision clarity in my left . I’m due to have it looked at again in the next few weeks.

Now, what was it that prompted me to make that appointment with my regular eye doc back in January of ’07? Well, it was time for my regular eye exam, however, I was starting to develop a blind spot. If I was to hold my hand in front of my mouth and out a couple of inches, I couldn’t see it when I used only my left eye. There was also a “puffy” or swollen kind of sensation. I was also starting to see “Lightning”, flashes that were within the eye itself, a common discription. What was happening was that the tumor was actually causing a partial separation of the retina as it grew. I consider myself blessed that the tumor was far enough away from the retina to allow for the procedure to be done. One or two millimeters closer to the retina and the procedure would have been impossible. Upon the discovery, a complete physical examination and blood work was done by my GP to detect cancer anywhere else within my body. Those results were negative.

Statistics conclude that six in every one million Americans will be diagnosed with Malignant Choroidal Melanoma. My doctors believed that my condition was caused by the many years I spent working as a steel fabricator being exposed to the “Arc” of electric welding, but would not give an absolute on that cause.

There are two primary types of Malignant Choroidal Melanoma, Type 1 and Type 2. Type 1 is a condition which has been manifested due to the presence of cancer in other parts of the body and has traveled to the eye. Type 2 manifests in the eye itself and if not found in time could and will move to other parts of the body, primarily the lungs, heart and pancreas. Biopsies for Malignant Choroidal Melanoma are not an option for confirming the presence of cancer. The main source of spreading the cancer to other organs is a leaking tumor; a biopsy would create such an occurrence. There is no guaranteed way to positively diagnose the existence of cancer cells in the tumor unless tissue samples are taken from a suspected eye which has been removed or postmortem. Therefore, the physical characteristics of the tumor are used based on the study of appearance and tissue samples as I noted above.

I have an acquaintance that was not as lucky as I. He lost his wife several years ago to this potential killer.

I live with the fact every day that the possibility still exists that there still may a presence of cancer. And that even now I have days when I get a slight throbbing pain in the eye. I have been told that it could take as long as two years for things to get back to normal, or as normal as it will ever be again. I have accepted the fact that I will never have good eyesight in the eye again, and that I can live with.

I can’t begin to express love and thanks to my family for the support they have given me. I know that this was harder on my wife than it was on me and I think still is. Thanks too, to my friends and employer for their support and understanding. I also wish to thank the team of doctors, my eye guy, Dr. James Fenilli. who got the ball rolling, Dr. Brownlow, who referred me to UNC Hospital, handled the post-op follow-up and took care of the post-op issues, and Dr. Duton and his team for the procedure.

I want to close by saying this. Eye health is as important as body health. We tend to overlook eye health when we can see without trouble, without the need for glasses or contacts.  As with many forms of cancer and the advances in today’s medicine, early detection is a matter of life and death. Make that appointment now, I am.

More information about Malignant Choroidal Melanoma can be found by clicking here as well as many other web sites.