Ocular melanoma prognosis for patients

Ocular melanoma (melanoma of the eye) is an aggressive cancer. If it spreads to other parts of the body, it is generally lethal. This process is called ‘metastasis’.

Unfortunately, metastasis will affect about 50% of people diagnosed with ocular melanoma.

The chance of the disease spreading (known as ‘metastasizing’) to other parts of the body appears to depend on a number of factors. For example, the size of the tumor in the eye (larger tumors are more likely to spread) and where in the eye the tumor is located.
 
Most commonly, ocular melanoma metastasis involves the disease spreading to the liver. This form of the cancer is called ‘ocular melanoma metastatic to the liver’.

If ocular melanoma metastasizes to the liver, it generally does so within 15 years of the tumor first appearing in the eye. Once this metastasis has been diagnosed, life expectancy is typically 2-7 months. Only about 15% of patients live more than 12 months from diagnosis.

The poor prognosis is largely due to the fact that ocular melanoma metastatic to the liver is highly resistant to routine cancer treatments.

For example, chemotherapy drugs given to the whole body (a process called ‘systemic chemotherapy’) are less effective at treating tumors in the liver than elsewhere.

That’s because the chemotherapy drugs are largely broken down when they enter the liver.

Simply boosting the chemotherapy dosage isn’t usually a solution to this problem. That’s because the higher dose can destroy healthy tissue elsewhere in the liver and the rest of the body. In turn, this can cause more problems than it solves.

As an alternative, doctors often compliment systemic chemotherapy with a variety of other treatments. For example, surgery, ablation and transarterial chemoembolization.

However, none of these are seen as a cure for ocular melanoma metastatic to the liver. Rather they are primarily designed to increase the quality – rather than length – of the patient’s life.

Clinical trials offer another route for patients. Besides potentially delivering immediate benefits, they are essential if the outlook for people with ocular melanoma metastatic to the liver is to improve.