Mixed News

Fintan was back at the Royal London Hospital yesterday (23 Jan) for his EUA to see if the new tumour had responded to cryotherapy treatment.  The consultants had not been very optimistic that the cryotherapy would work, but I think to everyone's surprise the tumour has now started to respond.  However, another area in the eye, previously treated with a radioactive plaque and which the consultants have been monitoring for some time, appears to have relapsed and is slowly spreading towards the new tumour.  Further treatment is required on the new tumour, despite it starting to respond to cryotherapy, and also the relapsed area.

A radioactive plaque is not now considered the best option because of the size of the area to be treated and the damage to other parts of the eye it would cause.  After much discussion, weighing up the pros and cons of various treatments (plaque, intra-arterial chemotherapy and 3rd line systemic chemotherapy), we have opted for Fintan to have some intra-arterial chemotherapy (melphalan).

He had this treatment in his right eye about 3 years ago and we initially felt it had not been very successful, but the consultants have been been over his notes very thoroughly and explained that the problems he had post melphalan were caused by other factors.  Also, at the time Fintan had this treatment previously he was only the third NHS patient to have this procedure and it has now been fine tuned and a little more practised!

Chemotherapy drugs will be administered directly to the back of the eye via a catheter inserted in the groin and fed up to the ophthalmic artery; this should just be a day case but he may need to stay in overnight.  It doesn't cause the traditional chemotherapy side effects of nausea, hair loss or attack the immune system, but his vision may deteriorate temporarily, haemorrhaging in the eye may occur or a droopy eyelid (or all three!) but these symptoms usually clear over the following few months.

Fintan will have an EUA 4 weeks later and it will be decided then whether a second dose is required.  If this doesn't do the trick, we hopefully still have the options of a radioactive plaque or traditional chemotherapy; both have risks, but we have to try everything we can to retain some vision for Fintan.

A pancake makes it all better (well a little bit)!