Chemotherapy for Eye Cancer
Chemotherapy (chemo) is the use of drugs to treat cancer. The drugs can be injected into a certain part of the body (such as the eye), or they can be injected into a vein or taken by mouth to reach throughout the body, making this treatment very useful for cancers that have spread. Chemo can be useful for treating intraocular (eye) lymphoma, but it is used less often for intraocular melanoma.
Chemotherapy for lymphoma of the eye
- Intraocular: Some chemo drugs can be injected directly into the eye. This concentrates the chemo at the site of the cancer, allowing higher doses to be given without causing severe side effects in other parts of the body.
- Intrathecal: If the lymphoma might have spread to the brain or spinal cord, chemo can be given directly into the cerebrospinal fluid (the fluid surrounding the brain and spinal cord). Often, this is done during a lumbar puncture (spinal tap). Another option is to place a special type of catheter (an Ommaya reservoir) into the fluid through a small hole in the skull. The end of the catheter, which has a dome-shaped reservoir, stays just under the scalp. Doctors and nurses can use a thin needle to give chemo drugs through the reservoir.
- Systemic: Chemo drugs can be injected into a vein (usually in the arm) or taken as pills, after which they will reach all areas of the body. This route is especially useful if the cancer might have spread to other parts of the body.
Methotrexate is a chemo drug often used to treat lymphoma of the eye. It can be given directly into the eye, intrathecally, or systemically. It is often given in combination with other drugs to treat lymphoma. Many other chemo drugs can be used as well.
Doctors give chemo in cycles, with each period of treatment followed by a rest period to give the body time to recover. Chemo cycles generally last about 3 to 4 weeks. Most chemo treatments are given on an outpatient basis (in the doctor’s office or hospital outpatient department), but some require a hospital stay. Sometimes a patient may get one chemo combination for several cycles and later switch to a different one if the first combination does not seem to be working well.
High-dose chemo followed by stem cell transplant: Doctors are limited in the doses of chemo they can give because of the side effects these drugs can cause. High doses of chemo can especially damage the bone marrow (where new blood cells are made), which can be life-threatening.
If standard doses of chemo are no longer working, doctors sometimes give high doses of chemo that they know will likely destroy the bone marrow. Before giving the chemo, they take blood-forming stem cells from the patient’s body. After the chemo has been given, they infuse the stem cells back into the body. These cells settle in the bone marrow, where they make new blood cells.
This technique can be useful in some situations, but it can be hard for the patient to go through and can cause serious side effects. For more detailed information on stem cell transplants, see Non-Hodgkin Lymphoma and Stem Cell Transplant (Peripheral Blood, Bone Marrow, and Cord Blood Transplants).
Chemotherapy for melanoma of the eye
Melanoma usually does not respond well to standard chemo drugs. Chemo is used only when the cancer has become widespread. If chemo is used, the treatment is generally the same as for melanoma of the skin. For more information, see Melanoma Skin Cancer.
Newer targeted drugs, which work in different ways from chemo drugs, have shown some promise in treating skin melanomas in recent years, and are now being studied for use against eye melanomas.
Possible side effects of chemo
Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body such as those in the bone marrow (where new blood cells are made), the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are likely to be affected by chemo, which can lead to side effects.
The side effects of chemo depend on the type and dose of drugs given, how they are given, and the length of time they are taken. The side effects of systemic chemo can include:
- Hair loss
- Mouth sores
- Loss of appetite
- Nausea and vomiting
- Diarrhea or constipation
- Increased chance of infections (from having too few white blood cells)
- Easy bruising or bleeding (from having too few blood platelets)
- Fatigue (from having too few red blood cells)
These side effects usually go away after treatment is finished. There are often ways to lessen these side effects. For example, there are drugs to help prevent or reduce nausea and vomiting. Some drugs may also have specific side effects not listed above. Be sure to ask your doctor or nurse about medicines to help reduce side effects, and let him or her know when you do have side effects so they can be managed.
Last Medical Review: December 9, 2014 Last Revised: February 5, 2016