Moving swiftly to treat eye cancer

Soon after Miguel A. Materin, MD, took over as director of ocular oncology a year ago, a 4-month-old baby was brought in with multiple tumors in both eyes. Materin quickly assembled a team of doctors from ophthalmology, ocular oncology, anesthesia, pediatric oncology and diagnostic radiology. The baby received an office evaluation, an examination under general anesthesia and a brain MRI. Then a treatment plan was started – all within two or three days.

“I don’t want any of my patients to have to wait,” Materin says. “I treat them like a relative or someone close to me. I know how high the anxiety is, and I try to lower that anxiety.” 

The baby was diagnosed with retinoblastoma, the most common malignancy originating in the eye in children. Advancements in treating the disease over the last century have increased the survival rate from almost 0 percent to 95 percent. Materin says his young patient is responding well to treatment.

Surprising number of patients

Materin, an internationally recognized ocular oncologist, received his medical degree from the University of Buenos Aires and completed a fellowship in ocular oncology at Wills Eye Hospital at Thomas Jefferson University in Philadelphia. Before coming to Yale, he served as director of diagnostic studies for the ocular oncology service at Wills.

Materin became interested in ocular oncology while he was working as a retina specialist in Argentina. “At that time, there was a need in Argentina, since nobody had the specialized training for these rare diseases,” he says. Since arriving at Yale, Materin has been surprised by the number of adult and pediatric patients he’s seen and the diversity of the diseases he’s treated. In less than six months he’s seen more than 100 patients, including four children with retinoblastoma.

“I don’t want to scare anybody,” Materin says. “Eye cancer is rare. Ninety-nine percent of the time, ophthalmology patients have something more common like a cataract or macular degeneration.”  

According to the American Cancer Society, in 2009, there were :

  • 2,350 new cases of cancers of the eye and orbit (primarily melanoma)
  • 230 deaths from cancer of the eye

Cancers that spread to the eye from another part of the body (secondary eye cancers) are more common than cancers that originate in the eye (primary eye cancers). In adults, any cancer can affect the eye, including those originated in breast or lung, lymphomas or even skin melanomas, among others.

Specialized care close to home

Three years ago, another doctor diagnosed one of Materin’s current patients with conjunctival melanoma, a dangerous but slow-growing tumor found on the surface of the eyeball or on the inside surface of the eyelid. The patient didn’t follow up because she was referred to an out-of-state specialist. Materin, who is now treating her, says, “It upsets me to think that a patient didn’t get treatment because she thought she had to leave the state to get it.”

With the Yale Eye Center’s new commitment to treating eye cancers, that’s no longer an issue. Materin says his patient who delayed treatment is now receiving the necessary specialized care close to home. Other patients are also coming to Yale Ocular Oncology from Connecticut and neighboring states, and from as far away as Mexico, Puerto Rico and Uruguay.  

Exploring new treatments

Looking toward the future, Materin is collaborating with colleagues in pediatric oncology and neurovascular surgery to launch a clinical trial of a new treatment for children with retinoblastoma. The treatment, called intra-arterial (ophthalmic artery) chemotherapy for retinoblastoma, provides a targeted delivery of chemotherapy through the ophthalmic artery instead of subjecting the patient’s whole body to the chemotherapy.

Patients diagnosed with ocular cancer have the added emotional burden of feeling “different” because their disease is so unusual, Materin says. “Eye cancer? Who gets eye cancer?’ Well unfortunately they have it, so we’re here, and we want to do everything we can to help them get through this difficult time.”

To contact the Yale Eye Center, please call 203-785-2020.

This article was submitted by Mark Santore on January 27, 2014.

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Miguel A Materin

Associate Professor of Ophthalmology and Visual Science and of Medicine (Medical Oncology)