[Reporter Lin Zhiyi/Report from Taipei] Mr. Chen, a pastry chef from Hong Kong, underwent a fundus screening for diabetes 2 years ago and found a black mass under his eyes. After follow-up, he was diagnosed with early-stage intraocular malignant melanoma. After considering crossing the sea to Taiwan, he received proton therapy at Chang Gung Memorial Hospital, which eliminated tumor activity and successfully preserved his vision. His life has returned to normal. Zhou Hongda, director of the Linkou Chang Geng Eye Cancer Center, also suggested that people should have an eye examination every one to two years to detect abnormalities early.
When a 40-year-old Mr. Chen underwent fundus screening for diabetes in Hong Kong, he discovered a black mass under his eye. Although the doctor judged it to be a benign intraocular nevus, he advised Mr. Chen to follow up closely. However, subsequent follow-up visits revealed that the tumor had changed. Therefore, Mr. Chen was advised by the medical team to come to Taiwan for medical treatment. After examination, he was diagnosed with intraocular malignant melanoma.
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Mr. Chen said that he never thought that a mole would grow under his eyes, let alone that it would develop into a serious tumor. Although the Chang Gung Memorial Medical Team recommended that he receive treatment as soon as possible, he was worried about changes in his vision, which would not only affect his work, but also that he might never be able to travel by car as he likes to drive himself. He considered coming to Taiwan for proton therapy after 2 months. He felt nothing special during the five-day treatment, and his vision did not change after the treatment. His life was back on track.
Zhou Hongda, director of the Linkou Chang Gung Ocular Cancer Center, said that "melanoma" is the most common primary intraocular malignant tumor in adults, but it is still rare among all types of cancer. The incidence rate in Asia is only one-tenth of that in Europe and the United States. In Taiwan, there are only 5 to 15 patients a year. Because of the small number of patients, it is difficult to develop a medical team that can provide treatment, and Asian patients can easily become "orphan patients."
Zhou Hongda said that intraocular malignant melanoma has a high fatality rate. About 50% of patients die due to tumor metastasis. However, there are almost no symptoms in the early stage, or they show floaters, flashes of light, distorted lines and other non-specific symptoms. It is difficult for patients to be alert and seek medical treatment early. When Asian cases are diagnosed, the size of the tumor is about 1.5 times larger than that in Europe and the United States. Treatment is more difficult, and most cases are diagnosed in the prime of 46 years old. The impact on families cannot be underestimated.
Regarding the treatment of intraocular malignant melanoma, Zhou Hongda said that in the early years, tumors would be removed by eyeball enucleation, but this procedure had a huge impact on the patient's appearance and psychology, and there was no possibility of preserving vision. In recent years, the treatment has turned to radiation therapy. Among them, proton therapy has the characteristic of declining immediately after the radiation dose reaches the target, which can reduce the damage to surrounding normal tissues and is a great tool for precise treatment.
Zhou Hongda pointed out that in terms of clinical treatment selection, doctors hope to not only save the patient’s life, but also preserve the eyeballs and vision. At the same time, they will discuss the most suitable treatment method with the patient based on the size, location and patient expectations of the tumor. When Mr. Chen discovered the tumor and sought medical treatment, it was still in a very early stage. The thickness of the tumor was only 2 mm and the width was 5 mm, so the prognosis was quite good.
Regarding the current situation of eye tumor treatment in Taiwan, Zhou Hongda pointed out that for adults, the national health insurance already covers radiation therapy, but proton therapy is still a self-paid item due to high equipment requirements. Proton therapy for children's eye tumors can be fully covered by the national insurance. Chang Gung Memorial Hospital also recently had a child with eye tumors who successfully received proton therapy.
