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Second Opinions - EEC019

Essential Eye Cancer Podcast

Release Date: 05/25/2020

Conjunctival Tumors Overview - EEC035 show art Conjunctival Tumors Overview - EEC035

Essential Eye Cancer Podcast

Tumors and cancers commonly occur on the conjunctiva and often grow onto the corneal surface. Both conjunctival melanoma and squamous carcinoma have been associated with sun (ultraviolet UV-ray) exposure, so Dr. Finger says, "Think of Sunglasses as Sunblock for your Eyes.®" Commonly treated with observation for growth, surgical removal or a combination of surgery and freezing "cryotherapy," over the last 10 years more and more patients are treated with immunotherapy or chemotherapy eye drops.

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Large Clinical Trials Won't Change Physics - EEC034 show art Large Clinical Trials Won't Change Physics - EEC034

Essential Eye Cancer Podcast

This Podcast takes a closer look at what I do to maximize eye radiation outcomes and minimize patient risk. Until we have a treatment for metastatic ocular melanoma, destruction of the intraocular tumor will be the best way to prevent and thus "treat" metastasis.  Across the world, each eye cancer center has its own radiation methods to destroy choroidal melanomas. However, a closer look at the methods of plaque selection and implementation reveals significant differences.

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Super-Thick Amniotic Membrane Grafts - EEC033 show art Super-Thick Amniotic Membrane Grafts - EEC033

Essential Eye Cancer Podcast

This Podcase discusses a technique I introduced to ophthalmic oncology. Sometimes, when eye cancer specialists have to remove a large tumor from the surface of the eye, we created a large tissue-defect on its surface. The surgeon cannot leave it grow on its own because the eyelid can scar and stick to the eyeball (called symblepharon). This scarring can hamper the movement of the eye and doesn't look normal.

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Iris Tumors - EEC032 show art Iris Tumors - EEC032

Essential Eye Cancer Podcast

Iris tumors are visible. Patients see them in the mirror and eye care specialists view them through the clear cornea. We use specialized ultrasound (UBM) and anterior segment OCT tests to reveal the contents, distribution and size of these tumors. Most are benign and thus can be observed for growth prior to intervention. Others are either clinically diagnosed and treated or undergo biopsy.

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Partial Sclerouvectomy PSLU Endoresection or Surgical Removal for Uveal Melanoma - EEC031 show art Partial Sclerouvectomy PSLU Endoresection or Surgical Removal for Uveal Melanoma - EEC031

Essential Eye Cancer Podcast

Cancer textbooks tell us to remove or destroy primary cancers to prevent spread (metastasis) to other parts of the body. In the 1950s, most eyes with choroidal melanoma were removed. Some small anterior choroidal, ciliary body and iris melanomas were locally resected. However, The multicenter, international, Collaborative Ocular Melanoma Study taught us that removal of the eye was not necessary for moderately sized choroidal melanomas.

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Vascular Tumors within the Eye - EEC030 show art Vascular Tumors within the Eye - EEC030

Essential Eye Cancer Podcast

There are many different types of vascular tumors within the eye. In the uvea or vascular layer beneath the retina, there occur both circumscribed and diffuse hemangiomas. The latter or diffuse variant is commonly associated with the congenital neurologic disorder Sturge-Weber Syndrome (encephalotrigeminal angiomatosis). It is associated with Port-Wine skin coloration, glaucoma, seizures, intellectual disability, and ipsilateral leptomeningeal angiomas.

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Basic Eyelid Tumors II Treatment Overview - EEC029 show art Basic Eyelid Tumors II Treatment Overview - EEC029

Essential Eye Cancer Podcast

Tumors and cancers commonly occur on the eyelids. Once the clinical or pathologic diagnosis is established it is time to consider treatment. Eye cancer specialists will recommend either removal or destruction of the eyelid cancer. Depending on the type, size, and location of the tumor, different surgical or treatment strategies will be used. These treatments can range from simple surgical excision of the tumor and margins or Moh's microsurgical resection, typically followed by oculoplastic surgical repair.

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Basic Eyelid Tumors Diagnostic Overview - EEC028 show art Basic Eyelid Tumors Diagnostic Overview - EEC028

Essential Eye Cancer Podcast

Tumors and cancers commonly occur on the eyelids. Most have been associated with sun (ultraviolet UV-ray) exposure. The most common eyelid cancer is basal cell carcinoma, but squamous carcinoma, sebaceous carcinoma and melanoma can occur. If the tumor doesn't have a classic, diagnostic appearance, a small biopsy for pathology evaluation may be needed. This podcast describes the clinical characteristics of these tumors, how they grow and even spread to other parts of the body.

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The Nevus of Ota and Ocular Melanosis - EEC027 show art The Nevus of Ota and Ocular Melanosis - EEC027

Essential Eye Cancer Podcast

Oculodermal melanocytosis or the Nevus of Ota means that there are increased numbers of cells called melanocytes in the eyelid skin, sclera and uveal vascular layer of the eye. Typically presenting at birth, it can increase during puberty and pregnancy. The pigmentation can follow the distribution of the trigeminal nerve and can therefore extend to the palate.

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Guidelines (ABS-AAPM) for Eye Plaque Radiation Therapy for Melanoma and Retinoblastoma - EEC026 show art Guidelines (ABS-AAPM) for Eye Plaque Radiation Therapy for Melanoma and Retinoblastoma - EEC026

Essential Eye Cancer Podcast

In 2014, the first multicenter, international consensus guidelines for ophthalmic plaque radiation therapy was "open access" published in the journal "Brachytherapy." Dr. Finger was selected to Chair the Ophthalmic Oncology Task Force which he assembled to discuss, survey and create these guidelines. In total, this committee included 47 eye cancer specialists from 10 countries. In this Podcast, Dr. Finger summarizes their most important findings.

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One of the most difficult subjects is second opinions. Dr. Finger says, "second opinions are great as long as both doctors agree." When they don't, sometimes they create more problems than expected. So, what is the patient to do when their two opinions don't agree? Typically, the patient will want a second opinion because they didn't like what they heard from the first opinion. Second, albeit less commonly, they want confirmation of the first opinion. Lastly, they have a relative who wants the patient to see "their" person. Dr. Finger's suggestion is to go to each opinion with a checklist of what is important to you. For example, ask which doctor will perform the surgery, ask who will answer the phone if the patient has an emergency, and ask what the likely outcomes will be for sight and life?

Paul T. Finger, MD, FACS
The New York Eye Cancer Center
115 East 61st Street
New York City, New York, USA
10065

E-mail: [email protected]

Telephone: (011) 212 832 8170