Retinoblastoma Treatment in India – Causes, Symptoms & Diagnosis

Retinoblastoma, a rare eye cancer originating in the retina—the light-sensitive tissue lining inside the eye—mainly affects young children, with occasional cases in adults. The retina, composed of nerve tissue, detects incoming light and transmits signals through the optic nerve to the brain for the interpretation of images. Retinoblastoma is most commonly found in children and can affect one or both eyes. This highlights the importance of regular eye checks, as it is the main type of eye cancer in young patients.

What is Retinoblastoma?

Retinoblastoma is a rare type of eye cancer that develops in the retina, the light-sensitive tissue at the back of the eye. It most often occurs in young children and most cases are diagnosed before age 3–5. While retinoblastoma commonly affects one eye, it can occasionally develop in both eyes.

Several treatment options are available for retinoblastoma, and the prognosis for diagnosed children is generally positive. Early detection plays a crucial role, as timely treatment can help preserve vision, prevent the cancer from spreading beyond the eye, and significantly improve long-term survival rates.

Retinoblastoma symptoms

Retinoblastoma symptoms are often subtle in the early stages, but regular eye check-ups can help detect the condition early in children. Recognising retinoblastoma signs promptly enables timely diagnosis, effective treatment, and improved chances of preserving vision and overall health. Some of the most common indicators include:

  • Unusual white reflection in the pupil visible in flash photos.
  • Persistent eye redness or inflammation not linked to an infection.
  • A noticeable difference in the color of the iris between the two eyes.
  • Poor vision or a change in vision capabilities.
  • Strabismus (crossed eyes/squint) or other alignment issues.
  • Enlarged or dilated pupils.
  • Irregularly shaped pupils
  • Complaints of eye pain or discomfort.
  • Change in the position of the eyes.
  • Squinting or difficulty focusing on objects.
  • Vision impairment or blindness if left untreated.

Causes & Risk Factors of Retinoblastoma

  • Retinoblastoma is primarily caused by genetic mutations. The retinoblastoma gene can be inherited or non-inherited. Causes of retinoblastoma may also be influenced by environmental or non-genetic factors, such as advanced paternal age, which has been weakly linked to a higher risk of germline RB1 mutations, probably due to accumulated DNA replication errors in sperm. The following are the main causes and risk factors of retinoblastoma:

    • The occurrence of retinoblastoma is closely tied to genetic mutations.
    • Retinoblastoma cancer can arise from either somatic mutations (non-inherited) or inherited germline mutations.
    • Inherited cases often involve the transmission of a mutated RB1 gene from parents to their children.
    • Some cases of retinoblastoma arise from spontaneous mutations during the early stages of fetal development.
    • A family history of retinoblastoma or other cancers is associated with an increased risk of the disease.
    • Diagnosis of retinoblastoma usually occurs before a child turns five.
    • Bilateral retinoblastoma, affecting both eyes, is commonly linked to hereditary factors, while unilateral cases may occur spontaneously.
    • Secondary retinoblastoma can develop as a consequence of radiation therapy administered for other medical conditions. 
    • Timely identification through regular eye examinations is pivotal for effective intervention and treatment.

Types of Retinoblastoma

Retinoblastoma is classified based on how it develops and whether it affects one or both eyes. The classification of retinoblastoma is crucial as it guides diagnosis, treatment, and genetic counseling. While inherited mutations cause some cases, others occur sporadically without a family history. Types of Retinoblastoma include:

  • Hereditary Retinoblastoma: Caused by inherited mutations in the RB1 gene, and usually affects both eyes (bilateral).
  • Non-hereditary (Sporadic) Retinoblastoma: Occurs due to new mutations in the RB1 gene, and typically affects one eye (unilateral).
  • Unilateral Retinoblastoma: Tumor develops in only one eye, and is often linked to sporadic mutations.
  • Bilateral Retinoblastoma: Tumors develop in both eyes and are commonly associated with hereditary cases.
  • Trilateral Retinoblastoma: A rare form where, in addition to eye tumors, a tumor also develops in the pineal or suprasellar region of the brain.

Diagnosis of Retinoblastoma

Retinoblastoma is diagnosed through a dilated eye examination using a special light and lens to visualize the retina, allowing early detection of the tumor and assessment of its spread. An ophthalmologist typically performs this detailed examination, sometimes under anesthesia, to ensure accuracy in diagnosing retinoblastoma. In addition to the physical exam, imaging techniques are employed to determine the size, location, and potential extension of the cancer to nearby tissues or the brain. Because its symptoms can mimic other eye conditions, evaluation by a specialist is crucial.

Retinoblastoma’s diagnostic procedures include:

  • Eye Examination: Detailed inspection of the retina, often with the child under anesthesia.
  • Ultrasound: Uses sound waves to visualize tumors within the eye.
  • Magnetic Resonance Imaging (MRI): Provides detailed images of the eye, optic nerve, and brain.
  • Computed Tomography (CT) Scan: Occasionally used but less preferred due to radiation exposure.
  • Genetic Testing: Helps determine whether the RB1 mutation is inherited or sporadic.

Stages of Retinoblastom

Stage 0:

  • Subgroup A– Very small tumor, usually less than 3 mm in diameter, and away from the foveola (center of the retina).
  • Subgroup B- Small tumor, typically less than 3 mm in diameter, located within 3 mm of the foveola.

Stage 1: Unilateral retinoblastoma with a larger tumor, but still confined to the retina.

Stage 2: Unilateral retinoblastoma with more extensive involvement of the retina. Involvement of the optic nerve may also place the tumor in this stage.

Stage 3: Extensive unilateral retinoblastoma with involvement of the optic nerve.

Stage 4: Bilateral retinoblastoma (tumors in both eyes) with or without optic nerve involvement.

Stage 5 (Recurrent): Unilateral or bilateral retinoblastoma with extraocular extension beyond the eye. This stage indicates invasion into nearby structures, such as the orbit or the tissues around the eye.

Benefits of Retinoblastoma Treatment

Timely and effective retinoblastoma treatment saves lives and also offers a multitude of benefits for young patients. Here’s are the major benefits of retinoblastoma treatment:

Preservation of vision:

Early intervention helps preserve vision and reduces the risk of visual impairment or blindness associated with advanced retinoblastoma.

Enhanced quality of life:

Successful retinoblastoma treatment contributes to an improved quality of life, allowing you to engage fully in academic, social, and recreational activities.

Prevention of cancer spread:

Treatment methods such as surgery, chemotherapy, and targeted therapies are instrumental in preventing the spread of cancer beyond the eye.

Reduced physical discomfort:

Prompt treatment alleviates physical discomfort associated with retinoblastoma, such as eye pain or inflammation, leading to a more comfortable daily life for the child.

Emotional well-being:

Retinoblastoma treatment extends beyond the physical aspect, addressing emotional and psychological well-being. It provides support for both the child and their family, fostering resilience and coping mechanisms.

Family reassurance:

Successful treatment brings reassurance to families, reducing anxiety about their child’s health and future. Regular monitoring post-treatment further assures long-term well-being.

Potential for normal development:

Treatment facilitates normal developmental milestones, allowing the child to grow, learn, and explore their surroundings without the hindrance of untreated retinoblastoma.

Retinoblastoma Treatment at Centre For Sight

Here’s an in-depth look at various strategies tailored to address the unique needs of affected children:

  • Retinoblastoma chemotherapy regimen: Utilizing specialized drug protocols, chemotherapy aims to either shrink or eliminate retinoblastoma tumors. The systemic nature of this treatment maximizes effectiveness while minimizing potential side effects, ensuring a comprehensive approach to the child’s care.
  • Radiation therapy for retinoblastoma : Targeted radiation therapy employs precision to direct radiation exclusively to areas affected by retinoblastoma. This focused approach serves to effectively treat the condition while mitigating any impact on surrounding healthy tissues, reflecting a delicate balance in the pursuit of optimal outcomes.
  • Enucleation (eye removal) in retinoblastoma: Enucleation, the surgery to remove the affected eye due to retinoblastoma, is a necessary step for medical reasons. This decision is made with great consideration for the child’s emotional well-being, aiming to eliminate cancerous cells and prevent further spread. Post-enucleation, the option of placing an eye implant comes into play. This surgical procedure recreates the appearance of a natural eye, addressing both cosmetic and psychological aspects. The artificial eye, crafted from biocompatible materials, helps restore facial symmetry, contributing to the child’s emotional healing, even though it doesn’t restore vision.
  • Laser and cryotherapy for retinoblastoma: Cutting-edge technologies in laser treatment and cryotherapy offer precise solutions for retinoblastoma lesions. By targeting affected areas with meticulous accuracy, these modalities spare surrounding healthy tissue, emphasizing the importance of both efficacy and preservation in the treatment process.
  • Thermotherapy for retinoblastoma: Thermotherapy introduces controlled heat application as a novel approach to retinoblastoma treatment. By harnessing the power of heat, this method showcases innovation in cancer care, demonstrating a commitment to exploring diverse modalities for improved outcomes.

Side Effects, Risk Factors and Complications of Retinoblastoma Treatment

Retinoblastoma treatment is often effective; however, certain side effects and risks may arise in some cases. Common side effects include temporary changes in vision, light sensitivity, and eye redness. Chemotherapy may cause nausea, fatigue, and hair loss, while surgical procedures can lead to emotional and psychological difficulties for both the child and their family. In rare instances, treatment might increase the risk of secondary cancers or long-term vision issues.

Awareness of these possibilities is important to ensure timely medical support and to address both the physical and emotional aspects of recovery.

How to choose the Right Treatment for you?

Selecting the most suitable retinoblastoma treatment is a careful decision. Begin with seeking guidance from a reliable eyecare provider who can provide specialized advice based on your individual circumstances. Additionally, here are some generic points to evaluate while considering the right treatment:

  • Extent of the disease
  • Overall well-being of the patient
  • Consider potential side-effects of a treatment
  • Treatment success rate

By evaluating these factors, along with the guidance of your eye doctor, you can make an informed decision regarding retinoblastoma treatment best-suited for the specific needs and circumstances of the child.

Recovery & Aftercare for Retinoblastoma Patients

Aftercare following retinoblastoma surgery involves both medical follow-up and supportive care to safeguard the child’s overall well-being. Proper surgical site care, including gentle cleansing and limiting physical activity, is essential. Long-term follow-up with ophthalmologists is also crucial to monitor for any signs of cancer recurrence.

Aftercare precautions include:

  • Regular follow-up visits with the ophthalmologist and oncologist
  • Monitoring for changes in vision or new symptoms
  • Protecting the eyes from injury and excessive sunlight
  • Supporting emotional well-being through counseling or support groups
  • Ensuring proper nutrition and adequate rest for recovery
  • Genetic counseling for families, if applicable

Cost of Retinoblastoma Treatment in India

Retinoblastoma treatment costs in India vary greatly depending on the severity of the condition and the required treatment approach. Factors such as the stage of the disease, type of treatment (chemotherapy, surgery, laser therapy, or radiotherapy), duration of hospitalisation, and follow-up care all impact the overall expenditure. Costs also differ between government hospitals, private healthcare providers, and specialised cancer centres. Individual procedures may include laser therapy or cryotherapy (₹20,000–₹45,000), radiation (₹80,000–₹1,50,000), and enucleation surgery (₹70,000–₹1,20,000).

Why choose Retinoblastoma Treatment at Centre For Sight?

Choosing Centre For Sight for retinoblastoma treatment ensures a comprehensive and compassionate approach. Our doctors and medical staff specialize in customized treatments, including surgery, chemotherapy, and laser therapy. We prioritize the unique needs of each child, offering world-class medical care and emotional support for both the young patient and their family. Our patient centric approach makes us stand out as a beacon of hope.

Explore FAQs

What is the meaning of retinoblastoma?

Retinoblastoma is a rare type of eye cancer in children that primarily affects those under five years old.. It occurs when retinal cells grow uncontrollably due to genetic changes, forming a tumor. If left untreated, it can lead to partial or complete blindness.

Retinoblastoma is diagnosed through a comprehensive eye examination, which may include dilated eye exams, imaging tests like ultrasound or MRI, and biopsy of the tumor tissue for confirmation.

Retinoblastoma is curable, especially when detected early. Treatment options include chemotherapy, radiation therapy, laser therapy, or surgery.

Yes, there are two main types of retinoblastoma patients:

Unilateral: Affecting one eye

Bilateral: Affecting both eyes. Bilateral cases are often hereditary and associated with a higher risk of other family members being affected

Regardless of the type, it’s crucial to consult with an eye specialist for accurate diagnosis and personalized treatment plans.

If a child has a heritable form of retinoblastoma, then regular check-up for the kid becomes vital. If the child is screened carefully, then early detection can help treat the condition successfully.

Infection, bleeding, and implant-related complications are risks related to retinoblastoma surgery which involves removal of the affected eye.

Enucleation is surgery in which the patients diseased eye is completely removed. During enucleation, the eye muscles and associated orbital contents are left untouched.

Retinoblastoma occurs mostly in children under the age of six. About forty percent of cases of retinoblastoma are inherited. Regular eye checkups for your child can help massively as retinoblastoma treatment can be more effective if the disease is detected early on.

Possible side-effects of chemotherapy are hair loss, loss of appetite, constipation, fatigue, mouth sores, vomiting, and bleeding.

The life expectancy of retinoblastoma depends on factors like the stage of the cancer, response to treatment, and whether it has spread to other parts of the body. With prompt and effective treatment, the prognosis is generally favorable.

The main cause of retinoblastoma is genetic mutations that occur in the cells of the retina.The life expectancy of retinoblastoma depends on factors like the stage of the cancer, response to treatment, and whether it has spread to other parts of the body. With prompt and effective treatment, the prognosis is generally favorable.

Retinoblastoma is treated through a combination of methods, including surgery (enucleation), chemotherapy, laser therapy, and cryotherapy. Treatment plans are tailored based on factors such as the extent of the disease, and early detection significantly improves prognosis. A multidisciplinary approach involving specialists, supportive care, genetic counseling, and long-term monitoring are essential components of the treatment process.The main cause of retinoblastoma is genetic mutations that occur in the cells of the retina.The life expectancy of retinoblastoma depends on factors like the stage of the cancer, response to treatment, and whether it has spread to other parts of the body. With prompt and effective treatment, the prognosis is generally favorable.

Retinoblastoma treatment depends upon several factors like:

  • The size of the tumour
  • Location within the eye of tumour
  • If the tumour is in one eye or both
  • If the tumour has spread outside the eye

Getting to know that anybody has cancer, is a feeling of shock, sadness and disbelief. You can help your child in several ways:

  • Make your family’s support system network secure. Being around family and friends can help a lot to feel positive.
  • Collect enough information about the condition that can help you make informed decisions.
  • Discuss freely with your doctor about your apprehensions
  • Understand that results of treatment are good and most children are able to have a normal life, provided the disease is diagnosed early

Post-enucleation retinoblastoma surgery, the eye surgeon places an artificial eye implant in the socket of the eyes. Then, eye muscles are attached to the artificial eye implant. It looks like natural eyes, but cannot see. But, it does move to some extent.Getting to know that anybody has cancer, is a feeling of shock, sadness and disbelief. You can help your child in several ways:

  • Make your family’s support system network secure. Being around family and friends can help a lot to feel positive.
  • Collect enough information about the condition that can help you make informed decisions.
  • Discuss freely with your doctor about your apprehensions
  • Understand that results of treatment are good and most children are able to have a normal life, provided the disease is diagnosed early

One of the ways chemotherapy is used is chemo reduction. In chemo reduction, drugs are used to shrink tumours that have not spread outside the eyes.

0-6 yearsOne of the ways chemotherapy is used is chemo reduction. In chemo reduction, drugs are used to shrink tumours that have not spread outside the eyes.

Retinoblastoma

Retinoblastoma