So after being examined, scanned, and having ultrasound every 3 months for 11months, the diagnosis of malignant transformation was relatively clear. Each time I was seen, the lesion got a little thicker. At 11 months, it had nearly tripled in thickness. I had also been experiencing increasing flickers or flashing in the upper portion of my right eye’s vision. At 15 months, in December 2016, the flashes/flickering was occurring closer to the center of my vision. Apparently this is an additional sign that the lesion is active.
When Dr. Fry told me she thought it was transforming into cancer, and after the blood returned to my head after a brief moment of the gravity of the news it me, she reviewed the treatment options that were available. Among them: plaque brachytherapy with Iodine or Palladium, proton beam treatment, or enucleation. She referred me to the New York Eye Cancer Center website (EyeCancer.com) because although it is the website of an ophthalmologist who treats these lesions, it contains links to a lot of information and studies about various forms of treatments. Being a healthcare provider and researcher myself, I felt comfortable reviewing the literature and starting to weigh my options.
I should also mention here that not only was I told about the cancer, but she had already described to me how, after treatment, I could experience some or complete vision loss beginning about one year after treatment. Complicating things was the fact that my lesion was extremely close to the macula (the part of the eye that is responsible for direct vision . . .what we see straight ahead of us) and the optic nerve.
For these reasons, I elected to go with Palladium-103 plaque brachytherapy with Dr. Paul Finger. He had developed a slot technique to adapt the plaque next to and around the optic nerve, and Palladium-103 may have slightly better vision-sparing properties. Dr. Fry emphasized that there are a number of reasons to consider each type of treatment, but because choroidal melanoma is relatively rare (about 2000 adults are diagnosed each year in the U.S.), their are a lot of differing opinions on what the best treatment is. I am hoping my choice is a good one!