Chemotherapy for eye cancer

Chemotherapy uses anticancer (cytotoxic) drugs to destroy cancer cells. It is sometimes used to treat eye cancer. Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of chemotherapy. Chemotherapy may be given alone, but it is sometimes combined with radiation therapy to treat eye cancer. This is called chemoradiation. The 2 treatments are given during the same time period. You may also receive other treatments.

Chemotherapy is given for different reasons. You may have chemotherapy to:

• destroy cancer cells in the body
• relieve pain or control the symptoms of advanced eye cancer (called palliative chemotherapy)

Chemotherapy may be given in different ways to treat eye cancer.

• Systemic chemotherapy travels through the bloodstream to reach and destroy cancer cells all over the body, including those that may have broken away from the primary tumour in the eye.
• Topical chemotherapy is applied to the skin around the eye or given as an eye drop applied directly to the surface of the eye or eyelid.
• Intraocular chemotherapy is injected into the eye.
• Intrathecal chemotherapy is injected in the cerebrospinal fluid (CSF) surrounding the brain and spinal cord.
• High-dose chemotherapy is a systemic chemotherapy that is sometimes used to treat eye cancer that doesn’t respond to standard doses of chemotherapy. High-dose chemotherapy damages the bone marrow so this treatment is followed by a stem cell transplant.
• Hepatic artery infusion may be used to treat eye cancer that has spread to the liver (liver metastasis). It delivers chemotherapy directly to liver tumours through the main artery of the liver (called the hepatic artery). Hepatic artery infusion is also called chemoembolization.

The type of chemotherapy drug used depends on the type of eye cancer. Some chemotherapy drugs used to treat eye cancer are:

• methotrexate
• cytarabine (Cytosar, Ara-C)
• thiotepa (ThioTEPA)
• procarbazine hydrochloride (Matulane)
• vincristine (Oncovin)
• 5-fluorouracil (Adrucil, 5-FU)
• mitomycin (Mutamycin)
• dacarbazine (DTIC)
• temozolomide (Temodal)

Lymphoma of the eye is most often a type of non-Hodgkin lymphoma. Find out more about chemotherapy for non-Hodgkin lymphoma.

The chemotherapy used to treat melanoma of the conjunctiva or eyelid is usually the same chemotherapy that is used to treat melanoma skin cancer. Find out more about chemotherapy for melanoma skin cancer.

Most tumours of the eyelid and conjunctiva are similar to types of non-melanoma skin cancer. These types of eye cancer are often treated in a similar way to non-melanoma skin cancer. Find out more about chemotherapy for non-melanoma skin cancer.

Side effects can happen with any type of treatment for eye cancer, but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.

Chemotherapy may cause side effects because it can damage healthy cells as it kills cancer cells. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after chemotherapy. Sometimes late side effects develop months or years after chemotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of chemotherapy will depend mainly on the type of drug, the dose, how it’s given, where it’s given and your overall health. Some common side effects of chemotherapy drugs used for eye cancer are:

• hair loss
• sore mouth and throat
• nausea and vomiting
• loss of appetite
• diarrhea or constipation
• low blood cell counts
• fatigue

The most common side effect of topical chemotherapy are skin problems and eye problems. This depends on whether the chemotherapy was applied to the skin around the eye or to the surface of the eye. Skin problems include dryness, itching, burning or swelling, and eye problems include eye redness or a watery eye. Eye problems, including infection, are also a side effect of intraocular chemotherapy.

Tell your healthcare team if you have these side effects or others you think might be from chemotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Details on specific drugs change regularly. Find out more about sources of drug information and where to get details on specific drugs.

Find out more about chemotherapy and side effects of chemotherapy. To make the decisions that are right for you, ask your healthcare team questions about chemotherapy.