What Is Uveal Melanoma?

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When we think about melanoma, we most often associate it with skin cancer that can be seen on the surface of the body. Uveal melanoma, however, is behind the eye and not visible. Dr. Sapna Patel, an assistant professor of melanoma at MD Anderson Cancer Center, describes uveal melanoma, who is at risk for this aggressive cancer, and how this rare type of melanoma can be prevented.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Hello and welcome to Patient Power. I’m Andrew Schorr. When we think of melanoma, we usually think of it as skin cancer. In fact, it’s our deadliest skin cancer. But did you know that it can develop at the back of the eye? And that’s called uveal melanoma. Who’s at risk, and is there a connection with family history? To help us understand, we’re joined by Dr. Sapna Patel. She’s a melanoma specialist from MD Anderson Cancer Center in Houston.

Carol Preston:

Dr. Patel, welcome.  Tell us about uveal melanoma.

Dr. Patel:

So uveal melanoma is a melanoma.  It's very—it's in the same family as skin melanoma.  It's a very aggressive type of cancer.  It's the second most common location for a melanoma to occur.  So when we think of melanoma the—90 percent of them occur on the skin surface, but at 5 percent the second most common location is in the eye.  The most common location is in the back of the eye, and so these often require a dilated eye exam for detection.

And most patients are not aware that they can have freckles or moles in the back of their eye, but you can, and so those are areas that need to be watched by an ophthalmologist for evolution.  And if they evolve or grow or change in nature, they become suspicious for a uveal melanoma.

Carol Preston:

Are these—I just wanted to ask you if these are caused by the sun, and that's why there's the recommendation for sunglasses.

Dr. Patel:

We're not totally sure, although because these cells originate from the same cells that form the skin melanocytes, the melanocytes in the back of the eye, or the pigmented cells susceptible to melanoma probably are also at risk of ultraviolet exposure, hence the recommendation for sunglasses.

However, scientifically it's not been perfectly found that sun or ultraviolet light is the main risk factor. It is true that it's diagnosed more frequently in a Scandinavian population and also in Australia where they have higher rates of skin melanoma as well.  And we think maybe lighter eyes, hazel eyes, even green eyes could be at risk of this disease as well.

But it is a fairly rare disease occurring in the United States—we think in only six per one million people.  So that equates to less than 2,000 people every year diagnosed with a uveal melanoma.

Carol Preston:

Any family history come into play?

Dr. Patel:

That's a good question.  So classically, we say melanomas are not hereditary, but we're learning more and more that there is a fragment of the population who get melanomas and potentially melanomas of the eye where there may be an inherited risk for that.  Right now, though, there are no national or international guidelines for screening for genetic hereditary mutations or risk factors.  That's why early detection with a skin specialist, a dermatologist looking for skin melanoma and ophthalmologist looking for eye cancer is very important.  And this is regardless of whether you need corrective lenses or not.  Everybody should see an ophthalmologist at least once a year for a dilated eye exam.

Carol Preston:

Dr. Sapna Patel, thank you so much for enlightening us about uveal melanoma.  We need not only to protect our skin, but we also have to protect our eyes.

Andrew Schorr:

Thanks to Dr. Sapna Patel for helping us understand this rare form of melanoma, so we have a full understanding of this disease. I’m Andrew Schorr. Remember, knowledge is the best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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Page last updated on April 9, 2015