When eye cancer is being diagnosed, doctors are likely to determine if it has metastasized (spreading to other parts of the body) and if so, it’s scale. The process refers to as staging where each particular stage describes the percentage or volume of cancer being spread in the body. It also helps in determining the severity of cancer and possible course of treatment.
Eye Cancer Stages Determination
Melanoma/cancer and intraocular lymphoma are other forms of eye cancers that can be diagnosed through certain imaging tests like CT scan, MRI, Ultrasound and so on for the determination of cancer stage. Staging is a worldwide acceptable and standard way through which cancer team describes metastasis. The most common systems describing eye melanomas that you’ll study even in ophthalmology in Abu Dhabi is the American Joint Committee on Cancer (AJCC) TNM system.
About AJCC TNM
Most of the eye melanomas begin in the uvea; the area includes ciliary body, choroid, and iris. In rare cases, melanomas may start in surrounding areas of the eye with their specific staging systems. It’s important for consulting the doctor to know more of the staging and the degree of eye melanoma. The system for determination is AJCC which is most recent and has been effective since January 2018. The information or data generated is based on three elemental aspects that are:
- T (Tumour): The size and extent of an eye tumor and whether it has invaded nearby structures.
- N (Lymph Nodes): Spreading of cancer to nearby lymph nodes that are around the neck or ear or perhaps its metastasis in other parts of the eye.
- M (Metastasis): Spreading of cancer to distant parts of the body with liver being one of the most common.
The appearance or arrangement of these letters would provide more details relevant to cancer and its advancement. It’s important to note that the “T” categories for iris melanoma, choroidal melanomas, and ciliary body are different. However, “N” and “M” categories are similar if melanoma is associated with all three parts of the uvea.
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“T” Categories – Iris Melanoma
- TX: Primary tumor remains can’t be assessed; information unknown.
- T0: Evidence of a primary tumor is non-existent or missing.
- T1: Existence of tumor only in the iris.
- T2: Tumour has spread to the choroid, ciliary body or both.
- T3: Tumour has metastasized into both ciliary body and choroid as well as in the sclera (white of the eye).
“T” categories – Ciliary Body & Choroidal Melanoma
Choroidal and ciliary body melanomas are further classified into four groups based on the thickness and diameter of the tumor. T1 tumors are the smallest whereas T4 being the largest respectively and each of these groups are subdivided based on the extent of metastasis.
“N” categories – Iris, Ciliary Body & Choroidal Melanomas
- NX: Lymph nodes can’t be assessed here.
- N0: Cancer hasn’t metastasized to the adjacent lymph nodes.
- N1: Metastasis has occurred in nearby lymph nodes or small cancer deposits are present in various parts of the eye.
The same staging sequence is followed for the “M” category and you’ll study this in ophthalmology in Dubai.