About radiotherapy for eye cancer

Radiotherapy uses high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. Radiotherapy may be given either from outside the body (external radiotherapy) or from inside the body (internal radiotherapy).

If you have uveal melanoma, radiotherapy may be the only treatment you need or it may be given with other treatments.

For conjunctival melanoma, you may have radiotherapy after surgery to reduce the risk of cancer coming back.

There are different types of radiotherapy.

External radiotherapy

External beam radiotherapy aims high-energy rays from a machine at the tumour. This only treats the area of the body that the rays are aimed at. It does not make you radioactive.

Proton beam radiotherapy

This treatment uses proton radiation to destroy cancer cells. The proton beam is aimed directly at the tumour, causing very little damage to surrounding healthy tissue.

Before the treatment, you have an operation to attach tiny metal clips to the white, outer wall of the eye. This is done under general anaesthetic. You cannot see the clips, but they show up on scans and this helps your team plan the treatment.

You have treatment in small doses (fractions) each day for four or five days. The clips are left in place after treatment, unless you are finding them uncomfortable. They do not cause any harm and most people cannot feel them.

Stereotactic radiotherapy

This treatment uses many small beams of radiation to target the tumour. It delivers high doses of radiotherapy to very precise areas of the body. This reduces the risk of side effects. You usually only need one session of treatment.

Internal radiotherapy (brachytherapy)

This treatment is given using a small radioactive disc called a plaque. It is often called plaque brachytherapy.

You have an operation to attach the plaque to the wall of the eye over the tumour. You usually have a general anaesthetic for this. But sometimes, the surgeon will give you a local anaesthetic to numb the area. They will also give you drugs to help you relax before putting the plaque in.

The plaque is left in place until the right amount of radiation has been given. This is usually takes 1 to 4 days. After this, you have another short operation to remove the plaque.

You stay in hospital for up to a week during this treatment. While the plaque is attached to your eye, there is a small risk of radiation exposure for the people around you. Your doctor or nurse will give you advice about keeping yourself and others safe.

You will need to stay in one room, and your visitors will only be allowed in for a short time each day. Once the plaque is taken out, you are not radioactive and you should be able to go home.

Side effects of radiotherapy

The side effects you have will depend on the type of radiotherapy and where the tumour is in the eye. Your doctor, specialist nurse or radiographer will explain what to expect during treatment and any likely side effects.

You may have side effects during treatment, or months or years after treatment.

Side effects may include pain in the eye or changes to your eyesight. Your doctor can often improve these with drugs, or other treatments, such as surgery.

Sometimes radiotherapy causes permanent damage to your eyesight. But this is becoming less common as new radiotherapy treatments are developed.

We have more information about coping with the side effects of radiotherapy.