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Genetic analysis and retionblastoma - Research Paper Example

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Genetic Analysis and Retinoblastoma Mansoor Aljohany November 20, 2011 Genetic Analysis and Retinoblastoma Retinoblastoma is a common intraocular cancer that affects mainly children below 5 year of age and tumors grows in the light sensitive eye lining (Nork, Terry, Himanshu and Lyndell, 1995)…
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Download file to see previous pages The current available methods of treating and managing retinoblastoma are; chemoreduction, thermotherapy, cryotherapy, radiotherapy, external beam radiotherapy, enucleation and systematic chemotherapy. Chemoreduction reduces the volume of the tumor thus allowing for therapeutic measures, which are more focused and less damaging (Shields, L. Carol and Jerry, A. Shields, 2002). Chemoreduction is used as an initial management of retinoblastoma. The most commonly used therapeutic agents are carboplatin, etoposide and vincristine (Shields, 2004). When an adequate tumor reduction is achieved, focal therapy is used on individual tumors. Such focal therapies are; laser photocoagulation, thermotherapy, plaque radiotherapy and cryotherapy. Plaque radiotherapy is used for tumors which fail other therapies and which reach a size of 8 or 10 mm. On the other hand, laser photocoagulation is used for small retinoblastoma located posterior to the eye equator. In thermotherapy, tumors are heated using diode infrared laser system and is usually carried out together with carboplatin or chemoreduction so as to enhance their effectiveness. For those tumors, which are adjacent to fovea and optic nerve, thermotherapy is best suited (Shields, 2004). Cryotherapy is very useful in the treatment of equatorial and peripheral tumors and it allows tumor consolidation after chemoreduction. In plaque radiotherapy, a radioactive implant is placed on the sclera over the base of retinoblastoma so as to irradiate the tumor. This therapy is used for those tumors, which are less than 16mm in base and 8 mm in thickness (Shields, 2004). In external beam radiotherapy, the whole eye is irradiated to treat advanced retinoblastoma especially if there is diffuse vitreous seeding. However, this radiation can increase the risk of developing a second tumor (Roarty, Mclean and Zimmerman, 1988). Enucleation is most appropriate if there is no hope for useful vision or if there is possibility of the tumor metastasizing to affect optic nerve, choroid and orbit. Through this method, the eye can be removed when intact and at the same time ensuring no seeding of the malignancy into the orbit (Shields, 2004; Murali,Patricia, Everlyn, Sharon and Richard, 2007). Genetic testing can be done during pregnancy to determine whether a child is likely to develop retinoblastoma. This test is done only if the genetic change responsible for retinoblastoma in the family has been identified. This testing allows the embryo to be tested just before implantation in the womb is done (Harbour, 1998). Though this technique is new, it has been performed many times and it has a low rate of achieving a pregnancy. There are numerous advantages of genetic testing as it reduces family uncertainties about the future, it enhances more accurate genetic counseling and the child’s attitude towards reproduction in adult age is made more responsible. However, genetic testing violates the rights of children, as they are not involved in decision making affecting their life. Reproductive plans can also be altered. Predictive genetic testing can also lead to emotional harm and unwarranted anxiety about possible early signs before presentation of any disorder and consequently damaging child’s sense of self esteem (Marteau,1994) Given that some forms of retinoblastoma are hereditary, research in retinoblastoma will help in effective management ...Download file to see next pagesRead More
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