The skilled team of doctors at Fortis Memorial Research Institute Gurugram has achieved a major feat by successfully removing a rare and malignant tumor – choroidal melanoma from the left eye of a 31-year-old woman. This type of cancer occurs only in 5 to 7 patients per million population worldwide. However, choroidal melanoma is a rare type of cancer and even if it is mild, it spreads to other parts of the body, so it is important to treat it immediately.
For the first time in India, a patient was given plaque brachytherapy, a special type of retinal eye tumor treatment, at Fortis Hospital. This is the first case when this technique was used in a private hospital in Delhi-NCR.
According to the information, a 31-year-old female patient was complaining of blurred vision in the left eye for the last six months, while the right eye had normal vision (6/6) but the vision in the left eye had reduced to 6/18. When the medical examination was done, it was found that there was stage 1 cancer in the left eye, due to which a wound of 6-7 disc diameter had formed in his eye and it was moving towards the macula. The tumor was close to his optic nerve and there was a high possibility of radiation exposure to the remaining part of the retina. Therefore the patient was given plaque brachytherapy. This technique uses a small, silver-covered disc-shaped device that is actually a radioactive source and delivers radiation directly targeted at the tumor, thereby minimizing the spread of the tumor to surrounding tissues. Is possible. This method proved to be very effective as it saved the patient’s vision and also succeeded in removing the tumor located near the optic nerve.
Regarding this, Dr. Anita Sethi, Director and HOD, Ophthalmology, Fortis Memorial Research Institute, Gurugram said, ‘We used indigenous notched ruthenium 106 plaque prepared from radioactive waste. In this complex procedure, we placed a radioactive plaque inside the eye, just above the tumor, usually under general anesthesia. This plaque emits beta radiation which attacks the cancer cells without affecting the surrounding tissues.
The second method is to remove the affected part or the entire eye through surgery, but the advantage of this procedure is that the patient’s vision can be saved. Another alternative treatment is enucleation in which the eye is removed but not only does the patient lose his vision completely but the patient’s face also looks bad after the surgery. We chose plaque brachytherapy so that not only could the young woman’s vision be saved by effectively removing the tumor, but the patient’s face would also not deteriorate after the treatment was completed.
How is this therapy done?
Dr. Sethi told that plaque brachytherapy is done in two stages. Plaque insertion is done in the first surgery and this plaque is removed in the next surgery. How long the plaque remains in contact with the tumor is determined by dosimetry (the science of how the period is determined based on measurements and calculations). Dosimetry is done by a radiation physicist based on the size of the tumor and radioactivity of the plaque. In this case we used notched ruthenium 106 plaque and both processes were completed in about 75 hours.
There was a big challenge in this surgery
Senior Vice President of the hospital, Mahipal Singh Bhanot, says that this case was quite challenging due to the location of the tumor inside the eye. Our priority was to remove this tumor as well as preserve the patient’s vision. The skilled doctors of the hospital, Dr. Anita Sethi, Dr. Neeraj Sanduja, Dr. Amal Roy Choudhary, Director – Radiation Oncology, preserved their patient’s vision by using plaque brachytherapy. This case reflects the commitment of Fortis Memorial Research Institute, Gurugram to provide high quality care with the help of skilled and experienced medical professionals and state-of-the-art technology.
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FIRST PUBLISHED: February 8, 2024, 21:43 IST