Q&A with Dr. Irini Yacoub: Treating Eye Cancer with Proton Therapy

At the New York Proton Center, we see some of the most complex and rare types of cancers, including patients with eye – or ocular – cancers. Proton therapy treats ocular cancers by depositing a high dose of radiation directly into tumors. Nearby healthy tissues, such as the retina, cornea, lens, optic nerve and brain, receive little to no radiation from treatment, greatly reducing the risks of side effects and toxicities such as blindness. We spoke with NYPC’s Dr. Irini Yacoub to learn more about how proton therapy treats ocular cancers and what patients can expect during treatment. Dr. Yacoub is an attending radiation oncologist at the New York Proton Center and Memorial Sloan Kettering Cancer Center and specializes in the treatment of brain and central nervous system cancers including ocular tumors, as well as head and neck and prostate cancers.

What types of ocular cancers affect patients?

Ocular cancer can occur in the globe (eyeball), muscles around the eye, and on the optic nerve, a bundle of nerve fibers that carries visual information from the eye to the brain. Additionally, some tumors such as lymphomas can occur anywhere in the orbit, the bony socket in the skull that houses the eye, its muscles, nerves, and other structures. Protons can treat many types of ocular cancer, including ocular melanomas, uveal melanomas, optic meningiomas, optic nerve gliomas, lacrimal gland lymphomas, conjunctival lymphomas, ocular adenoid cystic tumors, ocular sarcomas, and choroidal metastases. 

Despite its many different forms, ocular cancer is generally very rare. Only about 3,500 cases of the 1.7 million-plus cases of cancer diagnosed in the United States each year are ocular malignancies.

Why is proton therapy successful in treating ocular cancer?

Proton therapy is a highly targeted form of radiation therapy, which is especially critical when it comes to ocular tumors and other tumors in the central nervous system. With ocular cancers, there are multiple considerations with radiation therapy, including exposure to the brain and potential loss of vision. Surgery can result in blindness, and so ocular cancers are often preferentially treated with radiation therapy, and more specifically proton therapy. In the past decade, proton therapy has increasingly been demonstrated to provide optimized treatment of ocular tumors, with excellent rates of tumor control and vision preservation. When treating ocular cancers, it’s all about reducing toxicity and sparing the extremely sensitive structures in the eye area, like the optic nerve and the brain.

What can someone expect from treatment for ocular cancer?

Treatment plans at NYPC are always personalized and optimized for each patient. Depending on where the cancer is in or around the eye, patients can expect different timelines for treatment. 

For example, for optic meningiomas on the optic nerve itself, treatment is usually a 5-to-6-week course of radiation therapy. For lymphomas around the eye and in the surrounding muscle, radiation therapy most typically ranges from 2 to 12 treatments. For treatment of tumors within the globe, doses are most commonly given in 5 treatments. 

While ocular cancer is rarer than other types of cancer, proton therapy is uniquely positioned to successfully treat it, preserving vision and the vital surrounding tissues and organs. If you have more questions about ocular cancer, you can reach our team through our consultation form or contact page.