眼黑色素瘤 - 诊断与治疗 - 妙佑医疗国际

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眼黑色素瘤

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诊断

为了诊断眼黑色素瘤，医生可能会建议：眼部检查。医生会检查您的眼睛外部，寻找可能表明您眼睛内有肿瘤的肿大的血管。然后，在仪器的帮助下，医生会检查您的眼睛。有一种方法叫做双目间接检眼镜，它利用镜片和戴在医生额头上、有些类似矿灯的强光灯。另一种方法叫做裂隙灯生物显微镜，它利用产生一束强光来照亮眼睛内部的显微镜和透镜。超声波。眼部超声检查利用手持式棒状仪器（称为换能器）发出的高频声波来产生眼部图像。换能器置于您闭着的眼睑上或眼睛的前表面。肿瘤内部和周围血管的成像（血管造影）。在眼睛血管造影中，会在您手臂的静脉中注射一种有色染料。染料会流入您眼睛中的血管。带有特殊滤光片的照相机可以检测到染料，每隔几秒钟拍一次闪光照片，持续几分钟。光学相干断层扫描。成像学检查可产生葡萄膜和视网膜部分的图像。取可疑组织样本进行检测。在某些病例中，医生可能会建议从眼睛中取组织样本（活检）的医疗程序。为了取出样本，将一根细针插入眼睛，以提取可疑组织。在实验室里检测该组织，以确定其是否含有眼黑色素瘤细胞。眼部活检通常不需要诊断眼黑色素瘤。

确定癌症是否已经扩散

医生可能会建议额外的检查和医疗程序，以确定黑色素瘤是否已扩散（转移）到身体的其他部分。检查可能包括：旨在测定肝功能的血液检查胸部 X 线检查计算机断层成像（CT）磁共振成像（MRI）扫描腹部超声正电子发射计算机断层扫描（PET）

Determining whether cancer has spread

Your doctor may recommend additional tests and procedures to determine whether the melanoma has spread (metastasized) to other parts of your body. Tests may include: Blood tests to measure liver function Chest X-ray Computerized tomography (CT) scan Magnetic resonance imaging (MRI) scan Abdominal ultrasound Positron emission tomography (PET) scan

治疗

您采用哪种方案治疗眼黑色素瘤取决于眼黑色素瘤的位置和大小，以及您的总体健康状况和个人偏好。

等待治疗小眼黑色素瘤

小眼黑色素瘤可能无需立即治疗。如果黑色素瘤很小且没有生长，您和医生可能会选择等待并监测其是否有生长的迹象。如果黑色素瘤生长或者引起并发症，届时您可以选择进行治疗。

放射疗法

放射疗法使用高功率能量（例如质子或伽玛线）来杀死癌细胞。放射疗法通常用于治疗小型或中型眼黑色素瘤。通常是对肿瘤进行放射，方式是在眼部肿瘤上直接放置一个放射斑块，这种手术称为近距离治疗。用临时缝线将斑块固定住。斑块形状与瓶盖相似，内含数个放射粒子。斑块会在眼部放置四至五天，然后取下。也可以使用机器来对准眼部进行放射，比如质子束（外部射束放射或远距放射疗法）。这类放射疗法通常要进行数天。

激光治疗

在某些情况下，可以选择使用激光治疗来杀死黑色素瘤。一种名为温热疗法的激光治疗方法是使用红外激光器，有时会与放射疗法结合使用。

光动力疗法

光动力疗法将药物与特殊波长的光结合使用。药物会使癌细胞容易受到光的影响。这种疗法会破坏组成眼黑色素瘤的血管和细胞。光动力疗法适用于较小的肿瘤，对较大的肿瘤无效。

极冷疗法

极冷疗法（冷冻疗法）可以用于破坏一些小眼黑色素瘤中的黑色素瘤细胞，但这种疗法不常用。

外科手术

用于治疗眼黑色素瘤的手术包括切除部分眼睛或者摘除整个眼睛。进行哪类手术取决于您眼黑色素瘤的大小和位置。治疗方案可能包括：手术切除黑色素瘤和小部分健康组织。治疗小黑色素瘤时可能是通过手术切除黑色素瘤和周围的健康带状组织。手术摘除整个眼睛（摘除术）。摘除术通常用于大型眼部肿瘤。另外，如果肿瘤导致眼睛疼痛，则也可能采用这种手术。患有黑色素瘤的眼睛摘除后，会在相同位置放植入物，控制眼睛运动的肌肉会与植入物连接，从而使得植入物可以转动。在您经过一段时间痊愈后，就会制成人造眼睛（假体）。新眼睛的前表面会定制涂色，与您另一只眼睛匹配。

Waiting to treat small eye melanomas

A small eye melanoma may not require immediate treatment. If the melanoma is small and isn't growing, you and your doctor may choose to wait and watch for signs of growth. If the melanoma grows or causes complications, you may choose to undergo treatment at that time.

Radiation therapy

Radiation therapy uses high-powered energy, such as protons or gamma rays, to kill cancer cells. Radiation therapy is typically used for small to medium-sized eye melanomas. The radiation is usually delivered to the tumor by placing a radioactive plaque on your eye, directly over the tumor in a procedure called brachytherapy. The plaque is held in place with temporary stitches. The plaque looks similar to a bottle cap and contains several radioactive seeds. The plaque remains in place for four to five days before it's removed. The radiation can also come from a machine that directs radiation, such as proton beams, to your eye (external beam radiation, or teletherapy). This type of radiation therapy is often administered over several days.

Laser treatment

Treatment that uses a laser to kill the melanoma cells may be an option in certain situations. One type of laser treatment, called thermotherapy, uses an infrared laser and is sometimes used in combination with radiation therapy.

Photodynamic therapy

Photodynamic therapy combines medications with a special wavelength of light. The medicine makes the cancer cells vulnerable to light. The treatment damages the vessels and the cells that make up the eye melanoma. Photodynamic therapy is used in smaller tumors, as it isn't effective for larger cancers.

Cold treatments

Extreme cold (cryotherapy) may be used to destroy melanoma cells in some small eye melanomas, but this treatment isn't commonly used.

Surgery

Operations used to treat eye melanoma include procedures to remove part of the eye or a procedure to remove the entire eye. What procedure you'll undergo depends on the size and location of your eye melanoma. Options may include: Surgery to remove the melanoma and a small area of healthy tissue. Surgery to remove the melanoma and a band of healthy tissue that surrounds it may be an option for treating small melanomas. Surgery to remove the entire eye (enucleation). Enucleation is often used for large eye tumors. It may also be used if the tumor is causing eye pain. After the eye with melanoma is removed, an implant is inserted into the same position, and the muscles controlling movement of the eye are attached to the implant, which allows the implant to move. After you've had some time to heal, an artificial eye (prosthesis) is made. The front surface of your new eye will be custom painted to match your existing eye.

临床试验

探索 Mayo Clinic 的研究测试新的治疗、干预与检查方法，旨在预防、检测、治疗或控制这种疾病。

妥善处理与支持

应对视力变化

如果癌症治疗导致一只眼睛完全丧失视力，比如当一只眼睛被摘除时就会出现这种情况，但您仍然有可能像拥有两只正常眼睛时一样，能做大多数事情。但是您可能需要用几个月的时间来适应新视力情况。只有一只眼睛会影响您判断距离的能力。您可能更难觉察周围的事物，尤其是出现在没有视力一侧的事物。请医生为您介绍一个互助组或职业治疗师，他们可以帮助您制定应对和适应视力变化的策略。

准备您的预约

如有任何体征或症状令您担心，请先看家庭医生。如果医生怀疑您有眼睛问题，可能会将您转诊给眼科专家（眼科医生）。如果您有眼黑色素瘤，可能会被转诊给专门治疗眼黑色素瘤的眼外科医生。该专科医生可以解释您的治疗方案，并根据您选择的治疗方法将您转诊给其他专科医生。由于就诊时间短且通常涉及很多方面，因此最好做好就诊准备。以下信息可以帮助您做好准备，并了解医生可能会做什么。

您能做些什么

了解就诊前是否有任何限制规定。约诊时，请务必询问是否需要提前做任何准备，例如限制饮食。写下您目前出现的所有症状，包括那些看起来与您安排本次约诊无关的任何症状。写下关键的个人信息，包括整体健康情况，以及任何主要压力或近期的生活变化。家族病史也会有帮助。列出您正在服用的所有药物、维生素或补充剂。考虑邀请家人或朋友陪同。有时很难记住就诊时医务人员告知的所有信息。陪同人员可能会记住您遗漏或忘记的信息。写下要向医生咨询的问题。您的就诊时间有限，因此提前准备好问题清单有助于充分利用就诊时间。请按照从最重要至最不重要的顺序列出问题，以免时间不够。对于眼黑色素瘤，要向医生咨询的一些基本问题包括：我是否患有眼黑色素瘤？我的眼黑色素瘤长在哪里？我的眼黑色素瘤有多大？我的眼黑色素瘤是否已扩散到眼睛以外的部位？我是否需要其他检查？我的治疗方案有哪些？是否有治疗方法可以治愈我的眼黑色素瘤？每种治疗有哪些潜在的副作用？我是否必须要治疗？我有多长时间来决定治疗方案？您是否认为有一种治疗方法最适合我？治疗对我的日常生活有什么影响？我可以继续工作吗？治疗对我的视力有什么影响？我还有其他健康问题。在治疗过程中，我怎样才能管理好这些疾病？是否会将我转诊给其他专家？治疗费用是多少，我的保险能报销吗？有没有我可以带走的手册或其他印刷资料？您推荐哪些网站？哪些因素会决定我是否应该计划随诊？除了事先准备好的问题外，如果想到其他问题，您也可以随时询问医生。

医生可能做些什么

医生可能会询问您一些问题。准备好回答这些问题，或许可以给您留出时间，以便讨论您想解决的其他问题。您的医生可能会问：您第一次出现症状是在什么时候？您的症状是持续存在还是偶尔出现？

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet. Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment. Write down key personal information, including general health and any major stresses or recent life changes. Family medical history also will be helpful. Make a list of all medications, vitamins or supplements that you're taking. Consider taking a family member or friend along. Sometimes it can be difficult to remember all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot. Write down questions to ask your doctor. Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For eye melanoma, some basic questions to ask your doctor include: Do I have eye melanoma? Where is my eye melanoma located? What is the size of my eye melanoma? Has my eye melanoma spread beyond my eye? Will I need additional tests? What are my treatment options? Can any treatments cure my eye melanoma? What are the potential side effects of each treatment? Do I have to have treatment? How long can I take to decide on a treatment? Is there one treatment you feel is best for me? How will treatment affect my daily life? Can I continue working? How will treatment affect my vision? I have these other health conditions. How can I best manage them during treatment? Should I be referred to additional specialists? What will that cost, and will my insurance cover it? Are there brochures or other printed material that I can take with me? What websites do you recommend? What will determine whether I should plan for a follow-up visit? In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions that occur to you.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Being ready to answer them may allow time later to cover other points you want to address. Your doctor may ask: When did you first begin experiencing symptoms? Have your symptoms been continuous or occasional? 来自妙佑医疗国际员工申请 Mayo Clinic 预约症状与病因医生与科室 Aug. 09, 2022 打印

Living with 眼黑色素瘤

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