From Deseret News archives:

Routine exams urged to detect rare cancer of the eye

Published: Friday, May 11, 2007 12:09 a.m. MDT
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In the Mountain West, about six young children will be diagnosed this year with retinoblastoma, a rare eye cancer.

The disease had phones ringing at area hospitals and eye clinics Thursday, the day after the story broke that Utah Jazz player Derek Fisher's infant daughter, Tatum, is being treated for the condition.

Parents were calling about their own children and asking how to screen for the cancer, said Steve Brown, spokesman for the Moran Eye Center at the University of Utah. Bonnie Midget, Primary Children's Medical Center spokesman, said the children's hospital was also taking calls.

Retinoblastoma is a cancer that occurs within the eye's retina. It's believed that the children who get the rare cancer (1 in about 20,000 children) are actually born with it, since it appears between birth and age 5.

The vast majority of cases — 90 percent — are called "spontaneous," because neither of the child's parents nor any family members had a history of the disease. In those cases, the cancer is usually found in one eye, while children with a familial form may develop the cancer in both eyes, a condition called bilateral retinoblastoma.

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Nationally, doctors see between 200 and 250 cases a year, according to Dr. Richard Lemons, director of pediatric oncology at Primary and the U. Retinoblastoma accounts for about 3 percent of childhood cancers in those younger than 15.

The best way to protect children and detect the disease, Lemons said, is to have routine well-child health and eye exams. Pediatricians routinely check for the disease as part of the examination they give infants and young children, although parents may not realize it when they see the doctor shine a light into the child's eyes.

They're looking for what's called a "red reflex," and it's the same principle that accounts for the red-eye effect in flash photography. In fact, it is sometimes when looking at a young child's photograph that parents first notice something might be wrong.

The tumor cells block the red reflex, and it may appear as a white area on the pupil in a photo, Lemons said. Or the photo may show a subtle difference in the two eyes, including a "lazy eye" effect where one eye turns in.

Those are more commonly caused by other conditions. The white spot may also be a congenital cataract, said Dr. Alan Crandall, professor of ophthalmology at the U. and one of Moran Eye Center's specialists. But while less serious, both cataracts and conditions causing "lazy eyes" require treatment, so finding them early is a good thing, he added.

Neither doctor commented specifically on Tatum Fisher's case but spoke instead in general terms about the eye cancer.

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