om the cancer before surgery and send the sample to the lab for culture. After growing the tumor cells, a geneticist analyzed them to determine whether they were missing a copy of chromosome 3.
Of the nine patients in the UCLA study who underwent biopsy, four had tumors identified as high-risk for aggressive metastasis, and five were identified as low-risk.
“When physicians know upfront which patient has a poor prognosis, they will monitor the person more closely to detect metastasis earlier and consider more aggressive treatments to increase their chance of survival,” Young emphasized. “Knowledge of metastatic risk will also help patients and their physicians decide whether to pursue clinical trials of experimental therapies that target metastasis.
“Patients understand that no good treatment exists after their cancer spreads -- everyone wants to know what their metastasis risk is,” she added. “If the risk is low, it’s a giant relief and emotional burden off their shoulders. If the risk is high, it enables them to plan arrangements for their family and finances, and make the most of their remaining time alive.”
Pioneered by UCLA ophthalmic pathologist Dr. Ben Glasgow, the technique of fine-needle aspiration for collecting cancer cells from the living eye has been the standard of care at the Jules Stein Eye Institute since 2004, but adopted by only a handful of other ophthalmic centers in the nation.
“Until now, there’s been little we could do but radiate the patient’s eye and ask them to return for a follow-up exam in six months,” observed Young. “But it’s short-sighted to think of ocular melanoma as related only to the eyeball. Cancer can kill you, regardless of where it originates in the body.
“We’ve known for 10 years that this genetic marker is linked to fast-growing melanoma,” she added. “It’s time for ophthalmologists to expand their surgical practice to include the biopsy procedure, and u
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