Expert: Claes-Gustaf Nordquist, M.D. - 10/22/2008

Question
Hi I am a medical qualified doc in the UK was diagnosed with CM 2 years ago. I do not have mets yet. My tumor was small 2.2 in height and 7.9mm in height and 6mm in width. I had proton beam therapy by 5 and on the 5th day this was followed by a small amount of TTT(trans pupillary thermal therapy). By 5 months my tumor had shrunk by more than 60%. In the UK they do not screen for metastatic disease. Although I had a small tumor as its volume is more than 7mm cubic, I understand I am at risk of metastatic spread. I understand the rapid shrinkage of my tumor could indicate a high mitotic rate. My own doctors deny this but offer no explanation for its response to radiation. If I were to purchase private scans I understand that there is a 10% rate of those with liver mets having resectable disease. Is there any other treatment worth considering for choroidal melanoma liver mets. I am quite detached about it all I need to face the facts and be realistic there is no point wasting time and money yet at the same time I would like to put myself in the best possible position.

Answer
Proton beams are actually quite effective & efficient and may be reason enough for the rapid shrinkage of your tumour. There are interesting and promising experiments of immunotherapy going on but they are still very experimental so at present I'm unfortunately still unaware of any such method.