On World Cancer Day, we're raising awareness of eye cancer and our ocular oncology team here at Moorfields.
We interviewed Gordon Hay, ocular oncologist and director of A&E, who shared his knowledge on ocular cancer and gives us an insight into a typical day at the eye cancer clinic.
How common is eye cancer?
Cancers on the surface of the eye are seen quite frequently, although cancer at the back of the eye is quite rare. The UK will see around 900 new cases of melanoma every year.
What can people do to protect their eyes from cancer?
The main way to protect from cancer on the surface of the eye is to see an optometrist every two years who can check the surface for any suspicious lesions. You can also wear a good pair of ultraviolet protective sunglasses between April and October. A hat is also very helpful.
If you take immunosuppressive medication or anything which reduces your immunity, then it is particularly important that you should protect the surface of your eyes.
There is no real way to protect cancers at the back of the eye, although seeing an optician every two years can often pick up small suspicious lesions at a very early stage. Some of the largest tumours that we see in the eye cancer clinic are patients who have either never been to an optometrist or only go every five to ten years.
What does a typical day look like for the oncology team?
A typical day for the eye cancer team often starts with the morning briefing to see how many new patients and how many follow-ups will be in clinic. The team who are operating that day will start with the morning huddle and prepare the operating list. The clinical nurse specialist will also look through all the new patients to see what the likely outcomes will be, and how many operating dates will be required.
Can you share a case that your team were particularly proud to work on?
We were particularly proud to work on the case of a young lady who came in just before Christmas, via the A&E department, who was found to have lumps at the back of both eyes only a few weeks after giving birth.
She was very distressed, and we were delighted to be able to assist her by trying to make everything as smooth as possible.
I managed to talk to colleagues in various hospitals across London to ensure she would get all the scans and tests done in a timely manner and to get a final diagnosis. I was delighted and amazed that all of this took place in just a few days and that she was admitted for treatment very quickly thereafter.
We are so lucky in London to have almost every specialty available to us, and every special specialist who gave up their time freely and happily to expedite this lady's treatment. You don't often read about these positive stories in the press, but I am very proud of the work of my team and cancer specialists across London.
video transcript
Can you tell me a little bit about some of the signs and symptoms that you may need to look out for if you're worried that you may have eye cancer?
The main problems, with sun exposure in particular, are lumps and bumps on the surface of the eye. Particularly if you haven't worn sunglasses you don't typically wear hats. If you see any pink fleshy lumps or any brown lumps, which have suddenly appeared, you need to get those checked out. So see your optometrist and get a referral to your local Eye Clinic if you have any new lesions suddenly appear on the surface of the eye, or the cornea, or your eyelids.
How can people protect their eyes from cancers?
The best way to protect your eyes from cancers on the surface of the eye is to protect them with a pair of ultraviolet polarized sunglasses. Sunglasses are an excellent way of reducing the ultraviolet stimulation onto the surface of the eye, in the same way that wearing sunscreen is a really good way to protect your skin. The larger the better what even better if they wrap around, particularly if you're sitting driving all day, with sun coming in from the sides of your vehicle. So, large sunglasses with a bit of wrap around is the best way to protect the surface of the eye.
For cancers inside the eye, those tend to be invisible, and this is why it's absolutely essential for all adults to be seeing the community optometrist at least every two years for an eye health check. If you haven't seen your optometrist in the last two years, make an appointment. Optometrists are they're like GPs for eyes. They can have a look at the health of the eyes and if they find anything then they will refer you on. And indeed, most lumps and bumps and including cancers that we find at the back of the eye are actually detected by a community optometrist. So, please get an eye check every two years.
Why did you decide to specialise in ocular oncology?
The decision was made for me. I wanted to be a neurologist but my first SHO job was in neuro ophthalmology at the Royal London. I enjoyed this but discovered that when I was covering the oncology patients, I found it more interesting. I developed a fantastic relationship with the director at that time, the late John Hungerford.
My present colleague Amit Arora was also there at the time, and I really enjoyed working with them both. It led me away from neuro ophthalmology into ocular oncology.
Most days it is diagnostically challenging. Melanoma in the eye and on the surface of the eye are usually quite straightforward to diagnose, however when we see patients where the cancer has spread into the eye, or cases of ocular lymphoma, those can be very diagnostically challenging. It is like being a detective some days.
What is something that may surprise people to learn about working in ocular oncology?
Something that may surprise people is that many ocular cancers are very straightforward to treat with excellent outcomes. It is important that we detect tumours both on the surface of the eye and at the back of the eye at the earliest opportunity. I cannot stress enough how important it is for all adults to see an optometrist at least every two years, and annually if there is a family history of oculus surface cancer or cancer at the back of the eye.
