Tuesday, May 20, 2008

Eye Cancer Visionaries

This fascinating little volume (only 121 pages), documents a symposium held to honor Dr. Willem Manschot, the 1979 recipient of the Snellen Medal, the Netherlands's award in ophthalmology.

In 12 short papers, uveal melanoma researchers such as Oosterhuis, Zimmerman and McLean, Manschot and van Peperzeel, among others, discuss clinical versus histopathological diagnosis, tumor doubling times, natural history cases, treatment modalities (enucleation v. radiation), metastatic disease and mortality rates, proposing theories confirmed by the Collaborative Ocular Melanoma Study (COMS), more than 20 years later.

What all these ocular oncologists have in common - despite their differences of opinion - are their incredible powers of observation and analysis and bold argumentation in challenging the assumptions about the causes of and treatment for uveal melanoma (also called choroidal melanoma, eye cancer, eye melanoma, ocular melanoma, intraocular melanoma or eye cancer).

Zimmerman's radical thesis, later disproved, that enucleation caused dissemination of metastatic disease, nonetheless forced a change in the standard of care from enucleation to globe-sparing plaque therapy.

Manschot's powerful argument about the risks of tumor doubling times on both primary and secondary disease progression, led to advocacy of earlier diagnosis of suspicious lesions and research toward chromosomes and prognostic molecular testing.

These visionaries not only anticipated the COMS results, but also the revolution in molecular biology. That invaluable historical perspective keeps this 30-year old book relevant today.

And their broad, well-read and multidisciplinary perspective has inspired current clinicians such as J.W. Harbour, C.L and J. Shields, Dan Albert, Hans Grossniklaus and Bruce Ksander among many others who will help us see the next revolution in uveal melanoma.

It’s your sight.

It’s your life.

Together, we can see a cure.™

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