Retinoblastoma: When cancer robs young children of their sight

Muhammad, 6, an eye cancer patient at the Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, stared blankly with his right eye as people approach his bedside. His left eye protrudes from its socket with sight in the affected eye noticeably obstructed. His mother, Iya A’i said they first noticed redness and swelling in his eyes. […]

Muhammad, 6, an eye cancer patient at the Usmanu Danfodiyo University Teaching Hospital (UDUTH) Sokoto, stared blankly with his right eye as people approach his bedside. His left eye protrudes from its socket with sight in the affected eye noticeably obstructed.

His mother, Iya A’i said they first noticed redness and swelling in his eyes.

The Consultant Paediatrician at UDUTH, Dr Paul Ibitoye, confirmed that Muhammad was diagnosed with retinoblastoma, a rare form of cancers that rapidly develops from immature cells of the retina. The common cause of the disease is marriage within the same family and that it is usually seen in children below the age of five years, he said.

Explaining the signs of retinoblastoma, Dr Ibitoye said “Excessive tearing, the eye will be bringing out water, then the cat eye or red eye reflex, when you don’t respond well, there is blindness. The child won’t be able to see with the affected eye, then a tumour comes out of the eye. 

“Commonly, if they presented when the child started having excessive tearing or the cat –eye or red-eye reflex, at that time it is totally curable,100 percent, but our people will not come until they have wasted their little money and the tumour has come out of the eye, at that time it is almost impossible to cure.”

The medical expert pointed out it is a very simple tumour, “In fact, in the western world, once you see a child that has cat-eye reflex, that is  you look at the eye and  see a shining small spot inside the eye (we call it cat eye reflex), it shows there is a tumour inside the eye. So once you see that, all you need to do is just go to the hospital, they will confirm it and then they will kill it from inside the eye and the eyes will be preserved. But here, once they see that, they go to the traditional doctor and they start putting a lot of things, the tumour will now start growing from inside the eye until it comes out from inside it.”

He stressed that once it comes out, the eye is dead. “The point is that as it is coming out, it is also growing inside to other parts of the body, it can enter from the back of the eye, to the head, to the skull, it can enter to the blood and then spread to other parts, the intestine, liver, heart, so once it comes out of the eye, that means you have to remove the eye and put the patient on chemotherapy,” he further explained.

On treatment, the consultant  said if the child is presented early and taken to a good centre, they carry out a procedure called  Laser Therapy to destroy the tumour inside and the eye will still remain intact. 

But once it breaks out of the eye, medical experts first of all do a procedure called fine needle biopsy to confirm if it is retinoblastoma and then do some investigations. 

After the first or second use of the drug, he said the ophthalmologist will remove the bad eye.

He said: “We have to remove the tumour in the eye. In a good centre, they can put prosthetic eye there, of course the eye cannot see but it gives cosmetic effect unlike leaving the place empty. 

“What we do here is we just remove the eye and leave the socket because they cannot even afford the treatment. Most of the time, we even have to feed them ourselves and buy the drug for them because the drug is expensive. Usually they have to go through about six to 10 courses every month.”

Dr Ibitoye explained that each course may cost about N10,000 to N15, 000. Some may be fully cured after the chemotherapy but some may continue to have recurrence until the child dies from the tumour. If it has spread to other parts of the body it is more difficult.”

He said about 60 percent, that is six out of every 10 cases of the disease is congenital (hereditary), because their parents intermarried, and they carried the gene. “You need two people with the same gene, just like sickle cell,” he added.

He said cases are also common among children from poor families and children that are malnourished.

To prevent the condition, he advised people to avoid intra-family marriage, that  is marrying from the same family, as that cuts down the incident drastically.

He also advised people against saying it is caused by  spirit and not a hospital issue. 

“When you have cases like this, don’t go to see the traditional doctors,  it is not spirit, just present it as early as possible in the hospital; once you come early to the hospital, we can salvage the eye, it can be cured fully without problem,” he stated.