Understanding Uveal Melanoma
- Oprah’s former chef Sonny Sweetman, 53, experienced blurry vision for about six to eight weeks before he learned of his rare eye cancer diagnosis, called Uveal melanoma, which has since spread to his liver.
- The California-bound professional chef has since shared his story and is undergoing a newly-approved FDA treatment to fight the disease.
- About 1,500 to 2,000 people are diagnosed with it every year. And even after a first round of treatment, for about half of those diagnosed, the disease returns this time spreading to the liver.
- Tebentafusp (Kimmtrak) was recently approved by the Food and Drug Administration (FDA) to treat some people with melanoma of the eye, also known as ocular melanoma or uveal melanoma, whose cancer has spread or is not able to be treated with surgery. These patients previously had no approved treatment options.
- Other ways to treat Uveal Melanoma, according to the Melanoma Research Alliance, consist of radiation therapy, like Sweetman underwent, surgery, surgery, laser therapy, chemotherapy, and immunotherapy.
The 53-year-old professional chef, who resides in Redondo Beach, California, told TODAY.com in a recent interview that his symptoms began when he had trouble with his peripheral vision on his right side. About six to eight weeks later, as his blurriness persisted, he decided to see his eye doctor, who referred him to a retina specialist—and ultimately led to his diagnosis.
Read MoreAs Sweetman is continuing to undergo the innovative treatment, he remains grateful to continue living, working, and doing what he loves in the mean time.
A year after treatment finished, doctors found the cancer had spread to Sonny Sweetman's liver. But he received a new treatment for the Stage 4 cancer. https://t.co/xyE8L0Kbie
— TODAY (@TODAYshow) August 22, 2024
Recounting the start of his cancer journey to TODAY.com, Sweetman explained, “Things were just appearing on that right hand side when normally I would have seen them a while ago. I literally thought, ‘Hey, I’m getting older, maybe I need some new glasses.'”
His burry eyesight started up in 2022, but weeks went by before he saw his doctor. He explained, “I was like, ‘Glasses should fix that.’ But I was not correct,” later noting how he was incorrect as his doctor could see “something was wrong right away,” prompting him to see a retina specialist.
“I just had this sinking feeling. When [the retina specialist] looked at my eye he was like, ‘You don’t have an eye problem. We have to send you to the hospital,'” Sweetman added.
More Resources On Melanoma
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- Advances in Uveal Melanoma Treatment: Immunocore’s Chief Medical Officer On Their New Standards For Survival
A trip to the emergency room, where he underwent tests and scans, led to his melanoma diagnosis in April 2022, even though he had no family history of the disease.
As for the first treatment plan [a radiation patch which he wore for a week], Sweetman explained, “What they did is they use a patch, and it goes directly on your eye and it’s a measured dose of radiation.
“They put some type of oil solution behind the eye, so the radiation doesn’t go to other parts of the body. So, the radiation is really well contained. Over time, the radiation kills the cancer.”
Once the radiation patch was removed and the cancer was treated, Sweetman returned to work as normal and felt better. But 20 days later, he still experienced some trouble with his vision.
He said the blurry vision “is minimized but they’re not able to restore the vision totally … they were able to shrink the tumor … like taking a grape into the size of a raisin. But you’re still going to have the raisin. So, there’s a small spot in the corner of my peripheral vision in my right eye that’s still blurry.”
Following the radiation patch treatment, Sweetman was to undergo scans every three months to check for cancer recurrence or if it had spread. One year after his diagnosis, it was found to have spread to his liver, meaning it was stage four, uveal melanoma liver metastases.
After the patch therapy didn’t cure him, he underwent a minimally invasive, targeted therapy called Y90 Treatment (Radioembolization).
Columbia Radiology explains, “Y90 is a safe and highly effective treatment for cancer in the liver that targets tumors with a high dose of radiation without affecting other, healthy parts of the body. Columbia’s interventional radiologists were among the first to offer this treatment, and they have performed hundreds of Y90 procedures on patients with liver cancer or other cancers that have metastasized (spread) to the liver.
Y90 refers to the radioactive isotope yttrium90, which is inserted into tiny particles and used to deliver radiation directly to tumors via long, thin tubes called catheters. The treatment is not a cure for cancer in the liver, but it has been shown to prolong lives for months or years and to greatly improve the quality of life of cancer patients.”
However, when that wasn’t found to be successful for Sweetman, his doctors decided he should try a newly FDA-approved treatment called the Hepzato Kit, which sends high amounts of chemo into the liver through an artery, as it filters the medicine out of the blood.
As for how Sweetman feels on trying out a new form of treatment, he explained, “The surgeons made me feel very comfortable. I don’t get really nervous.
“I’m kind of analytical about it. If it’s going to help, if it’s the way forward I’m super excited and fascinated by the whole process.”
Sweetman told TODAY.com, “There’s certain things you shouldn’t do right away but as soon as that time period is over, I feel pretty normal. I have a pretty active job … I go right back to it.”
Now he’s embracing life more than ever, telling the news outlet, “You don’t want to make mistakes professionally or you don’t want to miss time with the family. Time isn’t infinite anymore. It’s finite … I’ve changed by appreciating things more, family and friends.”
All About Uveal Melanoma
A lot of people don’t realize it, but you can actually get cancer of the eye. So, eye health is another area that we should all be monitoring. Uveal melanoma is a disease that forms in the tissue of the eye. Unlike melanoma of the skin, uveal melanoma is not caused by UV rays from the sun … the cause of this disease is still being studied by researchers.
“It is a disease that happens the most frequently in Caucasians and it happens in patients with hazel, green, or blue eyes more frequently than brown eyes … though we’re not clear of the mechanism that protects darker iris individuals from melanoma,” Dr. Sapna Patel previously told SurvivorNet.
Possible risk factors for uveal melanoma include:
- Light skin and eye color
- Strong family history of cancers
- Personal history of cancer
- Certain mutations that cause familial uveal melanoma, such as BAP1, PALB-2, MBD4, or NF-1
- Choroidal nevus, a type of lesion in the back of the eye
- Ocular melanocytosis, another type of lesion in the eye
Even though the disease is rare, Dr. Sapna Patel, a melanoma oncologist at MD Anderson Cancer Center, recommends getting regular check-ups to monitor for uveal melanoma.
“Everyone should get dilated every year,” she said. “Even if you don’t need corrective lenses or glasses, contact lenses … it’s still important to have your eyes dilated and examined for physical changes such as melanoma or moles in the eye.”
If you do have any of the risk factors above or notice any changes in your vision, be sure to see an ophthalmologist as soon as possible. Early detection is key in treating any cancer, including uveal melanoma.
Advances in Uveal Melanoma Treatment
For decades there has been no change or advancement in treatment for those diagnosed with metastatic uveal melanoma. But thankfully, a new kind of immunotherapy recently developed by biotechnology company Immunocore is changing the standard for what survival looks like.
Uveal Melanoma is a rare cancer that is found in the middle layer of the eye. About 1,500 to 2,000 people are diagnosed with it every year. And even after a first round of treatment, for about half of those diagnosed, the disease returns this time spreading to the liver.
SurvivorNet previously spoke with Dr. Mohammed Dar, the Chief Medical Officer at Immunocore, to understand their new breakthrough treatment for metastatic uveal melanoma called KIMMTRAK (molecular name tebentafusp-tebn).
The treatment is a weekly immunotherapy that triggers the T-cells in your immune system to fight uveal melanoma tumor cells. With a 50% increase in survival for patients, it’s the first medication ever that has shown increased survival rates for the disease and it does so in a really novel way.
RELATED: How The FDA’s Approval of a New Immunotherapy Improves The Treatment of Eye Cancer
“What we did was to look at a simple blood test, which looks at the presence of tumor DNA,” Dr. Dar told SurvivorNet at the ASCO Annual Meeting. “What we found was that by week nine, among these patients who by CAT scans or MRI, there was no improvement in the size of their lesions, around 45% of patients had complete clearance of the tumor DNA in their bloodstream.”
So, to be clear, after taking KIMMTRAK for nine weeks, the lesions or tumors in these patients had not shrunk or disappeared. But the blood test showed that the tumor DNA was gone.
“When we looked at the survival of these patients who cleared their ctDNA blood, these are the patients who had the longest survival,” Dr. Dar said.
Could measuring tumor DNA over tumor shrinkage on skin be a new way of measuring treatment success rates? Dr. Dar thinks it is a possibility. And with the success of KIMMTRAK, he is very excited for future advancements in treatment for the disease.
“Historically, nothing had moved the needle, so no one really focused on it and now it’s shed light that there is actually hope,” Dr. Dar said. “There’s more treatments that people are now evaluating for metastatic uveal melanoma. So it’s a great time for research and development.”
KIMMTRAK is FDA-approved and to be eligible, a patient must be diagnosed with metastatic uveal melanoma or ocular melanoma. A patient also has to do a blood test to see if they have a special marker on the surface of their tumor cells called an HLA Allele.
Immunocore also announced at ASCO that they are expanding their research to see if KIMMTRAK could also be used to treat the most common melanoma skin melanoma or cutaneous melanoma. The new study will be launched in the United States and Europe.
Tebentafusp (Kimmtrak) was recently approved by the Food and Drug Administration (FDA) to treat some people with melanoma of the eye, also known as ocular melanoma or uveal melanoma, whose cancer has spread or is not able to be treated with surgery. These patients previously had no approved treatment options.
Dr. Jeffrey Weber, NYU Langone Health oncologist and melanoma specialist told SurvivorNet at the time that the approval is a “game-changer,” since the options went from nothing to something that has been shown effective.
Ocular melanoma can be difficult to diagnose since it often develops on part of the eye that can’t be seen. While most people don’t experience symptoms, those that do may find a dark spot on the iris (the colored part of the eye) or conjunctiva (the tissue covering the white of the eye) or experience blurred or distorted vision, a blind spot in side vision or the sensation of flashing lights. Ocular melanoma is often detected during a routine eye exam.
RELATED: Eye Cancer is Rare, But The Symptoms Are Not Always Obvious; Know What to Look For
“Uveal melanoma is a devastating disease that has historically resulted in death within a year of metastasis for our patients,” Dr. John Kirkwood, director of the Melanoma Center at the UPMC Hillman Cancer Center, said in a statement.
“The approval of (tebentafusp-tebn) represents a major paradigm shift in the treatment of metastatic uveal melanoma, and for the first time offers hope to those with this aggressive form of cancer.”
Other ways to treat Uveal Melanoma, according to the Melanoma Research Alliance, are:
- Radiation therapy: The most common treatment for uveal melanoma.
- Surgery: An possible option for small tumors that have not spread beyond the eye.
- Laser therapy: Laser therapy, using a high-energy beam of light to destroy cancer cells.
- Chemotherapy: An uncommon treatment for uveal melanoma, but it may help for advanced cases that have metastasized.
- Immunotherapy: A type of treatment using the body’s immune system to fight cancer. This may be used for advanced cases of Uveal melanoma.
Contributing: SurvivorNet
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