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Genetic Discovery Creates Anxiety
This past week I have been attending a national conference of eye specialists. It's a real hodge-podge of scientific presentations (new and rehashed material), technical displays, professional networking, and a few social gatherings.
At the end of such a meeting I usually depart enthused and energized - as if my 'doctor batteries' had just been recharged.
This year I went home worried.
Uveal melanoma is the most common malignant eye tumor. Roughly one-third of those affected die from their disease. Nobody has a clear answer on how best to treat this disease. There are many treatment options, and that typically means there is no single best way to cure the tumor.
Ruptured appendix? The recognized treatment is to remove the appendix. It works.
Uveal melanoma? There's observation, surgery, radiation, laser, chemotherapy, thermal treatment, cryotherapy, and any combination of the above.
About the one-third who do not survive, we now know who they are. Gene researchers have discovered the signaling protein that causes the tumor to spread. Tumor survivors do not have the gene and do not produce the signaling protein.
Now, who wants to know? The debate has started.
Should doctors inform patients that the gene test will soon be available? Other than estate planning I'm not sure what good would come from burdening the hopeful patient with such tragic news. Certainly, patients have the right to decide the course of their treatment and that includes the application genetic prognostic markers. I get it. Nevertheless, it is such a brutal death sentence. I think physicians and families should approach such disclosures with the most thoughtful sensitivity to the patient's true preferences.
What do you think? Would you want to know? Drop me a line here or at our WebMD Vision & Eye Disorders Message Board.
Related Topics: Intraocular (Eye) Melanoma, What You Need to Know About Melanoma
Technorati Tags: uveal melanoma, intraocular melanoma, genetic testing
At the end of such a meeting I usually depart enthused and energized - as if my 'doctor batteries' had just been recharged.
This year I went home worried.
Uveal melanoma is the most common malignant eye tumor. Roughly one-third of those affected die from their disease. Nobody has a clear answer on how best to treat this disease. There are many treatment options, and that typically means there is no single best way to cure the tumor.
Ruptured appendix? The recognized treatment is to remove the appendix. It works.
Uveal melanoma? There's observation, surgery, radiation, laser, chemotherapy, thermal treatment, cryotherapy, and any combination of the above.
About the one-third who do not survive, we now know who they are. Gene researchers have discovered the signaling protein that causes the tumor to spread. Tumor survivors do not have the gene and do not produce the signaling protein.
Now, who wants to know? The debate has started.
Should doctors inform patients that the gene test will soon be available? Other than estate planning I'm not sure what good would come from burdening the hopeful patient with such tragic news. Certainly, patients have the right to decide the course of their treatment and that includes the application genetic prognostic markers. I get it. Nevertheless, it is such a brutal death sentence. I think physicians and families should approach such disclosures with the most thoughtful sensitivity to the patient's true preferences.
What do you think? Would you want to know? Drop me a line here or at our WebMD Vision & Eye Disorders Message Board.
Related Topics: Intraocular (Eye) Melanoma, What You Need to Know About Melanoma
Technorati Tags: uveal melanoma, intraocular melanoma, genetic testing
