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Intermittent testing after ocular tumor removal may not be useful for patient, physician
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WAILEA, Hawaii — Intermittent testing after ocular tumor removal does not affect long-term life expectancy for patients who experience metastasis, but rather puts the patient and physician under unnecessary strain, a speaker said here.
 James J. Augsberger |
"Conventional practice of surveillance testing for metastasis and aggressive treatments of limited sub-stage metastasis are not justified by any currently available clinical evidence," James J. Augsberger, MD, said at Retina 2009. "Until that evidence is there, it makes absolutely no sense to blindly go along and get the surveillance testing done because it gives them false reassurance and does not give us the benefits we would like to have."
Traditionally, Dr. Augsberger said physicians complete a baseline metastatic search before ocular therapy, provide therapy, recommend periodic systemic surveillance for metastases and treat them if detected. This surveillance can be in many forms, from blood tests to chest X-rays to ultrasounds.
Although this seems to assure the patient and other physicians such as oncologists that there are no imminent problems, survival after detection is still dismal, he explained.
Generally, patients have less than 6 months after detection of metastasis. Median survival after symptomatic metastasis, which does not require periodic testing, is approximately 3 months to 4 months.
"Even with the most aggressive treatments, survival is about 10 to 12 months in asymptomatic patients," Dr. Augsberger said. "For doing all that surveillance testing, we provide that limited and extremely ineffective amount of time lengthening."