Treatments for lymphoma of the eye

The following are treatment options for lymphoma of the eye, including orbital adnexal lymphoma and intraocular lymphoma. Your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan.

If you have non-Hodgkin lymphoma (NHL) of the eye, your healthcare team may offer treatments usually used for that type of cancer. Find out more about treatments for non-Hodgkin lymphoma.

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is the standard treatment for lymphoma of the eye.

External radiation therapy is the most common type of radiation therapy used to treat lymphoma of the eye. Radiation is usually given to both eyes and to the central nervous system (CNS) to help destroy cancer cells that may have spread. External radiation therapy is delivered using a machine outside of the body. The technique used for lymphoma of the eye is called stereotactic radiosurgery.

Radioimmunotherapy (RIT) combines radiation therapy with a monoclonal antibody, which specifically targets cancer cells. The monoclonal antibody delivers the radioactive substance that is attached to it to the tumour. RIT is given through a needle into a vein (intravenous). The drugs used in RIT are also considered targeted therapy drugs. A type of RIT called yttrium-90 (Y-90) ibritumomab tiuxetan (Zevalin) may be offered for lymphoma in the uvea or adnexal structures. Very few people will have RIT for lymphoma of the eye.

Find out more about radiation therapy for eye cancer.

Chemotherapy uses drugs to destroy cancer cells. Lymphoma of the eye is sometimes treated with chemotherapy.

There are several different ways to give chemotherapy. Some chemotherapy drugs will be given through a needle into a vein (intravenous) or as a pill taken by mouth. These drugs travel through the blood to reach and destroy cancer cells all over the body, including cells that may have broken away from the primary tumour. This is described as systemic therapy. Other chemotherapy drugs will be given by a needle into the eye’s vitreous humour (called intravitreal) or the cerebrospinal fluid around the eye (called intrathecal).

You may have the following chemotherapy drugs:

• methotrexate
• cytarabine
• thiotepa
• chlorambucil
• vincristine
• cyclophosphamide
• etoposide
• lenalidomide
• temozolomide

You may also have the chemotherapy drug combination CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone).

Sometimes chemotherapy for lymphoma of the conjunctiva may be given as eye drops (a form of topical chemotherapy). You may be given the following drugs as topical chemotherapy:

• mitomycin C
• fluorouracil (also called 5-fluorouracil or 5-FU)

Find out more about chemotherapy for eye cancer.

Immunotherapy helps to strengthen or restore the immune system’s ability to fight cancer. You may be offered immunotherapy for lymphoma of the conjunctiva. The drug interferon alfa-2b (INF2b) is usually given as eye drops directly to the eye.

Find out more about immunotherapy for eye cancer.

Targeted therapy uses drugs to target specific molecules (such as proteins) on cancer cells or inside them to stop the growth and spread of cancer. In very rare cases, targeted therapy is offered for lymphoma of the eye.

You may be given the targeted therapy drug rituximab (Rituxan and biosimilars) for lymphoma of the eye. This drug can be given through a needle into a vein (intravenous) or directly into the eye (intraocular).

If you have radioimmunotherapy (RIT) for lymphoma of the eye, you will have yttrium-90 (90Y) ibritumomab tiuxetan. This is a type of targeted therapy that delivers radiation therapy directly to the cancer cells. It is given through a needle into a vein.

Find out more about targeted therapy for eye cancer.

Talk to your doctor about clinical trials open to people with eye cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

You may want to consider a type of care to make you feel better without treating the cancer itself. This may be because the cancer treatments don’t work anymore, they’re not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you can’t have or don’t want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.