Plaque Radiotherapy

When you undergo plaque radiotherapy, a small, thin metal disc — usually the size of a 10-pence coin (although this can differ) — is temporarily attached to the surface of the affected eye, overlying the cancer cells.

How is plaque radiotherapy given?

You will have two surgeries when getting plaque radiotherapy.

• In your first surgery, the plaque is placed in your eye. This surgery will last approximately 45 minutes.
  The plaque will then be attached to your eye for one to several days, depending on the radiation dose required. You will need to stay in the hospital for this period.

• You will undergo your second surgery a few days after the plaque has been placed in your eye. This surgery lasts approximately 25 minutes and is done to remove the plaque.

Your doctor will perform both operations under anaesthesia. You may either be given a general anaesthetic, where you are completely asleep during surgery, or a local anaesthetic with deep sedation, where you are very sleepy but not totally asleep.

In both situations, you should feel no pain or discomfort during your surgery.

Is plaque radiation safe?

The radiation does not cause harm to people around you. But you may still be asked to isolate in your room or only have visitors briefly, until the plaque is removed from your eye. Radiation safety guidelines may vary between treatment centres.

Although the radiation level of your plaque is low, it is recommended that pregnant women and children not be exposed to it.

Below, we’ve included practical advice from people who have undergone plaque radiotherapy to help you through the isolation. We also provide a list of side effects you may have from treatment.

How long will my treatment last?

Your treatment length is calculated by various factors like your tumour:

• type
• size
• location
• and the strength of the plaque being used for treatment.

The exact duration will be tailored to you and your tumour – your healthcare team will inform you of this.

Your hospital stay may last 2 to 7 days, after which the plaque is removed and the eye is given time to heal.

What is the plaque made of?

The plaque is made from silver, with the inner lining having a radioactive ruthenium layer.

What side effects should I expect?

Plaque radiotherapy is widely used for treating eye cancers.

Because this treatment is very precise, it does not damage healthy tissues beyond the eye, and it does not cause hair loss, diarrhoea, or other symptoms caused by well-known treatments used to treat other cancers.

But, this treatment can still cause some side effects with varying intensity. For example, you may experience some vision loss in your treated eye. You may also feel pain, irritation, itchiness, and dryness in the treated eye. Your doctor/specialist nurse will prescribe eye drops and painkillers to help with these symptoms.

Some people may experience some double vision (called diplopia) which is usually short-lived. If you experience any double vision, you should avoid driving and let your team know if it continues. Regular use of ice packs for short periods following surgery can help with swelling and discomfort.

Your care team will give you a more thorough list of side effects you may experience post-treatment.

Depending on your overall health, you may also have some rarer side effects. Most of these symptoms subside with time but, for some people, some level of vision loss can be permanent. Your team may be able to guide you on whether any vision loss may affect your central or peripheral vision in the treated eye.

Only specialist doctors in the UK perform this form of surgery — and they have expert teams to manage side effects.

No matter what your symptoms are, and how long you’ve been feeling them, please contact your care team about how they can help you.

How can I prepare for plaque radiotherapy?

This page includes questions about:

• Preparing for your hospital stay and other appointments
• What to expect while you’re at the hospital
• Other practical tips from our patient community

What can I expect beyond treatment?

This page answers questions like:

• Will I continue to have health check-ups?
• How do I know if my treatment worked?
• How soon can I get back to work?
• Can I continue to drive?
• What’s my prognosis?
• Is there a way to know if my cancer will return?

Where can I get more support?

This page signposts you to places where you can find further support:

• Your medical team
• Cancer charity helplines you can call
• Specialist psychologists
• Your employer
• Eye Clinic Liaison Officers (ECLOs)
• Other resources