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The majority of children in the United States
(over 95%) survive the cancer and have perfectly normal lives. All
the children with unilateral retinoblastoma have one normal eye
whose sight is not affected even though they may have had one eye
removed. Children with one eye have normal vision, play sports,
and later drive cars. It is, however, especially important for children
with vision in only one eye to wear protective eyewear during sports
and other hazardous activities. These children grow up and become
famous actors, physicians, lawyers, nurses, accountants, and parents
themselves.
The majority of children
with bilateral retinoblastoma retain at least one eye with good
vision and many are able to retain the use of both eyes. They also
live normal lives, go to school, enjoy life, have careers and have
families themselves. However, all children with bilateral disease
and the 15% of unilateral patients who have the familial form of
retinoblastoma will be at much higher risk
for other cancers not involving the eyes throughout their lives.
Five years after the initial diagnosis of retinoblastoma, more children
with the genetic form of retinoblastoma have died from these second
tumors than from the original retinoblastoma. The most common second
tumors are osteogenic sarcoma, a cancerous tumor which affects the
bones, soft tissue sarcomas, and cutaneous melanomas (tumors of
the skin, muscle and connective tissue). Although the reported incidences
of these tumors vary widely, the risk appears to be about 1% a year.
This risk is also increased by the use of external beam radiation,
although the amount of increase depends on the age at which the
child was treated.
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Follow-up appointments are very important when
a child is diagnosed with retinoblastoma. All children should be
followed by an ophthalmologist and by a pediatric oncologist. Frequency
of examinations depends upon the age of the child, the ophthalmologist's
suspicion of new tumors, the involvement of one or both eyes, and
the type of treatment that the child has received. Mothers and fathers
are encouraged to talk to the nurse and to call with questions between
visits.
Many parents meet other parents in the waiting
room of the phyisician's office, clinic, or hospital who also have
children with retinoblastoma. Some have found it very helpful to
talk to other parents who share similar concerns. Some institutions
have newsletters or formal support groups for parents of children
with retinoblastoma. Finally, some institutions have programs which
can make a child's return to school, home, and the community a bit
easier.
Retinoblastoma is a life-threatening disease,
but it is rarely a fatal one if treated appropriately. With the
correct treatment in the hands of an experienced ophthalmologist
and appropriate follow-up both for eyes and for other cancers, the
retinoblastoma patient has a very good chance of living a long,
full, and happy life.

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