Your child should be treated by an ophthalmologist and oncologist who work together to plan and deliver care.
When cancer is contained in the eye, the ophthalmologist (eye doctor) leads the medical team.
When cancer has spread outside the eye, the oncologist (cancer doctor) will lead the team.
Specialists in Retinoblastoma Care
Wherever possible, your child’s care should be led by a paediatric ophthalmologist / oncologist. These doctors specialize in caring for children.
Your child will usually be referred to a specific ophthalmologist with experience in treating children or eye cancer. At retinoblastoma centres of excellence, the ophthalmologist usually works with a specific oncologist. A general paediatric oncology centre may assign your child to the senior oncologist on call when your child is admitted.
Your nearest specialist retinoblastoma centre may be a long way from home, but it is vital your child be treated by doctors experienced in retinoblastoma. This is especially true if your child has bilateral, extraocular or trilateral retinoblastoma, or very small unilateral tumour/s.
Sometimes your child will be referred to the nearest paediatric oncology centre. This hospital may have an excellent reputation in treating children with cancer, and will likely be very able to remove an eye to save life. However, they may not have much experience with complex treatment such as eye salvage therapy, or chemotherapy for extraocular or trilateral retinoblastoma.
Questions to Ask the Doctors
Always ask the doctors to clarify what experience they have in treating children with retinoblastoma. Questions to ask include:
How many children do you treat each year with unilateral Rb?
How many children do you treat with bilateral tumours?
What is your success rate in saving eyes?
What treatments do you offer?
Do you consult with other retinoblastoma specialists?
Do you use a retcam to take photos of children’s eyes?
Is there a comparable Rb centre closer to home?
Identifying the Best Medical Team
You do not have the luxury of time in choosing your child’s doctors, especially if the cancer is advanced. Treatment must begin promptly to protect your child’s life, or give the best chance of saving sight if that is possible. However, you can take steps to ensure your child is receiving care from an appropriate team.
Most doctors who treat children with retinoblastoma are deeply caring, dedicated to their work and young patients, and very experienced. Here are the most important things to expect from your child’s doctors:
Board certified in ophthalmology or oncology
Always puts the interests of your child first
A good rapport with you and your child
Respectful and honest communication
Compassion when delivering difficult news
Clear, easy-to-understand explanations
Open to your questions, freely offering clear answers
Excellent medical skills
Shares results of all tests and explains them to you
If you choose not to consent to a particular procedure or treatment, you do not have to give a reason. However, explaining your reasons to the doctor or nurse can help them understand your concerns so they can give the best advice to protect your child.
You have the right to refuse treatment, but if the doctors feel this puts your child’s life at risk, they can request a court order for treatment. Your child’s welfare is paramount. If legal intervention is sought, both you and the doctors will have the opportunity to share your concerns.