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LETTER TO THE EDITOR
Year : 2015  |  Volume : 52  |  Issue : 2  |  Page : 180-181
 

Trends of reported cases of retinoblastoma post-enucleation seeking prosthetic rehabilitation: Few annotations


Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University UP, Lucknow, Uttar Pradesh, India

Date of Web Publication5-Feb-2016

Correspondence Address:
H Aggarwal
Department of Prosthodontics, Faculty of Dental Sciences, King George's Medical University UP, Lucknow, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-509X.175807

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How to cite this article:
Aggarwal H, Kumar P. Trends of reported cases of retinoblastoma post-enucleation seeking prosthetic rehabilitation: Few annotations. Indian J Cancer 2015;52:180-1

How to cite this URL:
Aggarwal H, Kumar P. Trends of reported cases of retinoblastoma post-enucleation seeking prosthetic rehabilitation: Few annotations. Indian J Cancer [serial online] 2015 [cited 2020 Jul 12];52:180-1. Available from: http://www.indianjcancer.com/text.asp?2015/52/2/180/175807


Sir,

We appreciate the authors of the articles entitled “Trend of reported cases of retinoblastoma under five hospital based cancer registries” and “20-year trends of retinoblastoma under five hospital-based cancer registries: Few observations” for putting forth their valuable perspectives regarding efficacy of reporting of retinoblastoma cases in India.[1],[2] Sachdeva [1] reported that retinoblastoma was the 4th most common childhood cancer with slight male preponderance with 1474 cases registered at five hospital based cancer registries in 20 year period (1984-2003) i.e., average 14.74 cases/year/center. We agree with Khetan and Sengupta [2] that the total number of retinoblastoma cases has been underestimated and there are a high proportion of unreported cases. The status of reporting and follow-up of retinoblastoma cases has increased manifolds, after Indian Council of Medical Research (ICMR) initiated National Retinoblastoma Registry Project in 2009; as is evidenced by records of our center, which reported 101 cases in a period of 3 years and 5 months (2008-2011).[3] However, there is an extreme paucity of any records related to the prosthetic rehabilitation of retinoblastoma patients with enucleation.

In a developing country like ours, the high-cure rates of 90% in retinoblastoma are not replicated and most of the cases are usually advanced at the time of detection, mandating enucleation. Just treating the patient for cancer is not enough; the rehabilitation with an ocular prosthesis is equally important and it should always be an integral part of their treatment, to help them reintegrate in the esthetic conscious society.[4] Being prosthodontists, struggling to raise the awareness of medical fraternity and the patients regarding the importance of prosthetic rehabilitation post-enucleation; we realized that, just mentioning that the ocular prosthesis can be given 4-6 weeks following enucleation in the National Guidelines for Management of Retinoblastoma by ICMR in 2010; doesn't really address the issue of the need and advantages of ocular prosthesis.

Enucleation during infancy leads to underdeveloped bony orbital growth, cosmetic deformity, facial asymmetry and psychological distress to the patient and the family. Ocular prosthesis not only fulfills the aesthetic and psychological demands, but also stimulates bony orbital growth and restores facial symmetry. In Indian scenario, where even a minor deformity is considered as a stigma; not having an eye is associated with myths and patients become victims of negative comments and stares of their own people. Most of our patient's parents report that after enucleation [Figure 1], neither is their child going to school nor to any social gatherings; indicating a sort of social boycott. After prosthetic rehabilitation [Figure 2], almost all of our patients joined their schools back and resumed their normal playful lives.
Figure 1: Pre-prosthetic view after enucleation of right eye

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Figure 2: Prosthetic rehabilitation with ocular prosthesis

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The repercussions of retinoblastoma, its treatment, and its outcome are felt throughout the life of the patient and his/her family, so providing the patient with ocular prosthesis is a highly positive approach for rehabilitation. Hence, it's a humble appeal to the concerned authorities to make it mandatory for all the centers dealing with retinoblastoma, to keep records and a follow-up of cases post enucleation, for prosthetic rehabilitation also.

 
  References Top

1.
Sachdeva S. Trend of reported cases of retinoblastoma under five hospital based cancer registries. Indian J Cancer 2010;47:473-4.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Khetan V, Sengupta S. Tw enty-year trends of retinoblastoma under five hospital-based cancer registries: Few observations. Indian J Cancer 2011;48:371-2.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.
Kumar A, Moulik NR, Mishra RK, Kumar D. Causes, outcome and prevention of abandonment in retinoblastoma in India. Pediatr Blood Cancer 2013;60:771-5.  Back to cited text no. 3
    
4.
Aggarwal H, Kumar P. Orbital retinoblastoma: Prosthetic frontier. J Can Res Ther [Epub ahead of print] [cited 2015 Jan 23].  Back to cited text no. 4
    


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