At that city’s Ivey Eye Institute, the chief ophthalmologist asked for additional testing beyond the normal examination, with the staff working through their lunch to include an ultrasound and angioscopy in the series of tests. Once completed, the doctor called Maggie and her parents, mother Lenny and father Rob, for a consultation.
The results were terrifying. The chief ophthalmologist believed that the nevis was an active melanoma cancer tumour. There were two paths to consider: one was enucleation (removal of the eye) while the other was ophthalmic plaque radiation therapy. It was recommended that Maggie be sent to The Princess Margaret’s Ocular Oncology Clinic for further tests and subsequent treatment options.
Reeling from the frightening news, the Bain family retreated to their London home to discuss the future.
Just over a week later, the Bains arrived at The Princess Margaret for Maggie’s tests. An ophthalmologist examined the young lady and confirmed that she did, indeed, have a malignant melanoma cancer tumour in her right eye. The doctor further informed the family that the tumour was contained solely in the eye and was quite treatable.
At a subsequent appointment, the Bain family met Dr. Rand Simpson, the Director of Ocular Oncology at The Princess Margaret. Dr. Simpson confirmed the diagnosis of an active choroidal melanoma, which he was confident was confined to the eyeball. After showing the family various images, ultrasounds and angiograms, Dr. Simpson detailed two available treatment options.
One was to remove the eye and replace it with a prosthetic. In this scenario, the tumour would be eliminated completely. The false eye would closely resemble the other eye and would move in concert with the good eye. The other option was radioactive iodine plaque therapy. In that scenario, a 1 or 2 mm. 14 karat gold plaque or dish is seeded with radioactive iodine and then sewn onto the outside of the eyeball directly below the tumour and slightly overlapping it. The plaque is left in place for a week and then removed, after which time some of the cancer cells are killed outright and the remainder have had their DNA disrupted such that when they go to replicate, they fail and are destroyed. The tumour is expected to be eliminated in eighteen months to two years. Maggie’s tumour was a candidate for this type of therapy.
Confused and frightened, the Bains were exhausted physically and mentally. Together, they weighed the options carefully and repeatedly. The first decision favoured enucleation, believing that surrendering Maggie’s eye would save her life, but a dramatic turn in thinking changed the decision. Realizing that plaquing would not have been offered if there was any possibility that that decision would detrimentally affect the outcome, the family contacted Dr. Simpson’s office and confirmed that plaquing was the path which they would like to follow for Maggie.
Maggie’s appointment at the Ocular Cancer Clinic was made for October 28. After being admitted and examined, Maggie stayed overnight with her parents at The Princess Margaret. The surgery to install the plaque took place the next day, with the entire family waiting anxiously in the waiting room. Dr. Simpson confirmed that the procedure went well, but that Maggie was to stay overnight in the hospital to ensure that there were no complications from the anaesthetic.
Maggie was discharged from the Cancer Clinic early on October 30, sporting a lead eyepatch as a precaution to contain any errant radiation from the plaque. Maggie and her mother stayed in Toronto while her Dad, brother and uncle returned to London. On Hallowe’en evening, Maggie’s brother Jamie went trick-or-treating with two bags – one for him and one for his sister.
On November 5, the plaque was removed and the next day, Maggie was able to return home for the first time in 11 days. Life returned to some semblance of normalcy for the Bains. Maggie joined Jamie back at school, Rob, whose understanding employer had allowed him to work when Maggie’s health allowed, returned to work full-time and Lenny was able to return to teaching vocal lessons.
Follow-up appointments for Maggie have gone very well, and the family expressed surprise at the amount of sight she was able to retain in her eye. The tumour had stopped growing and, in fact, was smaller in size. Some of the fluid that had been collecting around the tumour had dissipated.
On-going examinations every three months will be in effect for Maggie until Dr. Simpson and his team see a difference in the size of the tumour, and further pictures of the tumour reveal that it is actually scarring and dying from the radioactive treatment received. Maggie and her family feel the road to her recovery is much less bumpy, thanks to Dr. Rand Simpson and his team of brilliant doctors and staff at Princess Margaret Hospital.