Allison Dashow’s Journey with Rare Ocular Melanoma

Allison Dashow often hears people suggesting she should try her luck at the lottery, especially after being diagnosed with a cancer that affects only six in a million individuals. Perhaps there’s some truth to that, considering her surprising journey began with something that seemed minor.

Residing in New York, she didn’t think much of the intermittent pain in her left eye that started in April 2022. After all, she had a history of dry eyes and figured it was nothing serious. “I just thought it would probably go away,” the 29-year-old reflected.

Fast forward two months, when, after earning her doctorate in psychology, she casually mentioned her eye pain to her therapist. This proved to be pivotal, as her therapist insisted on a doctor’s visit. “It’s your eye; you should definitely take that seriously,” she recalled her therapist advising her. Ironically, Allison had always prided herself on being proactive about her health, but she hadn’t taken this pain seriously, perhaps because it was mild and sporadic.

Once she reached out to her local optometrist, she was urged to come in immediately. The doctor checked her out and said everything appeared normal, but he did notice some fluid buildup behind her retina and referred her to a specialist.

After a few scans, including an ultrasound at the retina specialist’s office, the doctor seemed intrigued. “This is very interesting. I want to bring in my colleague,” he said. Not exactly what you hope to hear. She felt a bit uneasy thinking, “I don’t want to be the interesting case.” When the colleague arrived, they asked numerous questions about her symptoms and family history.

“The good news is it’s not eye cancer,” they finally told her. Relief washed over Allison, “Great; I didn’t even know that was an option, so I’m glad to hear it.”

Initially, she was diagnosed with choroidal neovascularization (CNV), where abnormal blood vessels grow in the choroid, potentially harming the retina. Typically, CNV occurs due to age-related factors or other health conditions that Allison didn’t have.

Doctors advised starting injectable treatments right away. However, she opted for a second opinion. A week later, with another doctor, she underwent more scans.

This new physician diagnosed her with ocular melanoma without needing a traditional biopsy. It was specifically choroidal melanoma. “That was obviously a huge shock, because I didn’t go into that appointment expecting to hear that,” she recalled.

Each year, about 2,000 people are diagnosed with ocular melanoma, which is indeed quite rare—affecting just six in one million Americans annually. Although skin melanoma is more common, this type of cancer also begins in the melanocytes, the cells that produce pigment.

Dr. Tate Kirk, an interventional radiologist, explained to Allison that ocular melanoma is not widely recognized. “Most people have heard of skin melanoma, but not this one,” he noted, highlighting that fair-skinned individuals may be more at risk. Interestingly, Allison does have a fair complexion, yet her eyes are not blue.

The exact cause of ocular melanoma remains elusive, and while sun exposure is linked to skin melanoma, its impact on eye cancer is still unclear. After her diagnosis, her doctor recommended a laser treatment plan, but she sought further insights.

“This is a very serious cancer,” Allison stated, realizing she hadn’t fully comprehended its severity. After researching, she heard Dr. Paul Finger, an ocular oncologist in New York City, mention that he doesn’t endorse laser treatment, citing higher recurrence rates.

Seeking his opinion, Allison ended up receiving plaque brachytherapy on June 30, 2022. This method, a standard treatment since the 1990s, involved placing a radioactive plaque on the back of her eye for seven days to eradicate the tumor. After this period, the plaque is taken out, and the tumor is considered dead.

About six months post-treatment, her oncologist confirmed her tumor was gone, and she has since been classified as NED (no evidence of disease). She remains under Dr. Richard Carvajal’s care for routine check-ups.

However, in 2023, she encountered radiation retinopathy, a common consequence of plaque brachytherapy that affects about half of the patients. This slow-progressing disease damages retinal blood vessels and can lead to other serious conditions like glaucoma. Although there’s no cure, Allison receives injections every five weeks in her left eye to manage her vision.

Now, three years post-diagnosis, Allison is committed to raising awareness about this rare cancer. She will receive the Courage Award from the Melanoma Research Foundation at this month’s annual gala. Her connection with MRF blossomed as she sought to promote understanding of ocular melanoma, helping her find a community of like-minded individuals.

“It’s such an incredible organization,” she remarked. “Without them, I might never have met anyone with this cancer, so I’ve found immense gratitude for MRF.”

Dr. Kirk is also being honored as he receives the CURE OM Vision of Hope Award for his pioneering work with patients dealing with disease spread to the liver.

Reflecting on how her diagnosis has affected her life, Allison shared, “I remind myself that while I carry this heavy burden and grapple with uncertainty, I still have a wonderful life filled with family, friends, and work.”

She emphasized that while it’s crucial to acknowledge the challenges, she prefers to approach life positively. “I choose to accept what I’ve been dealt and try to focus on living day by day. It’s forced me to be more present, and I think that’s a silver lining.”