Sep 9, 2014

Interview Transcript

Interviewer: What exactly is mole mapping, and what can it do for you? We'll explore that next on The Scope.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: Dr. Doug Grossman is an expert in early diagnosis and treatment of skin cancers at Huntsman Cancer Institute and also head of the Mole Mapping Program. That name intrigues me. What is mole mapping?

Dr. Grossman: This is a unique program that we've offered at the Huntsman Cancer Institute for the past ten years, and essentially it involves taking full-body photographs of your skin. This is for patients who are at high risk for melanoma. Either they've had melanoma, it runs in their family, or they have lots of moles or what we call atypical moles. The most sensitive indicator for early melanoma is a change. The only way we can know that a lesion is changing is if I compare it at two points in time. So patients come in and we get the photographs just once. That serves as a baseline, and then at future visits we can refer to these and confirm that given moles are stable and detect changing moles.

Then we educate patients and family members to use these photographs, and then we provide them to them to use at home. So patients are checking at home and they're also seeing us, and we've detected a lot of melanomas at an early stage. I think equally important, we've avoided a lot of unnecessary biopsies and surgeries because we can confirm spots aren't changing; we don't need to remove them.

Interviewer: Before mole mapping, what did you do?

Dr. Grossman: Well, when I first came here and we didn't have total body photography, I used to take photographs of individual areas of the skin where there were moles, again with the idea being that I'm trying to monitor individual moles. At the same time, we started taking high resolution photographs of individual moles, although about ten years ago we realized that wasn't the best approach.

Our studies have shown that most melanomas in fact don't evolve from moles. They develop in the normal skin. Only about maybe 30% of melanomas will arise from moles. So if you're only checking the moles, you're going to miss a lot of the new melanomas that are arising in the normal skin. So we really needed a total body approach, so we switched to full body photography and we've been doing that ever since.

Interviewer: If somebody took that tool away from you, would you be seriously hindered in what it is you are able to do for your patients, do you think?

Dr. Grossman: I would. Having a photograph gives me a huge advantage when I'm examining a patient. If I don't have a photograph, then really one is just guessing about which mole might be changing or be particularly suspicious.

Interviewer: You said it's a unique program to Huntsman Cancer Institute. Why aren't other places doing it? It seems pretty simple to take a picture of the body.

Dr. Grossman: It is simple, but it's expensive. We have to have someone available to take the pictures who's trained to do that, we have to have the equipment to take the pictures, we have to have the IT support to securely archive all the photographs from thousands of patients, and so it's not something that one could provide in an office space practice and have it be profitable. But through the support from the Cancer Institute, we're able to provide this to patients who come here.

Interviewer: How many lives do you think it has saved?

Dr. Grossman: Well it's hard to answer that question.

Interviewer: Sure.

Dr. Grossman: I do know that we've detected a lot of melanomas that patients were not aware of when they came in, and we were able to tell that from the photography. As I said earlier, also avoiding unnecessary procedures. Hundreds of thousands of lesions we avoided having to biopsy because I was able to confirm from the baseline photograph that there was no change.

Interviewer: Yeah. I think that's one of the big discussions in medicine right now: how do we avoid some of these unnecessary procedures that cost thousands of dollars.

Dr. Grossman: Right.

Interviewer: If somebody's looking for more information on mole mapping, to decide if it's something they're interested in, where can they get that information? We provide some basic information on the Huntsman Cancer Institute's website. If you go to that website and search "mole mapping," you'll find information we've provided.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.


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