Search for tag: "u0260029"

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

Announcer: Health information from expects, supported by research. From University of Utah Health, this is TheScopeRadio.com.

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: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there’s a pretty good chance you’ll find what you want to know. Check it out at TheScopeRadio.com.

updated: May 21, 2019
originally published: September 9, 2014

Interviewer: Personalizing Treatments for chronic back pain. We'll talk about that next on The Scope.

Announcer: Health information from expects, supported by research. From University of Utah Health, this is TheScopeRadio.com.

Interviewer: You may have seen in stores swimwear or other types of clothing with UV protection built in. Is that a legit thing, or is it just a gimmick? We're going to find out right now.

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

Interviewer: We're with Dr. Doug Grossman. He's an expert in early diagnosis and treatment of skin cancers at Huntsman Cancer Institute. Let's talk about clothing with built-in UV protection. What do you know about that stuff? What gives it UV protection in the first place?

Dr. Grossman: Well I think anything that can block the UV rays from the sun is going to protect your skin and so I think it's important to try to cover up as much as you can and still be comfortable to protect these large areas of skin.

Interviewer: So let's talk about clothing that says that they have UV protection in them. What exactly does that mean, do you know?

Dr. Grossman: I think you have to look for a particular type of clothing for the type of activity you're going to be doing. If you're going to be on the beach or you're going to be in a pool, you want what I call sun-protected swimwear. It's basically something that you can wear in the water and you can also wear before you get in the water. It's going to essentially block all the UV rays. If you're getting any redness or tanning you know that some is getting through.

Interviewer: What blocks the rays in this type of clothing?

Dr. Grossman: Just the fabric.

Interviewer: It's the fabric? Just a tighter weave that just doesn't let light in?

Dr. Grossman: Right.

Interviewer: So does that mean that any clothing that has a tight weave would be just as effective?

Dr. Grossman: Just about. I tell patients that if they can hold the material up to the light in the room and still see through that, the pattern of the light bulbs for instance, then too much is getting through. Most clothing would be sufficient, but you want something, again, that is appropriate for the activity you're doing. So if you're going to be biking, then a biking jersey. Again, for in the water, materials that are made to get wet and be comfortable in the water. There are a number of companies that make these.

Interviewer: I would imagine, though, it could be a little misleading. Sure, I've got a shirt and some trunks on that are protecting me from UV rays, but I still have exposed skin. That's not necessarily a good thing, is it?

Dr. Grossman: No. So the idea is to protect as much skin as you can with clothing and be comfortable and that minimizes the areas that you then need to apply sunscreen to.

Interviewer: What type of sunscreen are we looking at?

Dr. Grossman: In general, there are two different classes that I think of with sunscreens. The best products are those that are mineral containing, that have either zinc oxide or titanium dioxide. What these chemicals do is they reflect all the UV rays. They stay on the skin and the UV rays just bounce off, and you get very long lasting protection. They're very difficult, actually, to wash off.

The other class of products, which tend to be much more popular, are the chemical based sunscreens. These work by absorbing the UV rays, particularly the higher energy rays that will cause sunburn. However, some of the longer wavelengths will still get through that can cause some tanning. In addition, these products, because they are absorbing the UV rays, they can quickly saturate and then a lot will get through. They break down quickly and you have to keep reapplying.

Interviewer: The mineral type, is that the type I find in the grocery store? Is that more expensive? It sounds more robust.

Dr. Grossman: They tend to be a little bit more expensive, but they work much better and you don't have to reapply as often. You get what you pay for. I think if it's just brief, short exposures outside, almost any product will be fine, but if you've got fair skin, if you're at high risk, and if you're outside for any period of time, I'd recommend the best protection.

Interviewer: If it comes down to, all right, I wear a long sleeved shirt when I go out hiking or I wear a short sleeve and sunscreen, in your eyes, is there a difference in the amount of protection I'm getting? Is there one better than the other.

Dr. Grossman: It just depends on what sunscreen you're using and how well you apply it. I would think of it as several levels of protection. The first and easiest thing to do is avoid the middle part of the day. If you can do a particular activity, gardening, hiking, or whatever you're doing in the morning or early evening, that's going to be best. The next level would be the clothing, protect as much as you can and still be comfortable. Then whatever is left exposed to apply the sunscreen. Usually it's just face, neck, hands, that kind of thing.

Interviewer: Does time of year make a difference? Is the sun in June worse than the sun in August?

Dr. Grossman: Here in Utah, really you need to protect your skin year round. Because of the altitude, the sun is much stronger than it would be at sea level. Even on a cloudy day, one could get sunburned.

Interviewer: We hear this message a lot, that you should wear appropriate clothing. You should wear a hat. You should wear sunscreen. What happens if somebody doesn't? How bad does it really get?

Dr. Grossman: You get sunburned, which can be uncomfortable but resolves fairly quickly. Any exposure we know causes damage to the skin. If you get a tan then the skin is telling you that the DNA in the cells have been damaged. The tanning response is a DNA damage response, and when the DNA in the cells is damaged this results in mutations that can potentially give rise to skin cancer. The other thing I would mention is that the longer-term effects of UV exposure, the damage to the skin, skin cancer, and all the changes that occur with chronic sun exposure that make you look older, take many years and are cumulative over time. Young people don't appreciate it. They go out, get a sunburn, get tan, and then they think their skin looks fine a week later but they're actually incurring that damage that accumulates over many years. It's usually not until 20 or 30 years after these long periods of exposure that one starts to see the signs of sun damage and ultimately skin cancer.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there’s a pretty good chance you’ll find what you want to know. Check it out at TheScopeRadio.com.

updated: February 5, 2019
originally published: September 3, 2014

Interviewer: All sunscreens are not created equal. There are actually some that are better than others. We're going to find out more about that next on The Scope.

Announcer: Health information from expects, supported by research. From University of Utah Health, this is TheScopeRadio.com.

Interviewer: Dr. Doug Grossman is an expert in early diagnosis and treatment of skin cancer at Huntsman Cancer Institute. All sunscreens are not created equal and I think I'm a little stressed out because I don't think I'm using the right sunscreen. Let's talk about that for a second. From my understanding, there are two different kinds of sunscreens.

Dr. Doug Grossman: There are actually a variety of products. A lot of patients like the sprays because they're easy to apply. The problem is you don't get enough of the material on the skin and so I also worry about if you're spraying a lot and inhaling.

Interviewer: I know. I was at the pool the other day and somebody was spraying and I was getting more in my lungs. My lungs were not sunburned after that.

Dr. Doug Grossman: Right, and some of these that have alcohol could also potentially be flammable, so that could be a risk as well. So I don't like the spray-ons. I do like the lotions that can be applied and as you indicated there are two basic types. The first are the mineral containing products that have either zinc oxide or titanium dioxide and these work as a physical UV blocker. The UV rays just bounce of these minerals and they stay on the skin, so they're very long lasting.

Interviewer: So kind of like a mirror?

Dr. Doug Grossman: Yeah and they block the entire UV spectrum. The other class of products which tend to be more popular because they tend to be less expensive and not leave as much of a white-ish residue on the skin are the chemical sunscreens and these work by absorbing the highest energy UV rays, so they prevent sunburn but some of the lower energy rays still get through and cause damage and they work again by absorbing so one they get saturated, then they loose their effectiveness, so they wear off very quickly, so you have to keep reapplying them.

Interviewer: So that's why you have to keep reapplying? So it's like if I tried to mix a lot of salt into water, eventually it can't absorb anymore. Is that kind of like the same thing?

Dr. Doug Grossman: Yeah.

Interviewer: Interesting. So if I don't know what kind of sunscreen I have, likely I have the chemical kind.

Dr. Doug Grossman: Yeah, most products in stores are the chemical base. There are a few products that contain the minerals that I recommend. My favorite product is Blue Lizard, it contain 15% zinc and titanium dioxide. I think that has the highest concentration of any product that I've found. It's made in Australia where they have the highest rates of skin cancer and it goes on a little white, but then it turns clear and I find that to be the most effective. There are several other products, Vanicream that has these sun blockers as well. And I know this from personal experience, these are the products that I use and I don't have any financial interests in these products?

Interviewer: You don't have stock, huh?

Dr. Doug Grossman: Correct.

Interviewer: I find that fascinating that the Blue Lizard that you talked about is from Australia where they have the highest incidences of skin cancer, so obviously they know what they're doing I guess.

Dr. Doug Grossman: I think so.

Interviewer: Yeah, so the other advantage to this from what I understand is you don't have to apply it as much either. It's like once on and you're good.

Dr. Doug Grossman: Right. Unless you're perspiring a lot and the skins getting wet and you're toweling it off, it stays on the skin and so you don't have to apply it nearly as often as the chemical based products.

Interviewer: So at the end of the day, these mineral based products may be a little bit more expensive, but you think they're well worth it.

Dr. Doug Grossman: Right, they definitely are more expensive, but you get what you pay for.

Announcer: Have a question about a medical procedure? Want to learn more about a health condition? With over 2,000 interviews with our physicians and specialists, there’s a pretty good chance you’ll find what you want to know. Check it out at TheScopeRadio.com.