Reducing fear: Total body digital photography may ease melanoma worry

Key Points

A growing number of dermatologists are using TBDP, says Zakiya M. Pressley, M.D., a clinical research fellow in the Clinical and Outcomes Research Unit of Emory University School of Medicine's department of dermatology, Atlanta, and a co-author of the study.

"Academic dermatologists believe TBDP may improve the ability to diagnose melanoma at an earlier stage. They also believe TBDP may reduce patient anxiety and cancer worry (Pressley ZM, et al. J Invest Dermatol. 2007;127:(Abstract)AB876, P876. Complete manuscript under review at Arch Dermatol.)," she says.

To take this research one step further, a team at Emory, led by principal investigator Suephy C. Chen, M.D., M.S., and another team at Arizona State University, led by principal investigator Clara Curiel-Lewandrowski, M.D., attempted to determine which patients were most likely to experience reduction in anxiety following TBDP.

Other researchers who contributed to the study include Laura K. DeLong, M.D., M.P.H., and Sallyann Coleman King, M.D., M.S.

Study parameters

Researchers focused on 44 patients with AMS (defined as having more than 50 atypical nevi with or without a history of melanoma) seen in these universities' pigmented lesion clinics between June 2005 and December 2007.

Investigators administered the following survey instruments at baseline and three to six months after TBDP to measure patients' anxiety level and quality of life:

The LOT and HADS assessments provided baseline indicators of optimism and anxiety/depression, respectively, Dr. Pressley says.

However, in multiple linear regression, neither these measurements nor other variables that researchers studied - including age, gender and personal history of melanoma - were statistically significant predictors of a change in MWS or RIES from baseline to follow-up (Pressley ZM, et al. Poster P2100 presented at 66th Annual American Academy of Dermatology Meeting, Feb. 1-5, 2008, San Antonio).

Adapted from a breast cancer worry scale, the MWS asks subjects to rate on a four-point ascending scale how much they worry about melanoma, how much these worries impact their mood and daily activities, and how much they worry about future skin examinations.

In the study, patients' median MWS survey scores dropped from 9.31 to 8.1 (of a possible 16 total; p<0.05).

Similarly, the RIES uses 15 questions to measure patients' subjective distress, Dr. Pressley says.

This scale asks subjects to respond to statements such as "I tried not to talk about (melanoma)" and "I had trouble falling asleep or staying asleep because of pictures or thoughts about (melanoma) that came into my mind." Median scores here fell from 14.3 at baseline to 11.16 months after (p<0.007).

However, the study is still ongoing.