NEW YORK — Dermatologists must adapt to digital technology in the diagnosis and treatment of melanoma, according to a presenter at the HemOnc Today Melanoma and Cutaneous Malignancies meeting.
“We are living in on-demand technology,” Steven Q. Wang, MD, director of dermatologic surgery and dermatology at the Memorial Sloan-Kettering Cancer Center in Basking Ridge, NJ, said. “The patient wants instant access to us.”
According to Wang, a rising epidemic in skin cancer, particularly in melanoma, is ongoing, with SEER data showing a doubling of melanoma incidences between 1975 and 2011.
Approximately 5 million skin cancer cases are diagnosed in the United States each year, with melanoma making up 2% of that number, according to Wang; however, the cost of taking care of the skin cancer cases is $8 billion, with melanoma patients making up approximately 41% of costs, he said.
Current technology allows for full-body exams using dermoscopy, 2-D and 3-D total-body photography, reflectance confocal microscopy and machine-assisted diagnosis, Wang said. The drawbacks of these diagnostic tools, however, include needing years of training for dermoscopy, security issues for total-body photography, costs for confocal microscopy, and cost and accuracy for machine vision, he said.
Greater challenges include a dermatologist workforce shortage in the United States, patient expectations and a shift in health care based on cost.
Wang reviewed four major advancements in digital technology, including cloud computing, analytics (big data), mobile and security.
There were 31,000 health, fitness and medical-related apps on the market in 2013, according to Wang. Some of the advantages of these consumer mobile applications are that they provide the tools to encourage self-exams and they deliver access of screening to remote regions. Challenges include gaining regulatory approval and a lack of accuracy, he said.
According to Wang, in terms of diagnosing and treating melanoma, the future of dermatology “is not that dim” because technology takes time to be introduced, and economic forces can be a restricting factor.
Wang quoted Louis V. Gerstner Jr., former CEO of IBM, who said, “Computers are magnificent tools for the realization of our dreams, but no machine can replace the human spark of spirit, compassion, love and understanding.”
“We, as physicians, cannot beat the machine on the pure analytical skills, but it is those intangible human qualities that will make us a better providers,” Wang said. “In this new space of health care, we as physician have less time to assert that human quality.” – by Bruce Thiel
Wang SQ. Envisioning the future of melanoma diagnosis through the lens of medical informatics. Presented at: HemOnc Today Melanoma and Cutaneous Malignancies. April 10-11, 2015; New York.
Disclosure: Wang reports no relevant financial disclosures.