Supportive Care in Cancer

, Volume 22, Issue 6, pp 1663–1671 | Cite as

Can we use technology to encourage self-monitoring by people treated for melanoma? A qualitative exploration of the perceptions of potential recipients

Original Article



People with melanoma traditionally attend cancer centre-based follow-up. Most recurrences and new primary melanomas are, however, detected by patients between hospital visits. Despite this, total skin self-examination (TSSE) practices are suboptimal. Digital technologies could be used to support TSSE. The attitudes of potential users are unknown; this study aims to explore the attitudes of people with melanoma towards using digital technologies and the effect of personal characteristics on their attitudes.


Twenty-one hospital joint melanoma clinic patients aged 37–83 were purposively recruited. Semi-structured interviews were conducted to explore patients’ views on the use of digital technology during follow-up and identify barriers or facilitators. Interviews were transcribed verbatim and subject to framework analysis.


Participants had a wide range of IT skills. All used a mobile phone, most had heard of telemedicine and several had used Skype. Participants felt that with thought, tailoring and training, technology could enable self-monitoring as part of melanoma follow-up. Technological benefits included having a co-ordinating nurse specialist, contactable electronically, and having a personalised skin map and tailored information about melanoma. Participants cautioned that technological developments must take account of personal needs and characteristics. Few had security concerns.


People are not currently equipped to undertake self-monitoring as part of their melanoma follow-up, but many would be keen to employ technology to support this. A range of technologies could be utilised with potential benefits. Technologies should be carefully designed and individually tailored, considering age, familiarity with technology, place of residence and time since diagnosis.


Melanoma Total skin self-examination Digital technologies Follow-up 



The authors wish to thank the interviewees for sharing their thoughts and giving their time to help with this study. The research described here is supported by the award made by the RCUK Digital Economy programme to the dot.rural Digital Economy Hub; award reference: EP/G066051/1.

Conflict of interest

All authors declare that they have no conflict of interest to declare.

Study approval

The study was approved on the 2nd of May 2012 by the North of Scotland Research Ethics Committee (REC Reference 12/NS/0039).

Study sponsor

The University of Aberdeen was the study sponsor.


  1. 1.
    Godar DE (2011) Worldwide increasing incidence of cutaneous malignant melanoma. Journal of Skin Cancer Article ID 858425, 6 pages doi: 10.1155/2011/858425
  2. 2.
    NICE (2006) CSG improving outcomes for people with skin tumours including melanoma: the manual. The National Institute for Health and Clinical Excellence, LondonGoogle Scholar
  3. 3.
    SIGN Guideline Number 72 (2003) Cutaneous melanoma—a national clinical guideline. Scottish Intercollegiate Guideline Network, EdinburghGoogle Scholar
  4. 4.
    Allen PJ, Coit DG (2002) The surgical management of metastatic melanoma. Ann Surg Oncol 9:762–770PubMedCrossRefGoogle Scholar
  5. 5.
    Marsden JR, Newton-Bishop JA, Burrows L, Cook M, Corrie PG, Cox NH, Gore ME, Lorigan P, MacKie R, Nathan P, Peach H, Powell B, Walker C (2010) Revised UK guidelines for the management of cutaneous melanoma. Brit J Dermatol 163:238–256CrossRefGoogle Scholar
  6. 6.
    Meyers MO, Yeh JJ, Frank J, Long P, Allison MD, Amos KD, Ollila DW (2009) Method of detection of initial recurrence of stage II/III cutaneous melanoma: analysis of the utility of follow-up staging. Ann Surg Oncol 16:941–947PubMedCrossRefGoogle Scholar
  7. 7.
    Lee KB, Weinstock MA, Risica PM (2008) Components of a successful intervention for monthly skin self-examination for early detection of melanoma: the “check it out” trial. J Am Acad Dermatol 58:1006–1012PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Oliveria SA, Dusza SW, Phelan DL, Ostroff JS, Berwick M, Halpern AC (2004) Patient adherence to skin self-examination. Effect of nurse intervention with photographs. Am J Prev Med 26:152–155PubMedCrossRefGoogle Scholar
  9. 9.
    Janda M, Baade PD, Youl PH, Aitken JF, Whiteman DC, Gordon L, Neale RE (2009) The skin awareness study: promoting thorough skin self-examination for skin cancer among men 50 years or older. Contemp Clin Trials 31:119–130PubMedCrossRefGoogle Scholar
  10. 10.
    Körner A, Drapeau M, Thombs BD, Rosberger Z, Wang B, Khanna M, Spatz A, Coroiu A, Garland R, Batist G (2013) Barriers and facilitators of adherence to medical advice on skin self-examination during melanoma follow-up care. BMC Dermatol 13:3. doi: 10.1186/1471-5945-13-3 PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    Murchie P, Iweuke FC (2011) Comparing personal risk, melanoma knowledge and protective behaviour in people with and without melanoma: a postal survey to explore educational needs in northeast Scotland. J Cancer Educ 26:341–347PubMedCrossRefGoogle Scholar
  12. 12.
    Commissioning PC (2013) Quality standards for teledermatology: using “store and forward” images. Leeds, UKGoogle Scholar
  13. 13.
    Pope C, Ziebland S, Mays N (2000) Qualitative research in health care. Analysing qualitative data. Brit Med J 320:114–116PubMedCentralPubMedCrossRefGoogle Scholar
  14. 14.
    García-Lizana F, Sarría-Santamera A (2007) New technologies for chronic disease management and control: a systematic review. J Telemed Telecare 13:62–68PubMedCrossRefGoogle Scholar
  15. 15.
    Ekeland AG, Alison Bowes A, Signe Flottorp S (2010) Effectiveness of telemedicine: a systematic review of reviews. Int J Med Inform 79:736–771PubMedCrossRefGoogle Scholar
  16. 16.
    Dickinson R, Hall S, Bond CM, Murchie P. Using technology to deliver cancer follow-up: a systematic review. Submitted to the Journal of Supportive Care in CancerGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Centre of Academic Primary Care, Division of Applied Health ScienceUniversity of AberdeenAberdeenUK

Personalised recommendations