Timothy G. Murray, MD, MBA (00:16):
Hello, I'm Dr. Timothy Murray coming to you live from Snowmass Village. It's my pleasure to speak with my colleague and friend, Dr. Tara McCannel, who spoke with us on prognostic biopsy in uveal melanoma, discussing her 20 year journey. Welcome to have you here. Thank you. I was fascinated to be able to have your experience with two decades because so many of our colleagues now are so much younger and they're bringing a totally different perspective. So tell me a little bit of the highlights of your 20 year journey.

Tara A. McCannel, MD, PhD (00:53):
Well, I think at the beginning when doing prognostic biopsy began to take off, it became very important to provide this very important information for patients because by prognostic biopsy, we can figure out if a person with their ocular melanoma has a low risk of the cancer metastasizing or has a high risk. And the fact that we have access to that information from the tumor tissue, it was incumbent upon us to provide that for patients. And after reflecting on things and looking back, I think that some of that initial, we must tell the patient their risk for me certainly has softened because I'm sure like yourself, we've seen many patients over the years who do incredibly well when the odds were stacked against them from the beginning. And we've seen patients who we think should just fly through this go on and develop metastatic disease despite what the prognostic biopsy tells us.

(01:55):
So I think it's part of our counseling for patients. It's not the most important thing we tell our patients. And I think in a field where there's a lot of new people and people have adopted biopsy as part of standard of care and sharing information with patients, I think that it's important not to make that the complete emphasis. There are many other things that we must do instead of just focus on predicting death.

Timothy G. Murray, MD, MBA (02:19):
You spoke to the importance of biopsy, but biopsy is a component of treatment. And I think you and I feel very similarly that this is a unique biopsy that gives us prognostic information, but we need to put that in the context of the patient. And at least for me, I don't biopsy anyone that I don't definitively treat.

Tara A. McCannel, MD, PhD (02:41):
Yes. I agree with you 100%. I think in our field, for many decades, providing a diagnosis of ocular melanoma is a clinical diagnosis where people, the expert looks at the patient, examines a patient, looks at the complimentary imaging that helps support the diagnosis and then confers their opinion. And I think today we're seeing less of that. We are a very ... Medicine is really evolving into lots of tests, procedures, doing things, imaging. I mean, we have phenomenal progress, but I think we are forgetting about examining the patient. And we need to look at the patient. We need to ask other questions. We need to kind of use our clinical experience together with the new technology. So I agree with you. Biopsy is for cases where we know it's a melanoma.

Timothy G. Murray, MD, MBA (03:38):
Well, Dr. McCannel, thank you so much for joining us. You gave a phenomenal talk and I'm looking forward to letting people more broadly have the opportunity to listen to you. So thank you for joining us. You're very welcome. At the 54th Aspen Retinal Detachment Society.

Tara A. McCannel, MD, PhD (03:53):
My pleasure. Thank you, Tim.

Timothy G. Murray, MD, MBA (03:54):
Thank you.