Melanoma FAQ

Q 1 : Is it better to go to a tanning salon than to sit in the sun?

Contrary to the tanning industry’s claims, there is clear link between melanoma-the most serious form of skin cancer and one of the fastest growing cancers in the U.S.-and exposure to ultraviolet rays (UV) from natural or artificial sources (such as tanning beds). In fact, approximately 65 percent of melanomas are attributed to UV exposure. There are clear, evidence-based data demonstrating the harmful effects of UVA and UVB radiation, including its carcinogenic/mutagenic effects on DNA. The use of indoor tanning (outside of medical practice) represents one of the most striking examples of an avoidable cause of lethal cancer in man. A 2007 study found that individuals who had first used a tanning bed prior to age 35 had a 75 percent greater risk of developing melanoma.

Q 2 : Is it possible to get a "safe" tan through UV exposure?

There is no such thing as a “safe” or “healthy” tan.

  • UV exposure causes a biochemical reaction in the skin that causes it to tan, but it is also the same process that damages DNA, causing cancerous mutations in skin cells. If those mutations are not completely repaired-as frequently occurs-skin cancers result.
  • Since the tanning process appears to be part of the same process that damages DNA, current research suggest that it may be impossible to uncouple the two.
  • Any UV ray exposure increases your risk of developing melanoma. Current research has documented that both UVA and UVB rays are mutagenic for the skin. Although DNA absorbs UVB rays more efficiently than UVA rays, 99 percent of rays reaching the epidermis (where skin cancer develops), are UVA rays.  Most indoor tanning devices emit 95 percent or more UVA rays.
  • A 2007 study found that individuals who had first used of a tanning bed prior to age 35 had a 75 percent greater risk of developing melanoma.
  • In 2009, the World Health Organization began classifying tanning beds as "carcinogenic to humans", putting them in the same category as asbestos and tobacco.
Q 3 : Is some UV ray exposure necessary for vitamin D production?

Vitamin D is a fat-soluble vitamin the body naturally produces when our skin is exposed to ultraviolet B (UVB) rays. It is essential to the body’s bone development and maintenance and emerging research has linked vitamin D deficiency with a number of serious health issues, including some cancers, diabetes and heart attacks.

Contrary to the tanning industry’s claims, the amount of UV exposure needed to produce sufficient vitamin D levels is very small and does not justify the need for sunbathing. In one 20-minute tanning session, a tanning salon patron receives 4.5-7 times the amount of UVB radiation needed for vitamin D production, in addition to the exposure to harmful UVA rays.

There is simply no benefit to using UV to boost vitamin D levels since it is a known carcinogen. In fact, dermatologists say most Americans get the adequate amount of vitamin D by going outside in the course of their daily duties and through nutrients found in food.

Healthy vitamin D levels can easily be accomplished by diet and taking oral vitamin D supplements rather than by seeking UV-induced vitamin D. The two are chemically indistinguishable and the oral form does not pose a cancer risk. Elderly and those with darkly-pigmented skin are at the highest risk for vitamin D deficiency. Although they are least likely to be vitamin D deficient, young, fair-skinned individuals are most likely to seek vitamin D through UV exposure.

Consult your healthcare practitioner before beginning any vitamin/dietary supplement regimen. When taken in excessive amounts, vitamin D is difficult to remove from the body since it is not water-soluble. Vitamin D excess can lead to too much calcium in the blood (hypercalcemia), which can create complications including kidney stones and kidney failure.

Q 4 : I have been diagnosed with melanoma. I have medical questions. Can you help me?

The MRF has several melanoma patient resources.

Although we cannot give out specific medical advice, you can email the MRF Nurse at askthenurse@melanoma.org with your medical questions. You can generally expect a response to your questions within 72 hours. 

In addition, our toll-free helpline (1-877-673-6460) is staffed with oncology social workers who can provide counseling and practical advice to anyone facing a melanoma diagnosis.

Q 5 : What do I do if I am diagnosed with melanoma? I'm scared.

First, understand that you have been given a diagnosis - not a death sentence. Melanoma survival statistics describe a group of similar patients…but they may have nothing to do with your chance of survival. Often for melanoma treatment, there is no single answer. You must be an active participant in your treatment.  We have a pamphlet titled “Just Diagnosed with Melanoma…Now What?” available online. We can send you this and other materials upon request.  We encourage you to visit our online community to talk with patients, caregivers, and their families and to keep an open line of communication with your treatment team.

Q 6 : What is lymphedema?

Lymphedema is when lymph fluid collects in tissue and causes swelling. Lymph nodes are responsible for filtering and circulating lymph fluid throughout the body. It also has a role in fighting infection. Clusters of lymph nodes are found in the underarm, groin, neck and abdomen. When the lymph nodes are removed as a result of surgery, this function might be strained, resulting in the build-up of fluid in the area where the lymph nodes were removed.  

Melanoma patients are at risk for developing lymphedema in the groin lymph node dissection in the leg and foot on the side of surgery as well as the abdomen, buttocks and genital areas. If lymph nodes were removed from the underarm area, the risk area is the chest wall, arm and hand on that side. 

The danger with lymphedema comes from the constant risk of developing an uncontrolled infection in the affected limb. Physicians and medical staff who practice in fields where this disease is uncommon may fail to correctly diagnose the condition due to the apparent lack of information regarding this disease. However, this is slowly changing thanks to education and awareness efforts.

Q 7 : What is a clinical trial?

In health care, clinical trials are conducted to allow safety and efficacy data to be collected for new drugs or devices. These trials can only take place once satisfactory information has been gathered on the quality of the product and its non-clinical safety, and Health Authority/Ethics Committee approval is granted in the country where the trial is taking place. Depending on the type of product and the stage of its development, clinical trials enroll healthy volunteers and/or patients into small studies initially, followed by larger scale studies in patients that often compare the new product with the currently prescribed treatment. As positive safety data is gathered, the number of patients can be increased. Clinical trials can vary in size from a single center in a single country to multi-centers in multiple countries. The Health Authority in the United States is called the FDA (Food and Drug Administration) where a new product application is referred to as an Investigational New Drug application.

Q 8 : Why should I participate in a clinical trial?

There are a number of reasons you doctor may want you to consider participation in a clinical trial, including:

  • Access to investigational treatments before they become widely available
  • Opportunity to play a role in the discovery of treatments, cures, and preventions for certain diseases or medical conditions
  • Ability to play a more active role in your own healthcare
  •  Access to free physical examinations and diagnostic tests related to the study
Q 9 : Can you help me find a clinical trial in my area?

The Melanoma Research Foundation has partnered with EmergingMed to offer you a free, confidential, personalized service that helps you understand which clinical trials may be an option for you.  

Melanoma Research Foundation Clinical Trial Finder

Note: This will take you to the EmergingMed website page that fully describes this free service. 

Q10 : Will there ever be a cure for melanoma?

"We are closer to a cure for melanoma than ever before because we have learned so much in the past few years," says Dr.  Meenhard Herlyn, DVM, DSc and a member of the MRF’s Scientific Advisory Committee. "I'm optimistic that in the not-too-distant future we will be able to offer patients meaningful new treatment options."

Q11 : What is the risk of recurrence?

The risk of melanoma recurrence is dependent on the thickness of the primary tumor, with thicker tumors carrying greater risk than thin tumors, the presence of ulceration in the primary tumor and the presence of satellite metastases surrounding the primary tumor. The probability that melanoma will recur after appropriate treatment is characterized as low- intermediate-risk, or high-risk.

  • Low-risk: less than 20% risk of recurrence
  • Intermediate-risk: 20-50% risk of recurrence
  • High-risk: greater than 50% risk of recurrence. High-risk melanoma has a high probability of having already spread to local or distant sites at the time of treatment.
Q12 : Can I die from melanoma?

Upon receiving a melanoma diagnosis, the prognosis, or outlook, is determined by several factors. The stage of diagnosis, current general health of the patient, and whether the cancer has spread to the lymph nodes or other organs, are all considered. Treatment options are also determined by these factors. Early state melanoma can often be cured by surgery, or removal.  Stage III and Stage IV melanoma, on the other hand, is often treated with a combination of surgery, immunotherapy, chemotherapy, and/or radiation therapy. Recent research findings show that these combination treatments, rather than a single treatment, are likely to increase the prognosis. 

Melanoma Facts:

  • Melanoma is curable in the early stages with an over 90% success rate.
  • Survival rates drop to less than 20 percent when melanoma has spread to other organs .
  • Melanoma is the most deadly form of skin cancer. 
  • Every hour of every day a person dies from melanoma.
Q13 : Where can I find current stats on melanoma?

The National Cancer Institute’s Web site (www.cancer.gov) has a section for statistics.  Click on “cancer topics”, then “melanoma” and scroll down to “statistics”.

Q14 : What is staging and what does my stage mean?

Melanoma staging is the process of attempting to determine the extent of the disease. Staging helps the cancer care team develop an appropriate treatment plan and determine the prognosis, or outlook.  Oncologists (doctors who specialize in cancer) consider three things when staging melanoma: 

  1. The thickness of the tumor, referred to as the Breslow Thickness, which is reported in your pathology report.
  2. Whether the tumor is ulcerated (cracked or bleeding) and
  3. If, and how far, it has spread.

In general, thicker tumors are more serious that thin tumors; ulcerated tumors are more serious than non-ulcerated ones, even if they are thinner; and tumors that have spread to the lymph nodes are more serious than tumors that have not spread.

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