Are vitamin D or smoking associated with melanoma survival?

The authors aimed to determine whether factors such as vitamin D levels and smoking can affect inflammation and overall melanoma survival. 

Inflammation is the body's method of self-protection in response to harmful stimulants like damaged, cancerous cells in melanoma. In some cases inflammation can become chronic (last for a long time) and can lead to tumor growth. Tumors hijack the inflammatory response of the body and prevent the immune cells from functioning. This allows cancer cells to grow and survive. Tumors promote inflammation in melanoma patients.

Ulcerated tumors are tumors that break through the skin membrane to form an open sore on the skins surface (ulceration). This type of tumor occurs when inflammation is increased and usually indicates a poor outlook in melanoma survival.  

The aim of this report was to determine whether vitamin D and other factors had an affect on inflammation and melanoma survival.

2,147 patients were used in this study. The average time from diagnosis to interview was 5.2 months. Factors evaluated in association with inflammation in this study included: weight and height, non-steroidal anti-inflammatory drug use (NSAIDS- reduce the effect of inflammation, pain and fever), use of aspirin, diabetes at diagnosis and smoking history.

Out of 2,147 patients, 426 had ulceration, 1,351 had no ulceration and in 370 there were no records of ulceration. Patients with ulceration were older (60 years compared to 55 years), more likely male, had a diagnosis of diabetes, used aspirin and smoked. Individually, a high body mass index (BMI –  body fat based on height and weight), diabetes and smoking at diagnosis were associated with ulceration. High vitamin D levels were associated with less tumor ulceration and a better melanoma-specific survival rate (patients have not died from melanoma within a defined period of time). When these factors were combined, only smoking at diagnosis and vitamin D had borderline significant associations with ulceration.

Patients with ulceration were more than three times more likely to have reduced melanoma-specific survival rates. When Breslow thickness (how deep the melanoma reaches into the skin layers) was increased, the patients were twice as likely to have reduced survival. When combined, vitamin D, BMI and duration of smoking were significantly associated with increased melanoma survival rates.

Vitamin D, smoking and BMI at diagnosis were associated with increased melanoma specific survival rates, but it is unclear whether this is associated with inflammation. 

Factors in this study have many implications on health and cannot be 100% contributed to the melanoma specific survival rates.