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Review
. 2013 Jan 1;5(1):121-9.
doi: 10.4161/derm.25244.

Vitamin D and melanoma

Sinead Field  1 , John Davies  1 , D Tim Bishop  1 , Julia A Newton-Bishop  1
Affiliations
Review

Vitamin D and melanoma

Sinead Field et al. Dermatoendocrinol. .

Abstract

Recreational sun exposure and sunburn are causal for melanoma but the risk is strongly genetically determined. Health promotion advice about sun protection should be aimed at susceptible individuals (pale skin, freckles, large numbers of melanocytic nevi and a family history). We discuss here the evidence that sun-sensitive people have lower vitamin D levels and that, in practice, it is very difficult for such individuals to achieve sufficient levels without supplementation in the UK at least. We conclude that melanoma susceptible sun-avoidant individuals should be advised to avoid insufficiency by supplementation. Vitamin D is anti-proliferative in vitro for some melanoma cell lines. In a large melanoma cohort we have observed that lower serum 25-hydroxyvitamin D2/D3 levels at diagnosis were associated with thicker tumors and poorer prognosis (study as yet not validated). In the UK, melanoma patients commonly have sub-optimal 25-hydroxyvitamin D2/D3 levels at and post diagnosis; we discuss approaches to management of such patients based on some new data from our group.

Keywords: 25-hydroxyvitamin D2/D3 levels; prevention; risk; supplementation; survival; vitamin D serum levels.

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Figures

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Figure 1. Data produced by Veronique Poirier for the NCIN on melanoma incidence in England in the periods 1985–1987 and 2007–2009 showing an increased incidence at all ages and for both sexes but that the increase was especially marked in those 60 y or older and especially in males.
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Figure 2. Forest plots showing the association between (A) inherited BsmI and (B) FokI polymorphisms in data from 5 association studies,-which were suggestive of a small association between VDR polymorphisms and melanoma risk.
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Figure 3. Average levels of 25-hydroxyvitamin D2/D3 in participants in the Leeds Melanoma Case-control study who were not taking supplements and in relation to the number of hours spent outside in the warmer months. The solid green line represents those defined as non-sun-sensitive and the purple, the sun-sensitive. It can be seen that the majority of individuals failed to reach the “optimal” 60 nmol/L even after reporting spending on average 6 h per day outside on both Saturdays and Sundays and that this was especially true of the sun-sensitive. Reported sun exposure in the UK was in this population insufficient to result on average in optimal levels of 25-hydroxyvitamin D2/D3.
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Figure 4. Box and whisker plot showing (in blue) levels in melanoma patients not supplementing a median of approximately 1 year after diagnosis and (in pink) after testing and tailored advice on supplementation with 400 to 1000 IU of vitamin D3.
See this image and copyright information in PMC

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