Melanoma is the scariest skin cancer. It’s responsible for a mere 2% of skin cancers yet causes 75% of skin cancer deaths. Each year, about 75,000 Americans are diagnosed. Each year, nearly 10,000 die. So it’s no surprise that researchers are always looking for new ways not just to treat melanoma but to prevent it.

Which brings us to breakfast. According to a recent study, the orange juice you gulped on the way out the door this morning might be increasing your risk of getting melanoma.

Yes, that “glass of sunshine” that you think is good for you might be a cancer risk factor.

The finding: A study of more than 100,000 health professionals (nurses and doctors) found that those who consumed citrus fruits or certain citrus juices 1.6 or more times a day, on average, had a 36% increased risk for melanoma.

The theory: Citrus fruits contain compounds that can make the skin more sensitive to sun damage that predisposes people to melanoma. The compounds are called psoralens.

A closer look: The study has many limitations, including the fact that health professionals are more diligent at checking suspicious moles than the general population, and so found melanoma at very early stages, including some that were less likely to be aggressive. So it might not be appropriate to compare these melanomas with those found in a general population. The study also had weird inconsistencies—there was a risk for eating whole grapefruit but not for drinking grapefruit juice, on the one hand, and a risk for drinking orange juice but not for eating whole oranges, on the other. Perhaps we should take our lead from the title of the editorial in Journal of Clinical Oncology, where the study appeared: “Dietary Advice for Melanoma: Not Ready for Prime Time.”

Verdict: Keep on enjoying grapefruits and oranges (and their juice)!

While you’re enjoying grapefruit slices, feel free to have a cup of coffee, too. Another statistical analysis looked at 450,000 white men and women with an average age of 63 (melanoma is much more common in Caucasians than in blacks, Asians, Hispanics or other groups with darker skin). The finding: The more coffee people drank, the lower the risk for melanoma. Four cups a day? That’s a 20% reduction in melanoma risk. It’s a statistical link, not evidence of causation, but we already know plenty of reasons why drinking coffee is healthy, so if java agrees with you, pour it on.


The best way to prevent melanoma, of course, is to avoid sunburns—intermittent sun exposure that results in burns, especially in childhood, is a strong risk. (On the other hand, 10 or 15 minutes of sun exposure, even without sunscreen, can build vitamin D, which is associated with lower melanoma risk.) Tanning beds are a definite risk, no question.

We don’t know all the answers, to be sure. Many cases of melanoma show up on areas of the body that don’t even get sun exposure—where, literally, the sun don’t shine—and there may be different factors at play in the development of melanoma in different parts of the body, such as the soles of the feet.

While researchers continue to look for answers, we do know this—getting any suspicious moles or skin changes checked out by a dermatologist is important. Melanoma is much easier to treat if it’s caught early. To learn more, see Bottom Line’s Hidden Melanoma and learn the truth about seven myths in Melanoma: Not Just a Summer Disease.

After breakfast, why not make an appointment for an annual skin check with a dermatologist?