Hormone replacement therapy and malignant melanoma: to prescribe or not to prescribe?

The mean age of presentation of malignant melanoma in women is the early fifties, a time that may be concomitant with the onset of the menopause. As the lesion can often be successfully surgically excised, many women will enter the menopause disease-free but in need of treatment for their menopausal symptoms. Melanoma has traditionally been considered to be an estrogen receptor-positive tumor, whose prognosis is adversely affected by estrogen, whether during pregnancy or in association with the oral contraceptive pill or hormone replacement therapy (HRT). Recent evidence now refutes this. As most recurrences occur in the first 2 years following treatment, it may be prudent to defer HRT until this time. There is a particular paucity of information pertaining to HRT and melanoma, such that, at present, there appears to be no justification for withholding this potentially beneficial therapy from menopausal women who have undergone treatment for melanoma.