We evaluated melanoma patients’ ability to predict quality of life (QOL) impact of alternate hypothetical melanoma stages after given prognostic and treatment information of that stage. QOL impact was evaluated by calculating utilities, which measure people’s preferences for health states and range from 0 to 1; zero represents a state equivalent to death and 1 represents perfect health in the patient’s mind. We measured utility with a computer-based time trade-off technique, which determines the amount of time patients would trade in order to live a shorter life without melanoma. The ratio of the shorter life duration to the average life expectancy represents that health state’s utility. We defined 6 different melanoma health states based on stage (I, II, and III) and time from diagnosis, new ( one year ago) or old ( one year ago). Subjects were interviewed for three health states: a hypothetical state of paralysis for practice, their own melanoma health state, and an alternate hypothetical melanoma health state, newly diagnosed. For each melanoma health state, subjects were shown a brief presentation of prognosis, treatment, and other patients’ reactions in that health state. One-way ANOVA and post hoc comparisons were used to analyze mean utilities. We recruited 317 consecutive melanoma patients from our database and melanoma clinics. A total of 64 patients (mean age 51.5 years, 50% male, and 100% Caucasian) have participated, as following: 51 old Stage I, 4 new Stage I, 2 old Stage II, 4 old Stage III, and 3 new Stage III. We do not have data for new Stage II patients. No statistically significant differences between real and hypothetical utilities were found for a new diagnosis of Stage I or III. The mean utility ( standard deviation) for real new Stage I was 0.94 ( 0.04); whereas hypothetical new Stage I utilities for patients with real health states of old Stage II, old Stage III, and new Stage III were 0.96 ( 0.05), 0.96 ( 0.05), and 0.91 ( 0.03), respectively. The mean utility for real new Stage III was 0.57 ( 0.26). Hypothetical new Stage III utilities for patients with real states of old and new Stage I were 0.49 ( 0.31) and 0.46 ( 0.23), respectively. Although the number of subjects in this preliminary study is small, these results suggest that hypothetical utilities are similar to the real utilities for melanoma patients, indicating that they may be able to realistically imagine alternate melanoma stages.