It’s a big deal. “Survivable” means intrusive treatment that is painful, not always effective and has side effects on things like fertility.

Or you can eliminate it by vaccination and avoid the suffering and risk.

You can detect melanoma with the eyes. But when you don't get there early enough it was game over. Now it's a coin flip.

I can see how you'd end up with that interpretation but I was actually talking about Hodgkins, so in that case the placebo arm would in fact be basically a death sentence. You've got an aggressive cancer, and you've decided (or your treatment arm has decided) to just let it take its course.