Can the "Little Blue Pill" Increase Cancer Risk?
In a perfect world, all medical interventions — whether it’s a surgery or a prescription drug — would be preceded by a detailed cost vs. benefit conversation with your doctor.
When you took a pill or consented to a procedure, all of the cards would be on the table. You’d know what you were signing up for... and there would never be any surprises.
But I don’t need to tell you that this isn’t the world you and I live in. Not even close.
The fact is, this level of candor is a pipe dream. And there are a lot of reasons for that. Some doctors are swayed by dollar signs in a profit-driven health care system. Some are simply following misguided official guidelines. And all doctors have a different stake than their patients when it comes to risks. (He doesn’t have to live with the side effects of your treatment decisions — you do.)
Factor that in with your typical 15-minute appointment time slot, and it’s a foolproof recipe for kamikaze prescribing practices.
But just as often, things go wrong because all the information just isn’t out there yet. Today’s wonder drug could become tomorrow’s pharmaceutical scandal on the turn of a dime. Which is why I’ve always harbored a healthy skepticism toward any drug that sounds a little too good to be true.
Viagra is one of those drugs. And as it turns out, my suspicions were warranted.
In case you missed it, there’s some new research out — and it’s very unsettling. Last summer the Journal of the American Medical Association (JAMA) published a study. It looked at data from more than 25,000 men participating in the decade-long Health Professionals’ Follow-Up Study.
Researchers asked these guys if they used sildenafil (the generic name for Viagra) for erectile dysfunction. They also checked for several forms of skin cancer — including squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and melanoma.
Results at the end of the study revealed a disturbing trend. The men who used Viagra were almost twice as likely to develop skin cancer than the guys who didn’t. Specifically, melanoma — a cancer that originates in your melanocytes. (Those are the cells that give you a tan by generating the skin pigment melanin.)
Now, if skin cancer is on your radar — and it should be — then you probably already know that melanoma is the most lethal and invasive form of the disease. So needless to say, this news made some waves.
It’s also true that this is just a single clinical study demonstrating correlation — not causation. So you can take that for what it’s worth.
But it’s not the only time ED drugs like Viagra have been put under the microscope only to come up dangerously short. In fact, the results of another, more recent study yielded equally concerning implications — albeit for a smaller, more specific population of men.
This study looked at almost 5,000 men who had undergone radical prostatectomy — that is, prostate removal — for prostate cancer between 2000 and 2010. About a quarter used a PDE-5 inhibitor (either Viagra, Cialis, or Levitra) after surgery. The other 75% didn’t.
Now, these two groups were pretty much identical in every other clinical parameter. But there was one noteworthy exception: The risk of disease recurrence five years out was significantly higher for the men taking ED drugs.
These guys were 38% more likely to see their prostate cancer return. Not exactly small potatoes.
Now, if you’ve never had a radical prostatectomy, then these results don’t necessarily apply to you. But if you have, then there’s also a good chance that you’ve relied on Viagra, Cialis, or Levitra in the months or years since. Because along with incontinence, erectile dysfunction is hands down the most notorious and fearsome side effect of prostate removal.
In other words, the subject pool might be small. But the finding itself is huge. And paired with last summer’s JAMA study, it creates enough controversy around Viagra and its ilk to raise an eyebrow or two.
Stay tuned and stay well,
Geo Espinosa, N.D., L.Ac, C.N.S., is a renowned naturopathic doctor recognized as an authority in integrative management of male and urological conditions. Dr. Geo is the founder and director of the Integrative Urology Center at New York University Langone Medical Center (NYULMC), a center of excellence in research and integrative treatments for urological conditions.
Li, W.-Q., Qureshi, A. A., Robinson, K., & Han, J. (2014). Sildenafil use and increased risk of incident melanoma in US men: a prospective cohort study. JAMA Internal Medicine, 174(6), 964–970.
Michl U et al. Use of phosphodiesterase type 5 inhibitors may adversely impact biochemical recurrence after radical prostatectomy. J Urol. 2015 Feb;193(2):479-83.