Is there a link between erectile dysfunction medicines and melanoma? The scientists do not have a definite answer.

You can decide for yourself what to choose: higher risk of malignant melanoma due to the intake of ED medications or taking ED medicines staying under the sun without protection such as hat or sunscreen.

Many studies revealed that lifestyle conditions can clarify why men taking PDE-5 inhibitors such as sildenafil, vardenafil and tadalafil face bigger risk of developing malignant melanoma. Stacy Loeb, MD, from NYU Langone Medical Center with the colleagues sticks to the same opinion.

When the results of 4000 Swedish male patients who suffer from malignant melanoma were studied, it was revealed that intake of PDE5A inhibitor was related to a 20% rise of risk for melanoma.

However, there was one interesting thing in this data.

Those who received only one prescription for the above mentioned medication had the biggest risk as opposed to a group of patients, for whom medicine was prescribed many times, and the level of risk was not that high. The researchers concluded that there was connection of behavior or some demographic aspects with risk.

As the author of the study put it, his team looked for association as they hesitated that one thing entails the other. The results of big work that was conducted by them were published in Medscape Medical News.

As far as the previous study is concerned, it was completed in 2014 and its results appeared in JAMA Internal Medicine. Then over 25 thousand men participated in it. It was revealed then that intake of sildenafil was related to considerably higher risk for melanoma. The risk was measured in hazard ration and its index reached 1.84.

The previous research was conducted because MEK/ERK signaling pathway in melanoma has to do with malignant cell production. PDE5 inhibitors use this pathway and this causes anxiety. Does that mean that medications contribute to the deterioration of disease? The scientists started looking for the answer to this question but they lacked some information. For this reason, the researchers initiated the study, the goal of which was to determine if there is any causal relationship between two factors. The team of researchers applied for data collected by Swedish healthcare organizations. They compared the results with the results of the group of patients from the Prostate Cancer Data Base Sweden.

Then huge work has been conducted to identify the patients who acquired melanoma in the period 2006-2012. They were also interested in the severity of disorder, and presence of potential risk factors that can include socioeconomic and demographic ones. In addition, they wanted to know if PDE5 inhibitors were prescribed to the patients.

Thanks to this work, during which 4065 male melanoma patients were studied, it turned out that 11% applied for a single prescription of PDE5 inhibitor in comparison with the other cohort where 8% of melanoma patients of the 20,325 were revealed.

When diverse parameters are regarded such as number of disorders, marital status, level of education and available income, the researchers discovered that use of PDE5 inhibitor is associated with risk index OR - 1,21 for melanoma risk among all male patients.

As it was pointed out, men with single ED prescription face the bigger risk (OR -1,32), but patients with numerous prescriptions for medication up to 6 and even more. The association is rather interesting.

This defies the aspect of causal relationship, otherwise men with more prescriptions would have higher risk but they do not have it. Dr. Loeb made this conclusion. He said it for Medscape Medical News.

It is also interesting to note that married men have higher risk. Also such factors as good education and high income increase odds of acquiring disease. Opposing to them, men with a score - 2 or even higher (according to Charlson Comorbidity Index) are less likely to develop this disease.

The researchers discovered a rather strong association between intake of PDE5 inhibitors and higher risk for other type of cancer - basal cell carcinoma with OR 1.19. All three PDE5 inhibitors regarded in the study produced considerable effect upon the participants.

The last discovery demonstrates that one more test to reveal the connection between medicines for treatment of erectile dysfunction and melanoma brought to nothing.

Dr. Loeb says that failure to discover the relationship with basal cell skin cancer means that there is no relationship due to melanoma pathway.

Therefore, the specialists consider that lifestyle theory is the most reasonable one due to the factors, which were revealed during the survey.

According to the opinion of Ryan J. Sullivan, MD, from Boston, this became the decisive factor. The basal cell carcinoma is not related to the same pathway.

The cause why basal cell carcinoma develops in a patient has to do with sun effect therefore similar processes noticed in the patients diagnosed with basal cell carcinoma and increase noticed in patients with melanoma supports the theory that it is connected with socioeconomic status and sun exposure. This view on the subject was published in an interview Ryan J. Sullivan in Medscape Medical News.

Besides, the researchers discovered that effect of such ED medications as tadalafil, sildenafil, the shortest-acting medicine and the PDE5 with long serum half-life does not differ much. It also makes the theory of causality rather dubious.

And, at last, intake of medications and advanced melanoma suggests lack of association, and if it appeared, it happened because of other reasons. Dr. Loeb admits it and thinks that just the same type of male patients experience similar health problems and develop risk for melanoma in the same way.