ED medications and melanoma: Is there a link?

Back in 2014, a study came out stating a possible link between a medication for erectile dysfunction (ED) – sildenafil – and melanoma which is the deadliest form of skin cancer. When the research was first reported, of course there was concern, but men who were using sildenafil, better known as Viagra, were told not to stop taking the medication without consulting with their doctor first.

Sildenafil or Viagra, falls into a class of drugs called phosphodiesterase type 5 (PDE5 inhibitors).  This ED medication along with other well-known drugs for this condition such as Cialis, Levitra, and Stendra, are all PDE5 inhibitors. These medications have been used for many years now and have helped thousands of men with ED to get back and preserve their sex life.

One year later in 2015, a second study was released in which the scientists came out stating that lifestyle factors could be playing a major role in the increase in melanoma in men who used PDE5 inhibitors and that the ED drugs probably did not cause the deadly skin cancer even though a link was still found.

Specifically what the researchers came to the conclusion was that their new study showed certain groups of men were more likely to get malignant melanoma for these reasons – men with higher disposable incomes and education who likely could afford more vacation in sunny locations and who also had the means to buy ED drugs which are expensive.

So, how does the issue of ED medications and melanoma stand today?  A 2018 report published in the Journal of Sexual Medicine looked over information from a health records database of over 610,000 men and women who were prescribed PDE5 inhibitors from 2007 to 2015. It should be noted that PDE5 inhibitors are used to treat other conditions besides ED.  Both men and women may be using them for condition such as pulmonary hypertension and lower urinary tract symptoms. Out of this database reviewed, 99.5% of the patients were male with the average age of their first prescription for a PDE5 inhibitors was 51.

The researchers with this study compared these patients with a control group of over 2 million people with ED or other conditions who were not prescribed PDE5 inhibitors.

What this new study found was in the group who took PDE5 inhibitors, 636 of them or only a tenth of one percent, developed melanoma. Of those in the control group who did not take any PDE5 inhibitors, 8,711 people were diagnosed with melanoma which represented less than a third of one percent of the total group. The researchers basically found no link between PDE5 inhibitors and melanoma in the control group.

However, of the group of men who took PDE5 inhibitors for ED, a link was found. The men did have a higher risk for basal cell carcinoma and squamous cell carcinoma, both which are types of skin cancer more common than melanoma. Researchers speculated that sun exposure was most likely the primary lifestyle factor at play here.

The final conclusion from these various studies was that their findings did support the safety of PDE5 inhibitors use in the United States.

In the meantime, all men (and women) should protect themselves from skin cancer. It is still important for everyone to practice the following tips to reduce their risk:

·      Stay in the shade and wear protective clothing such as long sleeves, long pants, and a sun hat

·      Use liberal amounts of sunscreen (SPF 30 or higher). Its recommended to apply about an ounce of sunscreen which is the amount that would fit in a shot glass for the average adult. Even on cloudy days, sunscreen should be worn.

·      Remember that water, sand, and snow can reflect the sun’s rays

·      Avoid the use of tanning beds

·      Check skin regularly and see a dermatologist if you see any unusual changes