Viagra/Cialis and Melanoma: Jury is Still Out

Raleigh, NCSexually active older men worried about the link between melanoma and Viagra/Cialis can relax—maybe. A new study has found that there is no link to skin cancer and the erectile dysfunction medications, but that doesn’t necessarily mean they should keep popping those blue pills.

In the Journal of the National Cancer Institute (May 19, 2017) study leader Dr. Stacy Loeb, a urologist and assistant professor at NYU Langone Medical Center, said that, "Physicians should still screen for melanoma risk, but they do not need to add the use of Viagra and similar drugs to the list of screening criteria specifically.” Analyzing data from more than 866,000 (!) erectile medication users, researchers found that men using these drugs had an 11 percent increased risk of melanoma, but there wasn't evidence that the drugs themselves caused melanoma.

Rather, researchers said the ED drug link and melanoma could be chalked up to "detection bias”, meaning that men likely to take ED medications are more health-conscious, more likely to see a doctor, and therefore more likely to get diagnosed with melanoma than other men of similar age.

Wilhelm, age 55, says he is health-conscious and gets yearly medical check-ups. Last year his doctor noticed an abnormal-looking spot on his back. “He referred me to a dermatologist who did a biopsy, and he diagnosed me with skin cancer,” says Wilhelm. “Soon after the diagnosis I had it cut out, just in day surgery. I got my wife to search me thoroughly and my dermatologist looked everywhere. He found another spot near my shoulder so I had another biopsy and went back to day surgery for the same procedure.”

Soon after the second area was removed, Wilhelm saw an advertisement on TV linking Cialis with melanoma. He had never made that connection. When the biopsies showed skin cancer, Wilhelm first thought about all those years he was out in the sun cutting grass, but always using sun screen. He had been taking Viagra and then Cialis for about ten years. He hasn`t taken an ED medication since seeing that TV commercial.

Wilhelm and his wife then went online and discovered so many men in similar situations, many of whom had filed Cialis lawsuits. ``I got my medical records from my doctor and dermatologist as soon as I found out about the lawsuit. I just hope they got everything from those two procedures and I don’t have to go back,” Wilhelm says.

In the wake of a 2014 report published in JAMA Internal Medicine that linked Viagra with an increased risk of melanoma, the FDA placed Viagra (sildenafil) and other erectile dysfunction drugs such as Cialis on its watch list of medications with possible safety issues. (These medications are in the same class of drugs known as PDE5 inhibitors, believed to interfere with the body’s ability to counter the spread of melanoma.) The JAMA researchers showed that men who used Viagra were 84 percent more likely to develop melanoma over a period of ten years. The study comprised more than 25,000 men in the US averaging the age of 65, six percent of whom had taken Viagra to treat erectile dysfunction.

Last year, the U.K.’s Daily Mail (March 2016), reported that scientists “revealed that Viagra promotes the growth of aggressive skin cancer,” and a study confirmed long-held beliefs that the drug raises skin cancer risk. Sildenafil, which is marketed as Viagra, stimulates tumors to grow more vigorously, researchers at the University of Tübingen in Germany discovered. Further, they found that sildenafil can encourage the growth of skin tumors. A correlation was confirmed in 2015 by another study of around 24,000 men in Sweden. On the other hand, those
studies were unable to say whether the increased melanoma risk is in fact due to a biological effect of the drug on tumor cells. They were “unable to discount the possibility that a higher incidence of skin cancer in men using Sildenafil may be due to their lifestyles, which included sunbathing holidays and visits to the solarium.”

Thousands of men in the U.K. are diagnosed with melanoma each year, and since the 1990s melanoma skin cancer rates have increased by 162 per cent in men, compared to by 89 per cent in women. These statistics beg the question: what if women also took Viagra and Cialis, would those percentages change?

The American Cancer Society estimates for melanoma in the United States for 2017, about 87,110 new melanomas will be diagnosed (52,170 in men and 34,940 in women). And the rates of melanoma have been rising for the last 30 years. Viagra was approved by the FDA in 1998 and Cialis in 2003.