Viagra an anti-cancer drug? Erectile dysfunction drugs may help treat esophageal cancer

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LONDON – Drugs that are commonly used to treat tens of millions of men with erectile dysfunction may also contribute to the arduous and slow chemotherapy treatment of esophageal cancer, new research shows.

Research funded by Cancer Research UK and the Medical Research Council finds that phosphodiesterase type 5, or PDE5, inhibitors help shrink esophageal tumors and reverse a patient’s resistance to chemotherapy. Many PDE5 inhibitors used to treat erectile dysfunction, including sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis), and avanafil (Stendra) may now help cancer patients of the esophagus.

These erectile dysfunction drugs can potentially work in tandem with chemotherapy to target cancer-adjacent fibroblasts (CAFs), which are found in and around the edges of esophageal tumors.

Esophageal tumors often grow rapidly because the throat microenvironment (area immediately surrounding the tumor) is made up of CAFs, malignant molecules, and contaminated blood vessels that form a “protective coat” against chemotherapy.

Esophageal cancer has low survival rates

Some studies of esophageal cancer have found that only one in 10 patients live longer than 10 years after diagnosis. This morbid statistic is due in part to esophageal tumors which often do not respond to chemotherapy due to the protective microenvironment. However, the researchers point out that these mortality and survival data are difficult to estimate due to low response rates and highly variable diagnostic times.

Professor Tim Underwood from the University of Southampton led a team that treated an esophageal tumor microenvironment with PDE5 inhibitors. Nine of the 12 samples tested showed positive signs indicating that the tumor had become “responsive” to the drug treatment of erectile dysfunction.

Half of American men take erectile dysfunction drugs

Additional tests involving mice implanted with chemotherapy-resistant esophageal tumors found no adverse side effects to PDE5 treatment. After years of helping with the physiological aspects of erectile dysfunction, the researchers say they hope continued testing can make chemotherapy easier for a multitude of cancer patients. Erectile dysfunction drugs, including sildenafil (Viagra), enhance the effects of nitric oxide, a natural chemical produced by the body that relaxes the muscles of the penis.

More than 50 million men in America regularly ingest these drugs for physiological treatment. Psychological causes of erectile dysfunction, however, include counseling or therapy that targets potential root causes such as stress or anxiety.

Several patients diagnosed with esophageal cancer, as well as researchers involved in these latest clinical trials, have expressed optimism that PDE5-inhibiting drugs may soon help facilitate chemotherapy treatment for others.

“The chemo usually doesn’t work very well on my type of esophageal tumor, so I knew it couldn’t completely remove the tumor, it could only shrink it in hopes of making the surgery more effective,” said Nicola Packer, a human resources manager from England, diagnosed with a condition adjacent to oesophageal cancer at 53, in a statement.

“The chemo was exhausting and every week they told me my tumor was shrinking, but slowly. The anxiety you feel after having chemotherapy and then having to wait weeks for recovery before you can have surgery, knowing that chemo couldn’t do much, is overwhelming,” Packer continues. “Research like this that could mean people like me may have a better response to chemotherapy is hugely important.”

The study is published in the journal Medicine Reports Unit.

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