Experimental evidence suggests that phosphodiesterase type 5 inhibitors may suppress tumor growth, postpone metastasis and prolong survival, but clinical data are lacking.
A study (on the effect of phosphodiesterase type 5 inhibitors on biochemical recurrence after radical prostatectomy for prostate cancer) was comprised of 4,752 consecutive patients with localized prostate cancer treated with bilateral nerve sparing radical prostatectomy between January 2000 and December 2010.
1,110 (23.4%) of these patients received phosphodiesterase type 5 inhibitors postoperatively while 3,642 (76.6%) did not.
The risk of biochemical recurrence was compared and propensity score matched analysis was performed.
Five-year biochemical recurrence-free survival estimates in the phosphodiesterase type 5 inhibitor vs nonphosphodiesterase type 5 inhibitor groups were 84.7% (95% CI 82.1-87.0) and 89.2% (95% CI 88.1-90.3), respectively (p=0.0006). Multivariate regression analysis showed that phosphodiesterase type 5 inhibitor use was an independent risk factor for biochemical recurrence and this was also true after propensity score matching.
Contrary to experimental data, the use of phosphodiesterase type 5 inhibitors after radical prostatectomy may adversely impact biochemical recurrence. Further studies are needed to validate results.
Erectile dysfunction after radical prostatectomy also remains a challenge. The introduction of phosphodiesterase type 5 inhibitors has revolutionized the treatment of ED. PDE5i are widely used for ED after radical prostatectomy, and have been proven to be effective and safe.
Recent studies of prostate cancer in men with ED treated with PDE5i during a 7-year period and in men with ED who were not treated, found that the use of PDE5i was associated with a decreased incidence rate of prostate cancer in these patients.
Source http://www.ncbi.nlm.nih.gov/m/pubmed/25196656/