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Men with Peyronie’s disease may have increased risk for cancer

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November 2, 2017

Alexander W. Pastuszak

Men with Peyronie’s disease demonstrated an increased risk for cancer, according to a large retrospective cohort study presented at the American Society for Reproductive Cancer Scientific Congress and published in Fertility & Sterility.

“This is the first study that both clinically and genetically links Peyronie’s disease with other genetically linked diseases — in this case, cancer,” Alexander W. Pastuszak, MD, PhD, assistant professor of urology at the Center for Reproductive Medicine at Baylor College of Medicine, told HemOnc Today. “It’s an important set of findings because it demonstrates how certain benign conditions like Peyronie’s disease can be associated with other more morbid conditions, such as cancer, and supports the need for continuous follow-up in men, as well as education of both patients and physicians about these types of associations.”

Peyronie’s disease is the development of fibrous scar tissue inside the penis that causes curved and sometimes painful erections. It has been associated with erectile dysfunction.

Researchers examined the risk for cancer among a sample of 48,423 men (mean age, 49.8 years) with Peyronie’s disease compared with 1,117,428 men (mean age, 48.4 years) with erectile dysfunction and a control group of 484,230 men (mean age, 49.8 years).

“We know that a genetic association exists between Peyronie’s disease and two other fibrotic conditions — Dupuytren’s disease and Ledderhose disease,” Pastuszak said. “We also know that there are other chronic conditions that are genetically linked, so it was logical to examine whether Peyronie’s disease was linked to cancer, particularly because this type of link would support the need for men with Peyronie’s disease to be monitored for these conditions.”

Researchers analyzed data collected from MarketScan (Truven Health Analytics) claims from 2007 to 2014. They used a Cox regression model to compare incidence of cancer among the groups.

Mean follow-up was 4.5 years in men with Peyronie’s disease, 4.3 years in men with erectile dysfunction and 4.4 years in the control group.

Men with erectile dysfunction had higher rates of obesity, hypertension, hyperlipidemia, smoking or diabetes than men with Peyronie’s disease and age-matched controls.

Compared with men with erectile dysfunction, men with Peyronie’s disease had higher risks for stomach cancer (HR = 1.43; 95% CI, 1.02-2), melanoma (HR = 1.19; 95% CI, 1.02-1.38), testicular cancer (HR = 1.39; 95% CI, 1.05-1.84) and all cancers (HR = 1.1; 95% CI, 1.06-1.14).

“We think there are genetic abnormalities that can predispose men to both Peyronie’s disease, as well as certain cancers, and potentially other genetically linked conditions, as well,” Pastuszak said. “We have some genetic data that support this association.

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“What we know is that a link between Peyronie’s disease and cancer exists, both clinically — when looking at a statistical association between Peyronie’s disease and numerous cancers — as well as genetically, when comparing genetic sequence from men with Peyronie’s disease and Dupuytren’s disease with genes that can predispose to cancer,” Pasutszak added. “As a result, men who are seen for Peyronie’s disease and treated for this condition should be counseled and monitored after treatment for malignancy and other conditions.”

Researchers noted future studies should focus on confirming these associations and elucidating pathways between Peyronie’s disease and cancer.

“We need to more clearly define the relationship between Peyronie’s disease and cancer by longitudinally following men with Peyronie’s disease and/or cancer to see if they develop reciprocal conditions,” Pastuszak said. “We would also like to investigate the genetic alterations that we identified in men with Peyronie’s disease and Dupuytren’s disease to see whether they truly predispose to malignancies.”– by Chuck Gormley

 

For more information:

Alexander W. Pastuszak, MD, PhD, can be reached at pastusza@bcm.edu.

 

Disclosures: The Eunice Kennedy Shriver National Institute of Child Health and Human Development Program funded this study. Pastuszak reports a consultant role with Endo Pharmaceuticals outside the scope of this research. Please see the abstract for a list of all other authors’ relevant financial disclosures.