Peyronie's disease causes the penis to develop a significant curve. Recent research shows that the total cancer risk in these men may be increased.
Peyronie's disease is a disorder of the connective tissue in the penis. Also referred to as penile fibrosis, it causes fibrous plaques to grow in the soft tissue. This scar tissue can cause painful erections and erectile dysfunction. It also shortens and curves the penis.
It is difficult to know exactly how many people are affected by Peyronie's, but estimates range from 1–23 percent of men aged 40–70.
The plaques that develop as part of Peyronie's are not contagious or cancerous, and the exact causes are still not understood. Some cases seem to be linked to an injury to the penis or a series of injuries over time, but this is not always the case. There may also be an autoimmune component to Peyronie's.
Peyronie's, genes, and cancer
The condition has been shown to run in families and, recently, the genetics involved in Peyronies has received growing attention. Interestingly, some of the genes that have a relationship with Peyronie's disease also appear to be involved in certain types of human cancer.
On the back of these recent findings, researchers from Baylor College in Houston, TX, decided to see whether Peyronie's disease is linked to a measurable increase in cancer risk.
Dr. Alexander Pastuszak was the lead investigator; their findings were published recently in the journal Fertility and Sterility and presented at the American Society for Reproductive Medicine's annual meeting on 31st October.
Data was taken from the Truven Health MarketScan claims database from 2007–2014. This database carries information about health insurance claims made through employers. The incidence of cancer in people with Peyronie's disease was compared against those without the condition and men with erectile dysfunction, who were used as a secondary control.
In total, there were 48,423 men with Peyronie's, 1,177,428 with erectile dysfunction, and 484,230 controls, with an average age of 49.8 years. The men were observed for an average of 4 years, accounting for around 7 million total years of follow-up.
Increased cancer risk
When compared with men with erectile dysfunction, individuals with Peyronie's had a 10 percent increased risk of all cancers.
When this was broken down, men with Peyronie's had a 43 percent greater risk of stomach cancer, a 19 percent increased risk of melanoma, and a 39 percent increased risk of cancer of the testis.
The authors concluded:
"Men with PD [Peyronie's disease] have an increased risk of developing cancer, suggesting a possible common etiology between PD and cancer development, supporting recent genetic findings."
To further drill down into these findings, the same team investigated the genome of a father and son with Peyronie's.
At a press briefing, Dr. Pastuszak explained what they uncovered: "We found that this father and son had a set of genes that predispose them to both genitourinary or urologic cancers, and testis cancer is within that group, as well as stomach cancers."
As they delved deeper into their DNA, they saw increases in either the "suppression of tumor suppressor genes or upregulation of oncogenes."
Because this is the first time that such a connection has been drawn, more work will need to be done to firm up the findings. The researchers call for more studies looking at potential pathways by which Peyronie's could influence cancer growth and development.
Although the exact pattern of interaction between Peyronie's and cancer is not yet known, the authors suggest a new level of caution from doctors treating men with Peyronie's, saying, "additional follow-up of men with PD after diagnosis and treatment of PD may be warranted."
Dr. Pastuszak says of Peyronie's and related conditions, "While they're significant in the sexual and reproductive life-cycles of these patients, linking them to other disorders suggest that these men should be monitored for development of these disorders disproportionately in contrast to the rest of the population. Nobody has made these associations before."