"Erectile Dysfunction" Drugs Heighten Natural Anti-Cancer Activity

Sildenafil and other "impotence drugs" that boost the production of a gassy chemical messenger to dilate blood vessels and produce an erection now also show promise in unmasking cancer cells so that the immune system can recognize and attack them, say scientists at the Johns Hopkins Kimmel Cancer Center.

Tests at Hopkins on mice with implanted colon and breast tumors showed that tumor size decreased two- and threefold in sildenafil-treated animals, compared to mice that did not get the drug. In mice engineered to lack an immune system, tumors were unaffected, proof of principle, the scientists say, that the drug is abetting the immune system's own cellular response to cancer.

In a report published in the Nov. 27 issue of the Journal of Experimental Medicine, the Hopkins team says boosted levels of the chemical messenger nitric oxide appear to dampen the effects of a specialized cell that diverts the immune system away from tumors, allowing swarms of cancer-attacking T-cells to migrate to tumor sites in the rodents.

Lab-grown cancer cells treated with sildenafil showed similar results, as did tissue samples taken from 14 head and neck cancer and multiple myeloma patients.

Sildenafil, marketed under the trade name Viagra, is one of a class of drugs used to treat erectile dysfunction in millions of men, and in recent years, its ability to stimulate the production of NO has been investigated by experts in diseases linked to the activity of blood vessels and blood components.

The new Hopkins study homes in on a tactic used by cancers to avoid detection by the immune system by turning elements of that system to its own advantage, says Ivan Borrello, M.D., assistant professor at the Johns Hopkins Kimmel Cancer Center.

Borrello and his colleagues found that tumors exploit nitric oxide-producing immune cells to create a sort of "fog" that keeps them hidden from white blood cells (T-cells) that mount attacks on tumors.

These NO-producing cells, a.k.a. myeloid-derived suppressor cells (MDSCs), normally use nitric oxide to help bring the immune system back down to surveillance levels after an "attack mode" response to foreign material.

The impotence drugs seem to reverse this process, stopping the production of nitric oxide by MDSCs thereby allowing other immune cells to "see" the cancer and attack it, says Paolo Serafini, Ph.D., a research fellow in Borrello's laboratory and lead author on the paper.

Nitric oxide is infamous among city dwellers as a component of air-polluting smog, but is gaining importance in medical research for its cell-signaling duties and its ability to divert soldiering T-cells that patrol and protect.

The Hopkins team also analyzed gene expression patterns of the myeloid-derived suppressor cells and found that sildenafil blocked two genes regulating enzymes -- arginase and nitric oxide synthase -- which are key to triggering immune suppression via MDSCs. Borrello's team found that the arginase enzyme, which metabolizes a dietary supplement called L-arginine, also contributes to dampening the immune system through MDSCs much like nitric oxide, and its production can be reversed by sildenafil.

"Impotence drugs won't cure cancer," Borello cautioned, "but could be used in addition to standard chemotherapy or immunotherapy treatments."

The investigators are planning human studies to begin in the next year.

Penis Enlargement

Penis enlargement procedures are techniques reported to make the human penis larger.

This is frequently the goal of men dissatisfied with their penis size. In general, where there is a perceived need to increase penis size, some safe self-treatment methods should be tried rather than attempting medical surgery. This is believed to be effective but extremly dangerous.

Very few men have a very small penis: this is known as a micropenis, and is a very unusual condition which will generally have been detected in early childhood. Penis-enlargement self-treatments are not effective on this condition.

Self-treatment methods

Cosmetic

Rather than attempt to change the actual size of the penis, one may make it appear bigger, by trimming the pubic hair or by losing weight, which may be of particular use if one is overweight.

Pills

"Penis enlargement pills" or ointments are commonly offered over the Internet; these, for the most part, are scams.Analyses performed by Flora Research of California and by the University of Maryland have uncovered harmful contaminants in a number of "penis enlargement" pills. Contaminants found included mold, yeast, dangerous E. coli bacteria, pesticides, and. Dr. Michael Donnenberg of the University of Maryland has described herbal pills marketed by Performance Marketing Ltd. as having "heavy fecal contamination", possibly from animals grazing near the plants harvested for herbal ingredients. There may however be a placebo effect i.e. a psychological effect of making the user think he has a larger penis, and increasing his confidence, when there is no actual change to his penis size. Some people have also reported that such pills make them feel sexually aroused, and give them harder erections, but again, without any actual growth of the penis.

Penis pump

A penis pump is a cylinder that is fitted over the penis, with a manual or motorized pump to create suction. As the apparatus creates a vacuum around the penis, blood is drawn into the penis causing it to become engorged. The higher the vacuum, the higher the blood-pressure becomes within the penis; excessive pressure causes vascular damage rather than a harder penis.

Pumping must be done very carefully to avoid injury: manufacturers' instructions should be followed. Manual pumps often recommend a gentle pump followed by a pause, then repeated. Over-enthusiastic pumping can burst blood vessels and form blisters. In some cases the testicles can be unexpectedly pulled into the cylinder and cause severe pain and injury. It is also believed that the rim of the cylinder can cut into the skin and over time cause damage to the ligaments surrounding the penis. These dangers are easily avoided by following instructions.

Penis pumps, usually described in this context as vacuum pumps, have use in conventional treatment of impotence. The pump itself is essentially as described above, although often made to higher standards of quality with a much higher price, and arrangements for distribution by suppliers of medical equipment. One or more flexible compression rings are fitted on the open end of the cylinder, then an erection is created by pumping. The rings are pushed by hand onto the base of the erect penis before releasing the vacuum. This enables the erection to be held even in the presence of problems of the vascular or nervous system which would otherwise lead to immediate loss of erection. In the best circumstances erections can be maintained for a considerable time, but manufacturers' literature recommends that rings should be removed after not more than 30 minutes for safety.

Jelqing and clamping

Jelqing is a method intended to enlarge the penis by increasing the blood pressure in the penis, with the goal of permanently increasing the maximum erect size of the penis. This technique, also called "milking", involves wrapping the thumb and index finger around the penis while semi-erect and repeatedly drawing them away from one's body to force blood into the glans, thus encouraging more vascularity in the corpus cavernosa and associated tissues. Whether jelqing actually works or not is a subject of controversy.

Jelqing is typically preceded by a warmup with a hot compress on the genitals, and concluded the same way.

Clamping is a technique that uses a constricting device, such as a shoe string, cable clamp(CableClamp/CableCuff), or a tight cock ring. The clamp is firmly tied, clamped, or put, respectively, on the base of the erect penis while "edgeing" (extended masturbation) with a firmly erect penis.

Stretching and hanging

Stretching consists of gripping the glans, or just behind the glans, and pulling for a set period of time. Giving a similar effect, hanging consist of attaching a device that grips the glans or just behind the glans and allows a weight to be suspended for specific amount of time.

The idea behind such exercises is to stretch the tunica albuginea and other various tissues of the penis. The general effect is to elongate the penis, although widening can also occur.