A serendipitous discovery leads a doctor to explore sildenafil citrate, Viagra’s active ingredient, as a treatment for lymphangioma. This physical deformity occurs most often in infants.
Lymphangiomas can occur anywhere on the body, and they can occur at any age. However, 90 percent of lymphangioma cases occur in infants under age two, and most involve some part of the head or neck. Some lymphangiomas are associated with chromosome abnormalities like Turner Syndrome (a condition where a female has only one X chromosome rather than two), while others don’t occur with any other recognizable condition. They are often diagnosed before birth with the help of ultrasound. Lymphangiomas may also be acquired, due to lymphatic obstruction or trauma.
Most lymphangiomas are benign and basically consist of a soft, doughy mass that grows slowly. They don’t turn into cancer and are typically treated for cosmetic reasons. However, depending on the location of a lymphangioma, the growth may press upon critical organs. For example, if a lymphangioma grows to where it compresses the trachea, it can be dangerous and needs to be treated. Many of the treatment methods for this condition, however, are unsatisfactory. Surgical removal, laser therapy, and radio frequency ablation (treatment using heat from high-frequency alternating current in the 350 to 500 kHz frequency range) have not proven to be as effective as hoped. Often the lymphangioma grows back after treatment.
However, researchers have discovered that sildenafil citrate, the active ingredient in the erectile dysfunction drug Viagra, may be another useful treatment option.
A Study of 7 Pediatric Patients
The Journal of the American Academy of Dermatology published a study of seven patients with lymphangiomas who were treated with sildenafil by pediatric dermatologist Al Lane, M.D., of Lucile Packard Children’s Hospital at Stanford University. Sildenafil has a strong safety profile and is actually already used in children who have a condition called pulmonary arterial hypertension. Of the seven children in the lymphangioma study, six responded to sildenafil, though some responded more favorably than others. One child’s lymphangioma worsened during treatment with sildenafil, however.
Lane and his team are now planning a larger, double-blind, placebo-controlled study in hopes of learning why these children responded differently to the medication. Currently, Lane is waiting to find out if the study will be funded through an orphan disease grant from the National Institutes of Health and the U.S. Food and Drug Administration.
Ocular Lymphangiomas
Lymphangiomas that occur near the eye often produce serious complications and are harder to treat than other lymphangiomas. The traditional treatments carry significant risks, and the results are hard to predict. In September 2013, the journal JAMA Ophthalmology published a study of two children with ocular lymphangiomas that was conducted by researchers at the Department of Ophthalmology at the University of California-Davis in Sacramento.
Two pediatric patients with ocular lymphangiomas were treated with sildenafil. One patient was a 12-month-old boy with an extensive orbital and facial lymphangioma who had been treated unsuccessfully using drainage procedures. He responded well to treatment with sildenafil. The other patient was a 12-year-old boy with an orbital lymphangioma that caused severe eye pain. He was facing possible removal of the eye due to the condition, but after sildenafil treatment, this was unnecessary.
Researchers hope to conduct larger clinical trials so they can clarify the optimal length of treatment with sildenafil and any possible long-term side effects.
How Does Viagra Help?
More research is needed to determine exactly how Viagra improves lymphangioma. In general, Viagra works by relaxation of the smooth muscle that lines blood vessels. It’s possible that this effect causes the channels of the lymphatic system to become decongested, reducing swelling. It’s also possible that dilation of blood vessels near the lymphangioma compresses the growth and causes it to shrink. Doctors won’t be able to routinely treat lymphangioma patients with sildenafil until they conduct a placebo-controlled trial and receive approval through the FDA.
It doesn’t make intuitive sense that Viagra could treat a condition like lymphangioma, so how did researchers figure it out? Lane at Lucile Packard Children’s Hospital in Palo Alto happened to be treating a child who had both pulmonary arterial hypertension and a lymphangioma. When he treated the pulmonary hypertension with sildenafil, he noticed that during treatment the lymphangioma shrank significantly. Unfortunately, this child’s primary pulmonary hypertension was severe enough that she died, but her case could have profound positive influence on how lymphangiomas are treated in the future.
Other Medical Uses for Viagra
Viagra started out as a compound being tested for treating high blood pressure and angina. It wasn’t useful for that purpose, but the compound’s notable side effect of helping men have stronger erections led to research of the drug as a treatment for erectile dysfunction. Viagra was revolutionary in many ways, not only offering an effective, simple new treatment for ED, but also prompting dialog between men, their partners, and their doctors about ED and showing that ED is not as uncommon as people may have believed.
In the years since Viagra was introduced, sildenafil has been studied as a treatment for numerous other conditions, including:
- pulmonary hypertension
- stroke
- altitude sickness
- menstrual cramps
And researchers continue to discover new possibilities about what sildenafil (or other drugs in the same class) may be able to treat.
Viagra may have given many men back their satisfying sex life, but it has also been shown to affect many serious illnesses. Primary pulmonary hypertension is probably the best-known of the non-ED conditions sildenafil treats, but there are many others, and there could be more yet to be discovered. Other drugs in the same class, like Cialis, have been used for other conditions too. In the case of Cialis, the drug is used to treat benign prostate enlargement as well as ED.
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