For prostate cancer patients, radical prostatectomy is a hope for survival. However, as well as being a blessing, radical prostatectomy can also be a nightmare for men, as ED (erectile dysfunction) often occurs after surgery.5 Phosphodiesterase type 5 inhibitors (PDE5i, Viagra, Cialis) are a boon for men with ED, and are certainly popular among post-prostatectomy ED oncology patients. The eternal theme in oncology research is “multiple use of one drug, new use of old drugs”. Some people say that aspirin can fight cancer, metformin can fight cancer, reaction stop can fight cancer, broccoli can also fight cancer. It’s hard to distinguish the truth from the facts. The ED drug, of course, should be hard! Preclinical studies have found that PDE5 inhibitors can inhibit the development and metastasis of many types of tumors, and their mechanism of action may be related to immunosuppression and apoptosis induction. In addition, epidemiological studies have likewise found that taking PDE5 inhibitor drugs significantly reduced the incidence of prostate cancer in ED patients compared to those who had ED but did not act on it. However, are PDE5 inhibitor drugs good or bad for oncology patients who have ED as a result of prostatectomy? For this reason, the Uwe Mich team at the Martin-Clinical Prostate Cancer Center and Department of Urology at the University of Hamburg-Eppendorf, Germany, conducted a clinical study to investigate the effect of PDE5 inhibitors on postoperative recurrence in patients with prostatectomized tumors, which was recently published in The Journal of Urology. The study included 4,752 patients with tumors who underwent bilateral nerve preservation-radical prostatectomy between 2000 and 2010. Postoperatively, 23.4% of patients (1,110) were taking PDE5 inhibitors, and 76.6% were not using them. A Cox multivariate proportional risk model was used to analyze the association between the use of PDE5 inhibitors and tumor recurrence after prostatectomy. The median follow-up time was 60.3 months. The 5-year biochemical recurrence-free survival rates were 84.7% and 89.2% for the PDE5 inhibitor group and the non-PDE5 inhibitor group, respectively. The results of multiple regression analysis showed that the use of PDE5 inhibitors was an independent risk factor for postoperative recurrence in patients with prostatectomy tumors. In summary, it can be found that the results of this study contradict the results of preclinical studies and epidemiological studies. It is likely that patients with oncology who unfortunately develop ED after prostatectomy and then use PDE5 inhibitors to help with “sex” may have a higher rate of recurrence after surgery. Of course, this result has yet to be verified in other retrospective and prospective studies. PS: ED (Erectile Dysfunction) is also known as erectile dysfunction. ED can be caused by a variety of reasons, and ED in prostate patients after surgery may be a side effect of treatment. Common ED medications include sildenafil sildenafil (Viagra), vardenafil (Levitra), tadalafil tadalafil (Cialis), all of which are PDE5 inhibitors. The general principle of action: Under normal conditions, PDE5 degrades cGMP (cyclic guanosine monophosphate) and maintains its normal level. If PDE5 activity is inhibited, intracellular cGMP concentrations increase abnormally, smooth muscle relaxation occurs, and intracavernous arterial blood flow to the penis increases.