Antihypertensive Drugs and Cancer: Simultaneously Development of Choroidal Melanoma and Colon Carcinoma after Administration with Valsartan/ Hydrochlorothiazide

Abstract

Recently published experimental data on the presence of different types of angiotensin receptors in melanoma tissue and in breast cancer, for example, are undoubtedly alarming and indicative because Sartan therapy (in certain groups of patients) may be a risk factor for the patients themselves. The reason for this is the ability of the specific group of drugs to promote carcinogenesis by blocking certain types of receptors, presented in certain types of tumors. The available in vivo and in vitro data in the world literature on the influence of antihypertensive drugs (Sartans and Thiazide diuretics) on melanogenesis and development of other cancerous forms, although disputed, are numerous. Even more disturbing are the further data in the medical literature on the development of multiple tumors after administration of Sartans alone or in combination with hydrochlorothiazide. According to other literature data, even monotherapy with the already mentioned diuretichydrochlorothiazide, could be seen as a possible key or risk factor for the development of cutaneous melanoma. We present a clinical case of a 67-year-old patient with anamnestic data for systemic antihypertensive therapy with a combined preparation containing Valsartan / hydrochlorothiazide 160 mg / 12.5 mg for the period from the end of 2011 to March, 2020, came on occasion of a prophylactic dermatological examination. The examination found a pigmented lesion in the right torso, clinically and dermatoscopically suspected of thin cutaneous melanoma. According to the anamnesis and available documentation, it is clear that within this combined antihypertensive medication, the patient has developed two additional neoplasms in the recent past: choroidal melanoma and colorectal carcinoma successfully treated surgically. To what extent, the shared data (on the occurrence of multiple tumors after combination treatment with antihypertensives such as sartans and thiazide diuretics) would lead to the necessary and desirable rethinking of therapeutic strategies for the treatment of hypertension and clarification of the mechanisms at molecular level, at this moment remains unclear. But in practice it should be highly recommended.