Alcohol and Cancer: The Facts
Like a lot of people I enjoy a glass of wine but since my diagnosis I have been looking at some of the evidence that links alcohol with cancer and there is no doubt it is worrying. For a while now we have realised smoking and various types of cancers are linked but now alcohol consumption is coming under the spot light.
There is more information coming to light about the causative effect of alcohol on cancer. There is no doubt that the less you drink the lower your risk of cancer (it doesn’t matter what type of alcohol or whether it is spread across the week or drunk in one go at the weekend). It is estimated (Cancer Research UK) that heavy drinking causes 3% of cancers in the UK every year.
It is also recognised that certain cancers are more common in people who drink alcohol. These are mouth, throat and larynx, oesophagus, breast , liver and bowel (Brown KF et al, British Journal of cancer:118, 1130-1141 (2018)) (Quite heavy science and stats!).
These are the facts.
For me this subject has prompted a lot of questions which I assume that other people are wondering too.
- Is there a safe amount to drink?
- Why does alcohol cause cancer?
- Does this mean alcohol could cause my cancer to come back?
- What are the guidelines?
- Why do people drink?
- What does this mean for me?
Sensible Drinking – is there a Safe Amount?
In January 2016 the UK’s Chief Medical Officer produced new guidelines for alcohol consumption. In the guidelines was the warning that drinking any level of alcohol increases the risk of a range of cancers.
The risk starts with any level of regular drinking and increases with the amount being drunk. The aim of the new guidelines is to try and reduce the amount of cancer and other alcohol related diseases.
Interestingly, at the same time it was announced that there is no justification for drinking for health reasons (the benefits of alcohol on a healthy heart are limited to women over 55 who consume approximately two glasses of wine a week).
The maximum amount of recommended units was reduced accordingly. Men should not drink more than 14 units a week (6 pints of weak beer) which should mean a lower risk of liver disease and cancer. This is now the same level as women. These units should also not be ‘saved up’. People that have 1 or 2 heavy drinking sessions a week are more at risk of death from accident or illness.
Why does Alcohol cause Cancer?
Alcohol causes cancer because of the way our bodies break it down. Alcohol is broken down into acetaldehyde by the liver. This nasty chemical then damages the DNA within our cells and prevents the cells from trying to repair this damage. Acetaldehyde also promotes faster liver growth and the faster an organ grows the more likely it is to produced abnormal cells (and lead to cancer).
In some cases of breast cancer higher levels of oestrogen which are caused by alcohol are responsible. Alcohol can also disrupt the absorption of other nutrients – folate for example and it is thought that this imbalance may play a part in causing some cancers eg. breast and bowel.
Of course we all know that alcohol contains calories so heavy drinking can be linked to a higher body weight and it is becoming more clear that being overweight or obese is a large cancer risk.
Does this mean Alcohol could cause my cancer to come back?
So far there is no strong evidence from medical studies that alcohol can cause cancer to come back. However, This doesn’t mean it can’t. The same mechanisms could occur again so it is worth bearing this in mind.
What are the Guidelines?
UK guidelines are 14 units for both men and women. It is advised that these are not stored up and drunk at one time.
For general guidance see the Drinkaware Website
Why do People Drink?
It’s interesting to think about why you drink alcohol. For most of us its a part of life (hopefully not daily!), that glass of wine after a hard day, that glass of wine after a good day, that glass because the weather is nice…. you can see where this is going.
The psychology behind our relationship with alcohol is also interesting. Different people will place different values on drinking alcohol and have different expectations of what drinking may do for them.
Some may drink to improve low mood or anxiety and some may drink to improve their confidence. They will have a certain level of expectation as to whether this will be achievable or not which may be based on previous experiences with alcohol.
Previous positive experiences of drinking alcohol – including feeling happy and having fun will influence someone’s decision to drink again. There are some negative experiences – that bad hangover for example that may make people think twice. But not always!
Of course, for a lot of us, stress is a motivating factor to drink alcohol and being diagnosed with cancer is a very stressful time. It is worth bearing in mind that the relief of stress with alcohol is only a temporary fix and the flipside can be feelings of depression and anxiety which are emotions you really do not need right now.
The biggie is probably that drinking alcohol, for all its well documented side effects and negatives, is the social norm in many western countries. There are a lot of situations in which drinking alcohol seems to be expected and it may take some effort not to drink.
Here I am thinking about alcohol and its link with cancer and that now may be the time (or not) to reset. Obviously there are some people that struggle more with their drinking. If you are worried have a look at this useful resource on NHS choices.
So what does this mean for me?
You obviously have a lot to think about at this time and alcohol is just one of those things. In the early days it may not be the most pressing as you are absorbing so many facts and potential life changing situations.
You may, like me, completely lose interest in alcohol (and being social too for a bit!) in the early days and especially around chemotherapy. But, with more and more people living after cancer it is definitely something to think about. I suspect more evidence will continue to come to light enabling us all to make good choices.
Chemotherapy and Alcohol
The safety and wisdom of drinking alcohol while on chemotherapy will depend on your drug regime. It is worth asking your oncology team whether the two are compatible. You may find it is not even a question that occurs to you as alcohol is the last thing that you feel like.
General consensus seems to be that the odd glass of wine or beer is ok in most cases. But double check.
Where to Now?
This is something that is changing – luckily (!) there are many more people who are living after or with cancer. This means there are now lifestyle choices to consider once you have been diagnosed or dealt with your cancer that people wouldn’t have had a few years ago.
My feeling is that we need to use this time wisely and make good choices but not forget to live a little. Science has done so much for us and making the most of it is now back in our hands!
Ultimately though I do think life is too short to either waste or not appreciate.