The link between cancer and alcohol usage

By Heather Knutson, MS, RD, CSO, LD Mar 29, 2017

Learning you are at high risk for cancer or developing health problems indicating you could be symptomatic of cancer can unsettle your world. And a conclusive cancer diagnosis can turn the world upside down. You may find yourself scrutinizing everyday behaviors and habits you have practiced for years. Alcohol consumption is among those lifestyle habits to consider examining. Can consumption impact your risk of developing a particular cancer? Or if you are already dealing with a cancer diagnosis, can you safely continue social drinking?

Most people understand heavy alcohol consumption can lead to addiction and other health problems. However, it is much less known that drinking can raise your cancer risk. Based on a 2009 study released by the U.S. Department of Health and Human Services National Toxicology Program, alcohol use is thought to account for an estimated 3.5 percent, or 19,500 individual cases, of all cancer deaths in the United States every year. Research indicates the more you drink, the higher your risk of developing an alcohol-associated cancer. What you drink doesn’t appear to be the biggest concern; rather, it is the amount of alcohol consumed over time. Most evidence points to ethanol as the primary risk factor, and ethanol is found in beers, wines and hard liquors. Different drinks have different percentages of ethanol.

If you really enjoy the occasional cocktail with friends or a drink before dinner with your spouse, you probably want to zone out about now. But hold on. As with many lifestyle patterns that are enjoyable but carry some risk, knowledge and moderation can be a good compromise.

What is too much alcohol?
For women, consuming three drinks in a day or more than seven per week is considered too much. For men, too much is consuming more than four drinks in a day or 14 in a week. The American Cancer Society defines moderate alcohol limits as no more than two per day for men and one per day for women. Because women have a smaller body size and their bodies break alcohol down more slowly, their recommended limit is lower.

What constitutes a “drink?”
It isn’t how much liquid is in your glass. Beers, wines and liquors all have very different percentages of alcohol. For instance, a 12-ounce glass of regular beer or hard cider has three to seven percent alcohol, five ounces of wine anywhere from eight to 15 percent, 1.5 ounces of 70- to 80-proof liquor or distilled spirits has 35 to 40 percent. (These are defined as a standard alcoholic drink in the United States.) Yet, all of these contain about half an ounce of ethanol. There are stronger drinks containing even higher quantities of both alcohol and ethanol.

Is it safe to continue drinking during and following cancer treatment?
Each individual, type of cancer and corresponding treatment differs greatly. There is no single answer here. Talk to your primary care provider or oncologist. Your health care team will know if you can safely drink alcohol in combination with chemotherapy drugs or other medications you may be prescribed. If you are having a treatment with a risk of mouth sores, it may be helpful to avoid alcohol intake during the course of your treatment. Even a small amount of alcohol can cause mouth sores or worsen existing ones.

For individuals who have completed cancer treatment, no strong evidence exists indicating alcohol intake may increase the risk of recurrence. Again, discuss this with your provider. Your specific cancer diagnosis and treatment, general health and risk of recurrence are all factors your provider will consider when advising you.

Will abstinence from alcohol guarantee that I will never get cancer?
The American Institute of Cancer Research does recommend abstinence as a prevention measure. Research indicates all types of alcoholic drinks increase the risk of several different cancers, particularly cancer of the mouth, throat (pharynx), voice box (larynx), esophagus, liver, breast, colon and rectum. However, there are no guarantees that any lifestyle change will definitively prevent the development of cancer.

We do know that your risk increases with the amount of alcohol consumed and with combined drinking and smoking. However, how alcohol affects cancers risk and the development of specific cancers isn’t well understood. What you choose to do in relation to alcohol consumption is a personal decision. Discussing it with your health care team and your loved ones will help you make the right decision for you.