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Life After Cancer A Roadmap for Cancer Survivors

Alcohol and Cancer Survivors
Ernest H. Rosenbaum, MD

Alcohol has been shown to be a small to modest cancer risk factor. Research reviewing 50 epidemiologic investigations of the role of alcohol in breast cancer suggests a modest positive association between alcohol and breast cancer (an approximate 25% increase in risk with daily intake of the equivalent of two drinks).

In 2006, researchers at the National Cancer Institute showed that premenopausal women given the equivalent of two drinks a day had a shift in estrogen hormone levels that could be the mechanism behind the rise of breast cancer associated with alcohol. Breast tissue is actively sensitive to estrogen, and certain types of estrogen are known to stimulate the growth of breast cancer cells.

The recommended alcohol consumption is two drinks for men and one drink for women per day. Women have a lower suggested allowance due to their lower body weight, higher body fat ratio, and because they metabolize alcohol less efficiently (slower) than men. Those who are heavy drinkers are often malnourished. Alcohol increases the need for folic acid; thus 400 mcg per day is suggested for those who consume alcohol. It has been observed that women with low folate and high alcohol consumption had a 43% greater risk of breast cancer when compared with nondrinkers with adequate folate intake. For breast cancer survivors, it is suggested to avoid or limit alcohol.

If you drink and smoke, you multiply the carcinogen effect of each substance and greatly increase your risk of oral and throat cancer (about 10 fold). This deadly combination is responsible for about 75% of oral and throat cancers.

A majority of American adults use alcohol. Drinking as a part of normal social activities, such as eating, family gatherings or social events, can contribute to general well-being and all-around happiness. In small amounts, such as one or two standard drinks per day, it appears to be mostly harmless. By reason of a favorable effect on cholesterol, it probably contributes to some reduction of coronary heart disease.

What is a standard drink? This means one ounce of spirits - whiskey, gin, scotch, vodka or brandy, which contains 40-50% alcohol; or two ounces of fortified wine, such as sherry; or four ounces of regular table wine; or twelve ounces of beer.

Consuming in excess of two drinks per day for men and one for women can be hazardous even for moderate drinkers and especially for those who consume more than fourteen drinks per week or more than five on any single occasion.

Problems include:
Body injuries, accidents, and falls
Legal problems
Problems with personal and professional relationships
High blood pressure
Heart - atrial fibrillation, fatal arrhythmias and cardiomyopathies (heart enlargement and muscle damage)
Gastrointestinal problems, such as cirrhosis and end-stage liver disease

The National Institute on Alcohol Abuse and Alcoholism is an excellent resource for information on diagnosing and treating alcohol abuse ( Interventions, either alone or in combination, with physicians, psychological counseling, behavior therapy, and/or motivational enhancement therapy have all been shown to help in curbing excessive drinking.

Alcoholics Anonymous can also play a major role in helping to keep excessive drinkers sober and functional. These non-drug therapies benefit not only the person who abuses alcohol but also can help families and friends better cope.

Drug therapies such as benzodiazepines (Valium, Ativan, Xanax, Altram) are very helpful in aiding with dependency and controlling alcohol withdrawal symptoms.

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