Alcohol and Cancer: Treating Comorbid Issues

According to the American Cancer Society (ACS), heavy use of alcohol is associated with an increased risk to develop numerous forms of cancer.

The National Cancer Institute reports that nearly 39 percent of all people in the United States will develop some form of cancer in their lifetime. The Substance Abuse and Mental Health Services Administration reports that there are nearly 15 million Americans in the United States that qualify for a diagnosis of an alcohol use disorder. While reliable figures on how many of these people will develop cancer are not available, it is a safe bet that there is significant overlap between alcohol abuse and cancer. This is because heavy alcohol use increases the risk of developing cancer.

Cancer Risks In General

According to sources such as Mayo Clinic, cancer is caused by mutations in DNA. DNA is packaged inside of cells within the genes. Genes provide the instructions and mechanism that allows cells to perform their functions, divide, and to grow. Errors in DNA disrupt the functioning of the cell and result in it becoming cancerous by:

  • Making abnormal cells divide grow more rapidly than they normally would: This results in abnormal cells proliferating throughout the body.
  • Failing to stop uncontrolled cell growth: Cancerous cells continue to grow and accumulate to form tumors.
  • Making mistakes in the function of the cells: These cells do not correct and repair errors. This results in cells becoming cancerous.

Genetic mutations in cells occur as a result of several different factors, but they are most often a result of heredity (a small percentage of cancers) and mutations that occur after an individual is born. Mutations that occur after birth are often the result of experience and other risk factors. A risk factor is some condition that increases the probability that a person will develop a disease or specific condition, but does not guarantee that the person will develop it, per Mayo Clinic.

  • A person’s family history is a risk factor. This includes both genetic factors and acquiring bad habits that can increase the risk for cancer from parents, older siblings, and other relatives. A person with a family history of cancer has an increased risk to develop cancer.
  • Getting older is a significant risk factor that contributes to the increased probability that someone may develop genetic medications. This is why elderly individuals are most often diagnosed with cancer, but cancer is not exclusively a disease associated with aging. Cancer can also be diagnosed in younger individuals under the age of 60.
  • The person’s medical history can increase the risk of genetic mutations that can result in the development of cancer cells. An individual’s medical history represents a combination of numerous factors, including their family history, age, environmental factors, and personal habits.
  • Environmental conditions can result in a person being exposed to chemicals or toxins that can increase the risk to develop cancer. These conditions can include air pollution; excessive exposure to the sun; intake of chemicals through air, food, and/or water; and exposure to secondhand smoke.
  • An individual’s personal habits are extremely important risk factors that can increase the probability that they may develop cancer. Habits that involve the use of tobacco products, drugs, and/or alcohol are particularly salient risk factors that can result in an increased risk to develop cancer.
Free and low-cost alcoholism treatment is available.

Cancer Associated with Alcohol Consumption

According to the American Cancer Society (ACS), heavy use of alcohol is associated with an increased risk to develop numerous forms of cancer. Research has linked alcohol use with:

  • Liver cancer and cancer of the kidneys: Chronic alcohol use damages the liver, and creates large amounts of scar tissue that can lead to inflammation and the risk of developing liver cancer. The kidneys often have to work excessively hard to get rid of alcohol because it can also act as a diuretic. This can increase the risk to get cancer.
  • Throat and larynx cancer: Alcohol increases the risk of these cancers, and the risk is increased exponentially if an individual uses tobacco products, such as cigarettes, and drinks alcohol heavily. This is because chronic heavy alcohol use inhibits the ability of the cells in the throat and larynx to repair the damage done by cigarette smoking.
  • Esophageal cancer: When a person uses tobacco products and is a heavy alcohol user, the risk is increased significantly, more than the risk associated with the use of tobacco products or heavy alcohol use alone.
  • Breast cancer: Even mild to moderate use of alcohol can increase the risk of breast cancer in women. Women who do not get enough folate (vitamin B9) in their diet are at an increased risk for the development of breast cancer when they use alcohol in any amount.
  • Colon and/or rectal cancer: Research suggests that the risk is higher for men who are heavy drinkers, but the increased risk occurs for both men and women.

In addition, alcohol use can increase the risk of developing cancer of the gastrointestinal tract (stomach and intestines), pancreatic cancer, and numerous other forms of cancer.

ACS reports that most people are aware that heavy alcohol use can result in health issues, but they are not aware that heavy alcohol use is associated with an increased risk of getting nearly every form of cancer.

Mayo Clinic, ACS, and other sources consistently report that it does not matter whether an individual uses or abuses beer, wine, liquor, or other alcoholic drinks. It is not the type of alcohol that determines the increased risk for the development of cancer, but the amount of alcohol and length of time an individual uses and abuses alcohol that are associated with an increased risk. Liquors have more alcohol by volume than beer and wine products, and for this reason, chronic use of liquor may result in an individual consuming more pure alcohol than they would have if they consumed the same volume of beer or wine.

Does Drinking Alcohol Cause Cancer?

According to Mayo Clinic, ACS, and the book Alcohol, Tobacco and Cancer, because it is not completely understood how any form of cancer is caused, there are probably numerous mechanisms that can result in an increased cancer risk from chronic or heavy use of alcohol. Different types of cancer may have different mechanisms that interact with the use of alcohol. There are various hypotheses that have been generated to explain the increased risk to develop cancer as a result of heavy and/or chronic alcohol.

  • Alcohol is an irritant that damages cells in the body. Any cells that are exposed alcohol in the body are damaged to some extent, and this can result in changes in the DNA of the cell that predisposes it to become cancerous. For instance, heavy alcohol use damages the liver, which can result in changes in the DNA of the liver that increase the risk to develop liver cancer.
  • Alcohol can kill healthy bacteria in the gastrointestinal tract, and this can increase the risk to develop cancer in these areas. In addition, some bacteria that are not killed as a result of exposure to alcohol can convert the alcohol into a chemical called acetaldehyde, which is a toxic byproduct of metabolizing alcohol. Acetaldehyde has been linked to the development of cancer in research studies using animals.
  • The use of alcohol is hypothesized to enhance the effect of the harmful chemicals that people may ingest directly or indirectly, such as through smoking tobacco or air pollution. Alcohol use may also weaken the body’s ability to rid itself of toxic chemicals.
  • The use of alcohol affects the body’s ability to sort nutrients. Problems absorbing specific types of nutrients have been demonstrated in research studies to increase rates of cancer in laboratory animals.
  • There is a positive relationship between the development of obesity and alcohol use. People who suffer from obesity are known to have an increased risk for many types of cancer.
  • The use of alcohol interferes with levels of hormones and other chemicals in the body. For instance, heavy alcohol use can raise estrogen levels, and this can increase the risk of breast cancer in women.
  • Heavy alcohol use is associated with a variety of chronic health issues and mental health disorders. Any one of these results in an increased risk to develop numerous forms of cancer.

The Need to Treat AUD

An individual who has developed any form of cancer and has an alcohol use disorder needs both of these conditions treated. Because there is a link between alcohol intake and the development of many different types of cancer, it is hypothesized that continuing to abuse alcohol during treatment for cancer would most likely directly inhibit the effectiveness of the cancer treatment. Moreover, the effects of alcohol abuse could indirectly result in an individual not adhering to their treatment schedule due to being intoxicated, having hangovers, lacking motivation, exacerbating other psychological issues, etc. In addition, ACS reports that direct exposure to alcohol on cancerous tissue or sores associated with the development of cancer would increase the harmful effects of these conditions.

The National Institute on Drug Abuse (NIDA) reports that there are factors associated with successful substance use disorder treatment, including the treatment of an alcohol use disorder. In general, these factors include:

  • A thorough examination of the person’s physical, psychological, and social functioning to identify all areas that need to be addressed in the treatment
  • Addressing all problem areas
  • For individuals with moderate to severe alcohol use disorders, enrollment in a physician assisted withdrawal management program, which is often referred to as medical detox, since alcohol detox can be potentially life-threatening (Depending on the situation, the person may be required to go through medical detox and safely negotiate the withdrawal period before intensive treatment for their cancer begins.)
  • The use of other medically assisted treatments for the person’s alcohol use disorder as indicated in the specific case
  • Concurrent treatment of any co-occurring mental health conditions
  • Participation in substance use disorder treatment therapy
  • The use of social support from family and friends, and participation in social support groups such as Alcoholics Anonymous
  • Monitoring to ensure that the individual remains abstinent during treatment
  • Participation in treatment for a significant length of time, generally at least 5-7 years

In addition to active participation in treatment for their alcohol use disorder, the individual would also be involved in intensive treatment for their cancer, which can include chemotherapy, lifestyle changes, further counseling, and other interventions. It is imperative that the person is treated for both their alcohol use disorder and cancer at the same time when possible.

In some cases, as mentioned above, certain aspects of treatment for a person’s alcohol abuse may precede formal cancer treatments. However, even in severe cases of cancer that require intensive treatment, alcohol abuse must be addressed. Ignoring the individual’s alcohol use disorder and concentrating on the individual’s cancer will most likely not be effective in treating either issue, and obviously, cancer is a serious disease that needs immediate attention once it is diagnosed. Thus, the early stages of treatment are quite complicated as individuals attempt to negotiate the withdrawal process associated with their alcohol use disorder while addressing issues associated with their cancer.

Remaining abstinent from alcohol results in increased effectiveness of an individual’s treatment for cancer. They are then able to comply with treatment, engage in healthy lifestyle changes, and experience enhanced physical, mental, and spiritual recovery that can prepare them for the battle with their cancer. The outlook for the individual depends on numerous factors, including the type of cancer they have, their ability to adhere to treatment, and other variables.