The abuse of alcohol is the leading risk factor for disability and premature death in the world. Besides tobacco an other harmful agents, alcohol is the most common cause of many illnesses in our midst, cancer included. Alcohol-related deaths claim almost 80,000 lives each year in the United States alone. Worldwide, it kills 2.5 million annually. Besides the health and psychological impairment among drinkers, the abuse impacts negatively on the family members and society in general. Among the mortalities are those who died of alcohol-related cancers.
While a glass or two of wine, especially the red variety, like my favorites, Pinot Noir (which usually has 25 percent Syrah in it) and Cabernet Sauvignon (which normally contains 25 percent Merlot in it) and other Reds are recommended with dinner for those who enjoy wine, heavy or regular alcohol consumption beyond that increases the risk for developing cancers of the oral cavity, throat, larynx (voice box), esophagus, liver, colon, rectum, and breast. The higher the intake, the greater the risk. Those with liver cirrhosis from alcohol also have higher risk for hepatoma (liver cancer).
How is alcohol produced?
Alcohol, medically called ethanol (ethyl alcohol), is results from the fermentation by yeast of sugars and starches. This substance is found in mouthwashes, some household products, wine, liquor, and beer. Wine and sake contain 9-15 percent alcohol; wine fortified with liquor has 16-20 percent; and beers and hard ciders, 3-7 percent. Distilled spirits (whiskey, gin, vodka, rum, which are made by distilling ethanol from fermented fruits, grains or vegetables) has at least 35-40 percent (70-80 proof) alcohol.
Any toxic agents during the process?
The following toxic and carcinogenic (cancer-causing) contaminants are found during fermentation and production: hydrocarbons, phenols, nitrosamines, and asbestos fibers. Obviously, those who imbibe lightly would get only a small does of the toxic agents and those who drink a lot would get a much higher dose of the cancer-causing agents.
What is the standard alcoholic drink?
In the United States, a standard alcoholic drink has 14 grams (0.6 ounces) of pure alcohol, which is found in 1.5 ounces or a “shot” of 80 proof liquor, 12 ounces of beer, 5 ounces of wine, or 8 ounces of malt liquor, according to the National Institute on Alcohol Abuse and Alcoholism.
How much is too much?
Moderate drinking is defined by the US federal guidelines as up to one drink per day for women (who are not pregnant) and up to two drinks per day for men. Imbibing more than three a day or more than seven per week for women, or more than four drinks a day or more than 14 per week for men is considered heavy drinking.
What is the evidence for this cancer link?
There is an overwhelming consensus, based on extensive studies, that clearly links alcohol intake to the increased risk for cancer of those organs listed above. The National Toxicology Program of the US Department of Health and Human Services considers alcoholic drinks as human carcinogen (cancer-causing agents). Cancer is the second most common cause of deaths (1 in 4) in the United States. An estimated 1,665,540 new cases of cancers are expected for this year, 2014, with more than half a million deaths. About 3.5 percent of cancers deaths in the United States is associated with alcohol.
How about alcohol-tobacco combo?
While drinking in moderation as defined above among people who can tolerate alcoholic beverages is generally considered safe for the majority, smoking, even one stick a day, a week or a month, is dangerous. Each person reacts differently to toxic agents. The combination of alcohol and tobacco (two common cancer-causing agents with countless toxins in them) exponentially increases the risk for cancer, pulmonary, cardiovascular, and metabolic illnesses.
How dangerous are energy drinks?
All energy drinks as advertised (a combination of coffee and alcohol) are unhealthy and dangerous, resulting in some reported deaths around the world. The caffeine in this concoction masks the effects of alcohol and the person’s level of intoxication. Those consuming any alcoholic drinks are twice as likely to ride with a driver who are intoxicated and be victims of rape and accidents. Women have slower metabolism for alcohol because, compared to men, they have lower water content in their body, and therefore, alcohol stays in their system less diluted, and longer. For energy drinks, the risk for developing cancer could be dose-related also as noted below.
What are the specific organ risks?
Persons who imbibe 50 or more grams of alcohol per day (about 3.5 more drinks a day) double or triple their risk for cancers of the head and neck (mouth, throat and voice box), and esophagus and liver (especially those with hepatitis B or C, which are primary causes of liver cancer themselves). Women who has 3 drinks a day has 1.5 times higher risk than nondrinkers for developing breast cancer. The study of 28,000 women in the United Kingdom shows that low to moderate intake of alcohol (for every 10 grams) had a 12 percent increase in the risk for breast cancer. Having 3.5 drinks a day increases the risk for colorectal cancer by one and a half times (almost doubled) compared to nondrinkers or occasional (social) drinkers.
Does alcohol LOWER the risk for other organs?
Yes, amazingly, it does for cancers of the prostate, stomach, ovary, pancreas, bladder and uterus, where there are no evidence in several studies to show any link between alcohol intake and these cancers. But in science, the absence of proof or evidence of link does not totally rule out a possible (yet unproven) association.
Any proven benefits of alcohol?
As far as cancers are concerned, there are two malignancies where consumption of alcoholic beverage appears to show 15 percent decrease (compared to nondrinkers) in the risk for their development: renal cell (kidney) cancer and non-Hodgkin Lymphoma (NHL), as shown in multiple studies and meta analyses.
Does race play a role?
Yes, because the genes influence an individual’s reaction to alcohol consumption. Chinese, Koreans, and especially Japanese carry a “superactive” version of the gene ADH (alcohol dehydrogenase) that encodes enzymes necessary in the metabolism (break-down) of alcohol. People from these 3 countries, foremost Japanese descent carry the code for a “superactive” form of the ADH enzyme, which rapidly converts alcohol to toxic acetaldehyde, which increases the risk for pancreatic cancer, among others, compared to those with common form of ADH. Those with deficiency of the other enzyme, ALDH2 (aldehyde dehyfrogenase 2), which converts toxic acetaldehyde to non-toxic agents, also have higher risk for alcohol-related cancers.
Does stopping alcohol intake reduce cancer risk?
Yes, but the reduction in the risk after cessation from drinking is not immediate. It can take up to 15 years before the cancer risk is reduced to the level of nondrinkers. This is the reason why moderation as defined in the abovementioned guidelines is the most prudent way to handle alcoholic beverages. It’s fun to drink, especially socially. Let’s enjoy it for a longer period of time.
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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]
