Avoid Alcohol During Cancer Treatments
Navigating the complex relationship between alcohol consumption and cancer treatments, the importance of open, non-judgmental discussions about alcohol use becomes evident. The health implications are significant, with alcohol potentially exacerbating the side effects of treatments and increasing exposure to various complications. However, societal norms and pressures around drinking may pose additional challenges, underscoring the need for a comprehensive patient care approach.
Text by Arja-Leena Paavola
Cancer Society of Finland
This blog post first appeared on the
Cancer Society of Finland website
Cancer drugs strain the liver and kidneys, thus it's good to limit alcohol consumption. Discussing drinking might be difficult for healthcare personnel to address without creating a judgmental tone.
The ethanol contained in alcohol is a carcinogen in itself, known to cause cancer. Furthermore, alcohol may interact with drugs used in cancer treatment. Especially, the effect of painkillers can unpredictably increase due to alcohol.
"We always ask in the preliminary form how much the patient consumes alcohol. It's common for those with alcohol problems to downplay it. On the other hand, patients who take good care of themselves might be unnecessarily worried. For example, refusing a toast at a celebration isn't necessary even when undergoing cancer treatments," states oncologist Sirkku Jyrkkiö.
Discussing drinking is a challenging subject in a doctor's office, as it can easily create an image of health terrorism. That's not the intention; instead, the goal is the best possible treatment outcome. Cancer treatments usually last about 4-6 months, sometimes longer. From the perspective of cancer treatment, situations are individual, but it's generally held that alcohol isn't used during cancer drug treatments. This ensures safe ground.
"During treatments, the main issue is that alcohol can affect the elimination of cancer drugs from the body and lead to abnormal drug metabolism. As a result, the side effects of drugs can increase. Typical side effects include weakening of blood cell production, susceptibility to infection, kidney damage, mucosal lesions, and elevated liver values. We see all of these anyways, but they can intensify due to alcohol," Jyrkkiö explains.
Impact on General Health
If long-term excessive alcohol use has already resulted in cirrhosis, it significantly complicates cancer treatment. A little-known fact is that when used continuously, alcohol causes diarrhoea, which also affects overall health. Taking a break from drinking is generally a good idea, as it allows the body to recover.
"Patients usually accept the recommendation well. However, those with a dependency might find it very difficult and continue drinking. We, as doctors, cannot intervene in the issue of alcoholism, even if we notice it. Especially in the age groups where cancer is most prevalent, alcohol is also heavily consumed."
According to Jyrkkiö, the biggest issue regarding alcohol is Finland's alcohol-positive culture. This includes underestimating alcohol-related harm and the fact that alcohol is offered in many places and situations. Many also pay attention if someone isn't drinking. Overall, social life encourages drinking, and there even might be some pressure to do so.
"The good thing is that there are more sober young people. At the same time, however, some young people still drink a lot, and concurrent use with illegal drugs has increased. Particularly for a woman's body, it's harmful to expose oneself to alcohol every day. This applies even if it's just one glass."
Alcohol makes a bad situation worse
Frequently, individuals turn to alcohol to lessen diverse levels of stress, anxiety, and symptoms of depression. Receiving a cancer diagnosis is a true crisis. If one is accustomed to using alcohol as a kind of comfort drink, the first thought may be to reach for the bottle. The old truth, however, also applies here: things never get so bad that drinking couldn't make them even worse.
Many want to know if there is a safe limit for drinking, one that would not harm their health. In Finland, a moderate risk level is defined as 14 units per week for men and 7 for women. Kaarlo Simojoki, the medical director of the A-clinic, has criticized that the limit for safe alcohol use is set too high in Finland. In addition, many might interpret these figures as target values, even though the idea is to stay below the risk limit when drinking.
"The fact is, alcohol is a poisonous substance to humans, there's no getting around that. It's also a contributing factor to many cancers. Even moderate alcohol use over a long period of time increases the risk of cancer," emphasizes Jyrkkiö.
"Up to 40 per cent of cancers could be prevented with healthy lifestyles, and alcohol is one of the most significant lifestyle-related cancer risks. The more alcohol is consumed, the higher the risk of falling ill. Particularly in large disease groups, such as prostate cancer, breast cancer, and colon cancer, there is a lot of scientific evidence of the effect of lifestyles on prognosis."
Often risk factors accumulate
Drinking alcohol causes cancer for several reasons. The ethanol contained in alcoholic beverages is a carcinogen that has been classified as causing cancer in humans. For example, drinking alcohol increases estrogen levels, which particularly increases the risk of breast cancer in women who have passed menopause. Alcohol and its by-products can also cause inflammation of the liver and cirrhosis. It is known that 10-20 per cent of cirrhosis patients get liver cancer.
Typically, multiple risk factors accumulate in the same individuals. Conversely, those who, for example, follow a healthy diet often also exercise, maintain a normal weight, and avoid excessive drinking.
"The true cancer burden of alcohol is increased by its combination with other carcinogenic substances. The worst combination for health is smoking and drinking alcohol simultaneously. Their combined use increases the risk of cancer many times over compared to the risk caused by each independently. Alcohol acts as a kind of solvent, facilitating the absorption of harmful compounds in tobacco. What we know for sure is that in cancer prevention, alcohol consumption does not bring any health benefits."
This article first appeared on the Cancer Society of Finland website