21 September 2015

Alcohol and cancer risk

Is the odd glass of beer likely to give you cancer? What about a couple of glasses of wine regularly over a meal? The research has very clear and possibly disturbing answers on this, so this week we investigate what alcohol is, what it does in our bodies and important questions like does red wine prevent cancer?

Then there is some breaking news on the subject, and my old friend and valued colleague Dr Nimrod Sheinman returns to present around Australia (see the Events Section below) but first,

                           Thought for the day

                  The world is too much with us.
                   Getting and spending,
                     We lay waste our powers.

                                       William Wordsworth

In an earlier blog we examined the alcoholic content of various drinks and their impact on health generally. That blog came with general recommendations for the consumption of alcohol generally and may well be worth revisiting (see the link below), but this time we investigate the specific connections between alcohol, cancer and stress; connections that make for fascinating reading.

What is alcohol ?
Alcohol is actually the common term for ethanol or ethyl alcohol, a chemical produced by the fermentation of sugars and starches by yeast.

We drink it in beer, wine, and liquor, and it is commonly found in medicines, mouthwashes, household products, and essential oils.

What is the evidence that drinking alcohol is a cause of cancer?
The evidence is very strong.

Research shows that heavy or even regular alcohol consumption increases the risk of developing cancers of the oral cavity (excluding the lips), pharynx (throat), larynx (voice box), oesophagus, liver, breast, colon, and rectum, while the risk of developing cancer increases the more alcohol a person drinks.

The National Toxicology Program of the US Department of Health and Human Services lists consumption of alcoholic beverages as a known human carcinogen – cause of cancer. Based on data from 2009, an estimated 3.5% of all cancer deaths in the United States are alcohol related.

The Million Women Study in the United Kingdom provided a more recent, and slightly higher, estimate of breast cancer risk at low to moderate levels of alcohol consumption: every 10 grams of alcohol consumed per day was associated with a 12% increase in the risk of breast cancer.

However, for two cancers – renal cell (kidney) cancer and non-Hodgkin lymphoma (NHL) - multiple studies have shown that increased alcohol consumption is associated with a decreased risk of cancer. A meta-analysis of the NHL studies found a 15 % lower risk of NHL among alcohol drinkers. The mechanisms by which alcohol consumption would decrease the risks of either renal cell cancer or NHL are not understood.

How does alcohol increase the risk of cancer?
Here are some of the many ways that have been identified

1. The ethanol in alcoholic drinks is metabolised into acetaldehyde, which is a probable human carcinogen that can damage both DNA and proteins.

2. Alcohol generates reactive oxygen molecules that can damage DNA, proteins, and lipids (fats) through oxidation.

3. Alcohol impairs the body’s ability to break down and absorb a variety of nutrients that are cancer protective including Vit A, the Vit B complex, Vits C, D and E, folate and carotenoids.

4. Alcohol increases blood levels of oestrogen, the female sex hormone linked to the risk of breast cancer.

5. Alcoholic drinks may also contain a variety of carcinogenic contaminants that are introduced during fermentation and production, such as nitrosamines, hydrocarbons, phenols and asbestos fibres.

How does the combination of alcohol and tobacco affect cancer risk?

Again the research is clear. Those who use both alcohol and tobacco have a much greater risk of developing cancers than people who use either alcohol or tobacco alone.

In fact, for oral and pharyngeal cancers the risks associated with using both alcohol and tobacco are multiplicative; that is, they are greater than would be expected from adding the individual risks associated with alcohol and tobacco together.

How do a person’s genes affect their risk of alcohol-related cancers?
A person’s risk of developing an alcohol-related cancer is influenced by the genes that encode (and regulate) enzymes involved in metabolizing alcohol.

For example, one way the body metabolizes alcohol is through the activity of an enzyme called alcohol dehydrogenase, or ADH. Many individuals of Chinese, Korean, and especially Japanese descent carry a version of the gene for ADH that codes for a "superactive" form of the enzyme that speeds the conversion of alcohol to toxic acetaldehyde. As a result, when people who have the superactive enzyme drink alcohol, acetaldehyde builds up and this results in a higher risk of pancreatic cancer.

Another enzyme, called aldehyde dehydrogenase 2 (ALDH2), metabolizes toxic acetaldehyde to non-toxic substances. Some people, particularly those of East Asian descent, carry a variant of the gene for ALDH2 that codes for a defective form of the enzyme. In people who have the defective enzyme, acetaldehyde builds up when they drink alcohol.

The accumulation of acetaldehyde has such unpleasant effects (including facial flushing and heart palpitations) that most people who have the ALDH2 variant are unable to drink large amounts of alcohol. Therefore, most people with the defective form of ALDH2 have a low risk of developing alcohol-related cancers.

However, some individuals with the defective form of ALDH2 can become tolerant to the unpleasant effects of acetaldehyde and consume large amounts of alcohol. Epidemiologic studies have shown that such people have a higher risk of alcohol-related cancers.

Can drinking red wine help prevent cancer?
Laboratory research has found that certain substances in red wine, such as resveratrol have anticancer properties. Grapes, raspberries, peanuts, and some other plants also contain resveratrol. However, clinical trials in humans have not provided evidence that resveratrol is effective in preventing or treating cancer.

Breaking news - the latest research findings

Even Modest Drinking Increases Breast Cancer Risk
Having just one drink per day increases breast cancer risk, according to a study just published in the British Medical Journal

For women, having just one alcoholic drink per day increased the risk for alcohol-related cancers (mainly breast cancer) by 13 percent, compared with those who consumed no alcohol. Many previous studies have found moderate alcohol intake increases breast cancer risk.

Among men, colorectal cancer was the principal alcohol-related cancer.  

Cao Y, Willett WC, Rimm EB, Stampfer MJ, Giovannuci EL. Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies. BMJ. 2015;351:h4238.

Scoccianti C, Lauby-Secretan B, Bello PY, Chajes V, Romieu I. Female breast cancer and alcohol consumption: a review of the literature. Am J Prev Med. 2014;46:S16-S25.

What I do
I gave up alcohol when diagnosed with cancer and continued to be an alcohol free zone for around 20 years. Then it seemed I was avoiding alcohol more out of habit than good reason, given that in my view modest amounts occasionally are not problematic and it is often easier in social situations to have a little; and I do like a cold beer on a hot day and an occasional glass of good wine.

The beer I drink at home is the Coopers brand, Birrell’s. It is very low alcohol, tastes great and is bought off the shelf in the Supermarket (due to its 0.5% alcohol content).

When out I usually drink Cooper’s Light as it is low alcohol and naturally brewed and Birrells is not usually sold at restaurants and the like. Artificially brewed beers have a strong association with increased risks of bowel cancer.

So I am not wanting to sound like a wowser, but Ruth and I often share one glass of wine between ourselves when we eat out, and often do not actually finish it all.

Everyone knows moderation makes sense. Alcohol free days are really helpful if you are drinking regularly.

And do remember to drink responsibly :)


Alcohol, health and wellbeing

A volatile mix – stress, epigenetics and cancer


Details of all coming programs Ruth and I will be presenting are on our website: www.iangawler.com/events, and here are the next few:

Meditation Under the Long White Cloud   24 - 30 October 2015

7 day retreat at Mana Retreat Centre, Coromandel Peninsula, New Zealand

                 Take time out from the busyness of everyday life; spend time with your self
           Slow down, reflect, contemplate – regain perspective, vitality, balance and clarity
      Deepen your understanding and experience of mindfulness, contemplation and meditation

Full details, CLICK HERE


CANCER and BEYOND     October  2015     Monday 12th to Friday 16th 

Finding peace in the Healing Process

Five Day Residential Follow-up Program at the Gawler Foundation in the Yarra Valley

This program is specifically designed for those with cancer along with their support people who have attended a previous Gawler Cancer Foundation program or equivalent such as with Sabina Rabold, CSWA, Cancer Care SA, CanLive NZ, or with the Gawlers themselves.

A unique opportunity to meet with like-minded people once again, to consolidate what you already know, to learn more from the combined knowledge, experience and wisdom of Ian and Ruth, to reaffirm your good intentions, and to go home refreshed and revitalised.

FULL DETAILS Click here 

MIND-BODY MEDICINE and CANCER    November  2015    Tuesday 10th to Saturday 14th

Five day Residential program in the beautiful surrounds of Wanaka, New Zealand
- an easy drive from Queenstown airport and very accessible for Australians

This program is open to anyone affected by cancer. Health professionals interested to learn more of this work are also welcome to attend.

While the focus of this program is on therapeutic meditation and nutrition, the power of the mind and emotional health, ample time will be given to answering any questions you may have relating to the Gawler program - exercise, positive thinking, healing, balancing medical options, successful ways of dealing with setbacks, sustaining your good intentions and the relevance of finding meaning in life to healing and recovery.


for a highly recommended series of presentations

Please help spread the word and help distribute the events

- October 8th, Mindfulness in Education, Bastow Institute of Educational Leadership, Melbourne.

- October 8th, Mindfulness-based Therapy in Paediatric Care, National Institute for Integrative Medicine, Melbourne.

- October 12th, University of Canberra, School of Education

- October 14-15th, Nan Tien Institure (near Sydney)

- October 17th, Mindfulness With Children – Empowering Resilience, Emotional Intelligence
and Wellness, The Relaxation Centre, Brisbane.