Significant knowledge gaps on the impact of alcohol use (and cessation) among cancer patients and survivors remain. A better understanding of alcohol consumption’s effects on therapeutic response, disease progression, and long-term cancer outcomes may support medical decision making and improve survivorship. The plant secondary compound resveratrol, found in grapes used to make red wine and some other plants, has been investigated for many possible health effects, including cancer prevention. However, researchers have found no association between moderate consumption of red wine and the risk of developing prostate cancer (32) or colorectal cancer (33). According to the federal government’s Dietary Guidelines for Americans, 2020–2025, individuals who do not drink alcohol should not start drinking for any reason.
Finally, invasion of HT1080 cells from the tumor into blood vessels (i.e., intravasation), which occurs during metastasis, increased more than eightfold in response to ethanol. A recent study compared innate immune-system functionality with the number of circulating tumor cells in patients with a variety of cancers. In patients with metastatic disease, these circulating tumor cells are promising as biomarkers for tumor progression and overall cancer survival, with relatively high circulating cell numbers correlated with a poor prognosis. Decreased NK cytolytic activity also has been linked with other types of cancer, including colorectal cancer (Kim et al. 2013), metastatic melanoma (Konjevic et al. 2007), and head and neck cancer (Baskic et al. 2013). Alcohol might interfere with oestrogen pathways by increasing hormone levels and enhancing the activity of ERs, important in breast carcinogenesis [38].
Tumors also release factors that can directly or indirectly suppress antitumor immune responses, thus facilitating angiogenesis, invasion of surrounding tissues, and metastasis to distant sites in the body (for a general review, see Jung 2011). (For more information on the processes involved in tumor metastasis, see the sidebar.) The following sections will review the role of alcohol in cancer growth and progression, both in humans and in animal models. For oral and oropharyngeal cancer, an MR study using genetic data on 6000 oral or oropharyngeal cancer cases and 6600 controls found a positive causal effect of alcohol consumption independent of smoking [16].
Alcohol and Immune Interactions in Animal Models of Cancer
The effect of ethanol on MCF-7 cells also was correlated with increases in estrogen receptor alpha content. When the MCF-7 cells were cultured together with human skin fibroblasts in 0.4 percent ethanol for 72 hours, ethanol suppressed estrogen receptor alpha expression compared with untreated cells (Sanchez-Alvarez et al. 2013). Thus, the tumor micro-environment is important in determining estrogen-receptor status and the effects of alcohol on breast cancer.
The Dietary Guidelines also recommends that people who drink alcohol do so in moderation by limiting consumption to 2 drinks or less in a day for men and 1 drink or less in a day for women. Heavy alcohol drinking is defined as having 4 or more drinks on any day or 8 or more drinks per week for women and 5 or more drinks on any day or 15 or more drinks per week for men. The study had several limitations, including that it only looked at current alcohol consumption, not past drinking habits, said Dr. Abnet. Surveys worldwide often have not collected information about past alcohol use, “but for a lot of people, there’s a pattern where they drink more heavily when they’re young and moderately as they get older,” he explained.
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