In a commentary published July 21 in the journal Addiction, a leading addiction researcher in New Zealand drives home a simple message: Make no mistake, there is plenty of solid research that shows alcohol causes several types of cancer, including cancers of the oropharynx, larynx, esophagus, liver, colon, rectum and breast.1
In the commentary, she says conflicting reports in the media about the dangers of alcohol need to be clarified. She also drives home the fact that some alcohol-related cancers may be reversible if you quit drinking now.
“There is strong evidence that alcohol causes cancer at seven sites in the body and probably others,” Jennie Connor writes. “Current estimates suggest that alcohol-attributable cancers at these sites make up 5.8 percent of all cancer deaths worldwide. Confirmation of specific biological mechanisms by which alcohol increases the incidence of each type of cancer is not required to infer that alcohol is the cause.”
Dr. Dmitri Alden, a New York City cancer surgeon and a Fellow of the American College of Surgeons (FACS), specializes in cancers of the liver and pancreas. He practices at Lenox Hill Hospital.
He told DualDiagnois.org that while he doesn’t agree with every argument Jennie Connor makes in the Addiction piece, “We know one fact, and it’s very clear. If you drink heavily, the risk of esophageal, throat, breast and especially liver cancer, is higher. Alcoholics get liver cancer. Period.”
“We know one fact, and it’s very clear. If you drink heavily, the risk of esophageal, throat, breast and especially liver cancer, is higher. Alcoholics get liver cancer. Period.”Dr. Dmitri Alden
Alden stressed “I live in a world of evidence-based medicine and hard science … Every study about alcohol also must consider smoking and other factors. It depends where a person lives, their environment, the food they are eating, their income, stress level, genetics, do their parents smoke or drink….” But he added, “People who stop drinking completely, the liver recovers after one year,” Alden said. “When I say recover, it recovers from liver dysfunction. It does not completely eliminate the risk of liver cancer.”
Alden said it’s important for heavy drinkers to see a liver specialist, including after they stop drinking. A liver biopsy – “a simple needle stick,” Alden emphasized – provides a doctor with a lot of information about the degree of damage that may exist in the liver.
He said that even a simple blood test can detect levels of alpha-fetoprotein, or AFP, which only is present in pregnant women and people with liver cancer. But the absence of AFP in the blood does not mean you’re off the hook for cancer, because 20 percent of liver cancers do not make the protein.
He said he cannot emphasize enough that it is important to understand that any sort of thinking along the lines of “Oh well, I have liver cancer anyway, so I may as well keep drinking” is extremely fatalistic. “By stopping drinking, you eliminate the continuous damage,” Alden stressed. “Yes, your risk of cancer remains, but it’s much, much lower compared to the risk of those who continue drinking all the time. At least by stopping drinking you’re eliminating the risk of other complications, such as liver failure, water in the abdomen and bleeding.”
He said anyone who has hepatitis C, a disease of the liver common in Baby Boomers, “or any kind of hepatitis,” including A (which is transmitted by food) or B (which is commonly transmitted by sex) accelerates the damage to the liver by 10-fold in people who continue to drink. All three types of hepatitis also are transmitted by blood and are commonly acquired among injection drug users who share needles.
Surgical procedures can help a damaged liver regenerate faster by stopping the blood flow on the damaged side to stimulate growth on the undamaged side. “If there is no surgery and no procedure, it’s a very, very slow process, but cells are gradually replaced by healthy ones. This can only occur if the drinking stops early enough in the disease phase, not during advanced cirrhosis.”
He said recovering alcoholics also would be wise to ask their doctors about having an endoscopy to examine any possible changes at the juncture of the esophagus and stomach, where cancer can develop. “These things can be picked up early and treated.”
In her paper, Connor argues that any reluctance to acknowledge that drinking alcohol causes cancer often is based on arguments of semantics.
For example, any alcoholic – particularly alcoholics who suck down cigarettes while throwing back cocktails – knows that the heartburn brought on by the habit cannot possibly be good in the long term. While a mechanism of action (how the cancer physically develops) may not be scientifically understood yet for cancers of the head and neck, “a recent systematic review of the risk of laryngeal and pharyngeal cancers after quitting also found that the risk was reversible, with a reduction of approximately 15 percent of the excess risk in five years, and equivalence with never drinkers after more than 30 years,” Connor wrote.
She implied one particularly chilling detail (which is true in general, to some degree, of medical research on controversial topics) – even some doctors can be bought. An opinion piece in a New Zealand newspaper disputing evidence reported from an alcohol and cancer symposium was headlined, “To Say Moderate Alcohol Use Causes Cancer Is Wrong.”
Connor also reported, “The article was attributed to a former senior scientist in the United States now employed by an alcohol industry body, while continuing to publish on alcohol in the scientific literature.”
Connor also noted in her paper that many people dispute any cancer-causing associations with alcohol by quoting stories they have heard about wine reducing cardiovascular risk. They don’t see how you can have it both ways.
Alden explained there is some research showing that some red wines, in moderation, ward off cardiovascular disease.
He cautioned drinkers to remember that “the cardiovascular protective effect of red wine is lost once you are above a glass and a half a day.” And only red wine has the cardio-protective effects – not other types of alcohol.
“If you look at France, and the drinking there is pretty heavy, pretty significant … I lived there, and it’s not just casual, here and there, they really drink,” Alden said. “They have the lowest incidence of cardiovascular disease in the world, and it’s attributed to the cardio-protective effect of red wine, which is being used in France as the most common way of alcohol consumption. Red wine contains polyphenols that seem to have cardio-protective effects.”
“But, (and there’s a big ‘but,’ Alden warns), they have one of the most significant incidences of liver cirrhosis, liver damage, liver cancer and so forth.”
He said it’s one of the reasons that France has been pioneering in the field of liver surgery and liver transplants.
1. Connor, J. (2016, July 21). “Alcohol consumption as a cause of cancer.” Addiction. Retrieved Aug. 6, 2016, from http://onlinelibrary.wiley.com/doi/10.1111/add.13477/full
Written by David Heitz