12 things to know about alcohol and cancer

It can feel like there are always opportunities to have a drink: Mimosas at brunch. A glass of wine at happy hour. A nightcap after a long day.

But drinking alcohol is linked to an increased risk for several cancers. About 5.5% of all new cancer diagnoses and 5.8% of all deaths from cancer are attributed to drinking alcohol, according to the National Institutes of Health (NIH).

For those who drink, hearing this can be scary, not to mention confusing. It might lead to questions like ‘Is all alcohol linked to cancer?’ and ‘Do I need to stop drinking entirely?’ 

For answers, we called on Therese Bevers, M.D., medical director of MD Anderson’s Cancer Prevention Center, and Victoria Lee, a senior clinical dietitian.

What do experts say about alcohol consumption?

MD Anderson’s official guidance is that for cancer prevention, it’s best not to drink alcohol.

While no alcohol is best, women who choose to drink should have no more than one drink a day, and men no more than two drinks a day.

What's considered one drink?

It may be tempting to think that whatever fits in a glass counts as one drink. However, a standard drink looks different depending on what type of alcohol you are drinking. That’s why Lee says it’s important to know your serving sizes.

She notes each of the following counts as one drink:

• 12 fluid ounces of beer
• 5 fluid ounces of wine
• 1.5 fluid ounces of 80-proof liquor

If alcohol is a carcinogen, why do we give serving recommendations?

Bevers acknowledges that most Americans are not going to avoid drinking alcohol completely. Because of this, she believes it is important to share examples of what drinking less, or moderately, might look like.

“The important thing to remember is that every time you drink, you increase your cancer risk. As with cigarettes and processed meat, there is no safe amount of alcohol,” she says.

Why do men and women have different alcohol serving recommendations?

Men and women who choose to drink have different serving recommendations because of how their bodies respond to and break down alcohol.

“Women are generally smaller and break down alcohol more slowly than men,” Lee says.

Alcohol affects men and women differently both immediately and in the long run.

The Centers for Disease Control and Prevention (CDC) writes that even if a man and woman drink the same amount of alcohol, the woman will usually have a higher blood alcohol level. And not only do women usually experience the immediate effects of alcohol more quickly than men, but they are also at a higher risk for alcohol’s long-term health effects.

What types of cancer can be caused by drinking alcohol?

The NIH writes that alcohol increases the risk for cancers including:

• oral cancer
• pharynx and larynx cancers
• colorectal cancer
• esophageal cancer
• liver cancer
• breast cancer
• stomach cancer

Why does drinking alcohol increase your cancer risk?

There are many reasons why alcohol can increase your cancer risk. These include:

Acetaldehyde: Alcoholic beverages contain ethanol. When the body breaks down ethanol, it becomes acetaldehyde, which Bevers says is a known carcinogen. “This compound damages DNA and stops our cells from repairing the damage. This can allow cancerous cells to grow,” she explains.

Hormonal effects: Alcohol can affect the levels of hormones like estrogen, Bevers says. She notes that these hormones act as messengers that tell our cells to grow and divide. “The more cells divide, the more chances there are for something to go wrong and for cancer to develop,” she says.

Reduced nutrient absorption: Alcohol makes it harder for the body to absorb and use nutrients that protect it from cancer. These include vitamins A, B1, B6, C, D, E, K, and folate, iron and selenium. “These are just a few vitamins and minerals that are responsible for immunity, protecting cells from oxidative damage, reducing inflammation and aiding in DNA synthesis and repair,” Lee says.

Weight gain: Consuming more calories than your body burns leads to weight gain. “Alcohol can contribute to weight gain from excess calorie intake. Excess weight is linked to over 12 types of cancer,” Lee says.

It increases the risk of tobacco-related cancers: If you drink and smoke, you may be at an even higher risk for certain cancers including oral cancer and throat cancer. Lee says alcohol may make cells more sensitive to other substances that cause cancer. “The combination of drinking and smoking increases the risk of developing mouth or throat cancer more than drinking or smoking alone,” she says.

Does drinking less reduce cancer risk?

If you enjoy alcoholic beverages, it can be hard to decide how to proceed. Does drinking less help reduce cancer risk, or does the only benefit come from not drinking at all?

“When it comes to your cancer risk, the less you drink, the better,” Bevers says.

While she says the best way to reduce cancer risk is not drinking alcohol, drinking less can have a positive impact.

“We know for certain cancers, like breast cancer, the risk increases with each additional drink,” she says.

For example, this means that someone who usually has three drinks a week could reduce their cancer risk by limiting themselves to two drinks a week instead.

“Cutting back one drink is a risk reduction, but the greatest risk reduction is going from three drinks to zero,” Bevers says.

Interested in drinking less alcohol? Lee suggests trying nonalcoholic beer or wine, opting for a mocktail or cocktail with only a splash of alcohol and making several days a week alcohol free.

What is the best thing to drink if I’m going to have alcohol?

“When it comes to managing your cancer risk, there is no alcoholic drink that is better than the other. All of them — including beer, wine and liquor — have ethanol, which is linked to increased cancer risk,” Bevers says.

She recommends that those concerned about alcohol’s impact on weight choose something that is lower in calories.

She also dispels the myth that drinking red wine has more health benefits than risks. While she says some studies suggest that there are compounds in red wine that offer cardiovascular benefits, there are plenty of other ways to keep your heart healthy.

“If you drink red wine in the hopes that you are protecting your heart health, I would look for other ways to do that,” she says. “The potential benefits of drinking wine do not outweigh the cancer risk."

What should I do if I don’t drink?

Lee’s advice for non-drinkers is simple: If you don’t drink, don’t start.

What should those in cancer treatment know about alcohol and cancer?

“Alcohol can worsen the side effects of chemotherapy and drugs used during cancer treatment,” Bevers says, listing side effects including nausea, dehydration and mouth sores. 

Additionally, she says drinking alcohol increases the risk of additional cancer diagnoses.  

“Cancer patients should talk to their doctor about the use of alcohol,” she says.

How does drinking alcohol affect a person’s chances of cancer recurrence?

While Bevers says studies show that alcohol is a risk factor for certain cancers, the link between alcohol and cancer recurrence is not known, especially for those who have completed cancer treatment.

"It’s best to avoid drinking after a cancer diagnosis, since it increases cancer risk,” she says.

Does my cancer risk decrease if I stop drinking?

Research has shown that when you stop drinking, the risk for alcohol-related cancers declines over time, Bevers says. 

“It may take many years to fully eliminate that risk,” she says. “But quitting is a very important step to improving your health and decreasing your cancer risk.”

Request an appointment at MD Anderson online or call 1-877-632-6789.