Alcohol and Prorogen Cancer Risk
Alcohol is a common part of many people's social lives, whether it's a glass of wine with dinner or a beer while watching the football game. However, if you're paying close attention to your prostate health, you might wonder whether drinking alcohol could increase your risk of prostate cancer. Or if you're getting treatment for prostate cancer, you may be asking if it's okay to drink.
Studies on alcohol and prostate cancer don't all agree, which can make it tricky to know what's safe. Here's what experts say so far.
The Connection Between Alcohol Use and Prostate Cancer Risk
The connection between alcohol use and the risk of prostate cancer is not clear, and scientists agree that more research is needed. But studies do show a pattern, especially when it comes to heavy drinking.
Current research indicates that alcohol consumption, especially heavy or long-term intake, is associated with an increased risk of aggressive forms of prostate cancer, says David Taub, MD, a board-certified urologist and the director of urologic oncology at Baptist Health South Florida in Boca Raton. The risk seems to be even higher for those who begin heavy drinking at a younger age.
Heavy drinking for men means five or more drinks on any day, or a total of 15 or more drinks per week. For reference, a standard drink is about 12 ounces (oz) of beer, 5 oz of wine, or 1 oz of liquor like vodka or whiskey. Having more than about 30 grams (g) of alcohol daily (roughly two or more standard drinks) may increase the risk of both getting prostate cancer and dying from it, says Brian Helfand, MD, a board-certified urologist at Endeavor Health in Glenview, Illinois.
In general, the more alcohol you drink, the higher your risk tends to be. Even low to moderate drinking (about one to two drinks per day) has been linked to a slightly increased risk of prostate cancer compared with not drinking, although this varies by the type of alcohol. Beer and liquor seem to drive most of this link, says Dr. Taub, while wine doesn't show the same connection.
That said, not all studies agree. Some even suggest that drinking moderate amounts of red wine may be linked with a slightly lower risk of the more-serious, fast-growing types of prostate cancer.
How Alcohol May Affect Prostate Cancer Risk
When your body metabolizes alcohol, the alcohol breaks down into acetaldehyde. This is a known carcinogen, meaning a substance that can increase the risk of cancer. Alcohol and acetaldehyde can damage the genetic material in cells, increase inflammation in your body, and interfere with hormones, all of which can create conditions where cancer is more likely to develop, says Taub.
The evidence linking alcohol to prostate cancer continues to grow, according to the American Cancer Society and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Both groups recommend limiting alcohol consumption to reduce cancer risk.
The research results don't all line up, but there's enough evidence to suggest that drinking in moderation or limiting alcohol intake is a reasonable way to help protect yourself, says Dr. Helfand.
Drinking Alcohol During Prostate Cancer Treatment
One question you might have if you've been diagnosed with prostate cancer is whether alcohol can interfere with treatment. Here's how alcohol can affect prostate cancer treatment and recovery.
Surgery
Drinking alcohol, especially with heavy or regular use, can increase the risk of complications after prostate cancer surgery, says Taub.
He says that people who drink alcohol before surgery face higher rates of:
- Infections
- Wound-healing problems
- Breathing troubles
- Long hospital stays
They also have a higher risk of death after the surgery, he says. The risk of death is even greater for older adults, who often have other health conditions. But stopping alcohol use for at least a few weeks before surgery, ideally four to eight weeks, can greatly reduce these complications, says Taub.
Drinking alcohol can also worsen urinary symptoms like urgency, frequency, and stress incontinence, says Helfand. These symptoms are already common if you have prostate cancer or an enlarged prostate. Many men report that stress incontinence gets noticeably worse after having two or more drinks during the recovery period after surgery, he says.
Chemotherapy
Alcohol consumption during chemotherapy for prostate cancer may worsen certain side effects, says Taub. It can also affect how your body processes chemotherapy medications, potentially making them less effective or more toxic.
Alcohol and its by-products can stress your liver, heart, and nervous system, which may make chemo-related fatigue or nausea worse, says Taub. It can also change how your liver breaks down chemotherapy medications, changing how well they work and increasing the risk of side effects. A small research study found that 38 percent of people who drank while getting chemo for various cancers experienced complications.
Radiation Therapy
When it comes to radiation therapy for prostate cancer, alcohol use may make the treatment less effective. Alcohol promotes inflammation and weakens your immune system, both of which can interfere with healing and radiation's ability to target cancer cells. Alcohol use during radiation therapy is also linked to poorer treatment outcomes and a higher risk of the cancer returning.
Targeted Therapy and Immunotherapy
Little research has been done on alcohol consumption during targeted therapy and immunotherapy. But there appears to be similar effects seen with other treatments, such as weakening of the immune system. More research is needed on this topic to fully understand how these effects might happen, but it's safest to limit alcohol during these treatments as well.
Taub emphasizes that people getting cancer treatment who drink alcohol face increased risks of the cancer coming back, developing new cancers, and dying from the disease. Both experts agree that limiting or avoiding alcohol before, during, and after prostate cancer treatment can help your body heal better and may improve treatment success.
Alcohol and PSA Levels
If you're getting tests to track your prostate-specific antigen (PSA) levels, be aware that alcohol may affect your test results. PSA is a protein made by your prostate gland. A high PSA level could be a sign of prostate cancer or other health conditions.
Alcohol intake can modestly lower PSA levels and may interfere with the accuracy of PSA testing, says Taub. This means prostate cancer may be harder to detect in people who drink moderate to large amounts of alcohol. And the more alcohol a person drinks each week, the more their PSA levels tend to drop.
Lower PSA levels in drinkers may reduce the sensitivity of PSA-based prostate cancer screening, potentially delaying diagnosis or underestimating risk, says Taub. Because current guidelines don't list alcohol as a factor that may affect PSA interpretation, it's important to mention your drinking habits to your healthcare provider when discussing PSA results.
How Much Alcohol Is Safe?
There's no truly safe amount of alcohol when it comes to health. Alcohol is a toxin, says Helfand. Our bodies can handle small amounts, he says, but repeated exposure can cause problems.
Helfand recommends drinking in moderation or completely avoiding alcohol for most people. Men at higher risk of prostate cancer, such as those with a family history of prostate cancer or genetic mutations like BRCA2, should be especially careful and consider abstaining from alcohol altogether, he says.
If you do choose to drink, current guidelines suggest keeping it to no more than two alcoholic beverages per day for men. Drinking more than that is linked to a higher cancer risk, says Taub. Cancer survivors should stay within these limits or avoid alcohol to support their long-term health, according to organizations like the National Comprehensive Cancer Network (NCCN).
While some studies suggest that red wine may be less harmful when it comes to prostate cancer risk compared with beer and liquor, the findings are inconsistent. Experts agree that the safest choice for anyone concerned about their risk of prostate cancer or for anyone getting prostate cancer treatment is to avoid alcohol or limit intake. The less alcohol, the better for individuals with or at risk for prostate cancer, says Taub.
Replacing alcohol with nonalcoholic drinks is one way to support your health and lower your cancer risk. In addition to mocktails or nonalcoholic beer, other options include flavored or sparkling water, kombucha, and juices, to name a few. If you're thinking about cutting back on alcohol or you need help quitting, ask your healthcare provider to guide you to resources and support.
If you or someone you know is struggling with substance use, reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-HELP (4357) for resources near you.
The Takeaway
There's a link between heavy or long-term drinking and a higher risk of aggressive prostate cancer, though more research is needed.
Alcohol can interfere with prostate cancer treatment and recovery, making surgery, chemotherapy, radiation, or targeted therapy less effective, with potentially worse side effects.
Drinking may also lower PSA levels, which can make prostate cancer harder to detect. Be sure to tell your healthcare provider about your drinking habits when reviewing test results.
The safest choice for prostate health is to avoid alcohol or limit it to no more than two drinks per day, especially if you're at higher risk or you're currently getting prostate cancer treatment.