La consommation d’alcool identifiée comme un facteur de risque pour le cancer
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Alcohol Consumption Identified as a Risk Factor for Cancer
Story at-a-glance
- Cancer is a leading cause of death in the U.S., with an estimated 2,001,140 new cases and 611,720 deaths expected in 2024. Major risk factors include smoking, obesity and alcohol consumption
- Alcohol is widely consumed but classified as a drug. A 2024 study found it to be the fourth largest contributor to cancer cases in men and third in women
- Alcohol consumption can lead to cancer through multiple mechanisms, including DNA damage, increased oxidative stress, inflammation and disruption of the gut microbiome
- Regular exercise can help mitigate alcohol's negative effects by improving overall health and reducing alcohol consumption. Moderate-intensity exercise is recommended for optimal benefits
- Strategies to reduce alcohol-related damage include thiamine and NAC supplementation, regular coffee consumption and using milk thistle to support liver health. However, abstaining from alcohol is the best prevention
Cancer is one of the leading causes of death in the United States. According to the National Cancer Institute, it's estimated that 2,001,140 new cases will be diagnosed during the entirety of 2024, and that 611,720 people will die from the disease. The most common cancers include breast, lung, prostate, colon, melanoma and liver cancer.1
The causes of cancer are multifactorial,2 but certain examples can greatly increase your risk. For instance, cigarette smoking3 and obesity4 have long been linked to cancer. However, alcohol is another example that warrants discussion, as I believe this topic isn't explored enough.
Excessive Alcohol Intake Puts Your Health in Danger
On July 11, 2024, CA: A Cancer Journal for Clinicians published a study5 investigating modifiable risk factors that can lead to cancer. The top examples they identified include cigarette smoking and obesity. Another leading modifiable factor was alcohol consumption.6
Alcohol is one of the most widely consumed drugs in the U.S.7 It's classified as such because it's considered to be a "psychotropic central nervous system (CNS)" depressant. This means that alcohol can impact your cognition and emotions.8 While alcohol (along with tobacco) is legal, it does not fall under the Controlled Substance Act. Instead, its production and sale are regulated by the Alcohol and Tobacco Tax and Trade Bureau.9
In a 2022 survey10 compiled by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 221.3 million people aged 12 or over reported that they drank alcohol at one point in their life. However, what's most concerning is the statistics regarding stronger consumption. The survey noted that 61.2 million people aged 12 and older reported binge drinking in the past month, and 16.1 million people aged 12 and older admitted to heavy alcohol use.
While alcohol consumption may seem like a normal part of society, chronic drinking may lead to disease, specifically cancer. According to the study authors:11
"Alcohol consumption was the fourth largest contributor to all cancer cases in men (4.7%; 42,400 cases) and the third largest contributor in women (6.2%; 54,330). Approximately one half of oral cavity (49.9%; 10,350) and pharyngeal (44.6%; 6460) cancers in men and one-fourth of oral cavity (25.1%; 2600), esophageal (24.2%; 1000), and pharyngeal (22.5%, 760) cancers in women were attributable to alcohol consumption.
However, female breast cancer had the largest number of attributable cases (44,180 cases), followed by colorectal cancer in both men (13,850) and women (4630). The proportions of cases attributable to alcohol consumption by cancer type were higher in men than in women, except for esophageal cancer."
The researchers concluded their study by emphasizing the impact of adopting a healthier lifestyle to reduce the risk of cancer. According to their analysis, around 40% of all cancer cases and half of all recorded deaths were attributed to the modifiable risk factors mentioned in the study.12 These also include physical inactivity, dietary choices (low fruit and vegetable consumption) and chronic infections.13
How Alcohol Can Cause Cancer
According to a study14 published in Cancer Epidemiology, Biomarkers & Prevention, "Alcoholic beverages are carcinogenic to humans." Chronic consumption may lead to liver cirrhosis, which is a known risk factor of liver cancer. The researchers pinpoint the ethanol content in these beverages as the culprit, causing negative changes in your body's biological processes. Affected areas include DNA repair, immune function and sex hormone regulation.15
Going deeper into the mechanisms, a study16 published in Nutrients noted that once ethanol is consumed, it turns into acetaldehyde, which "is highly reactive towards DNA and has several carcinogenic and genotoxic properties." Like the previously cited study, researchers noted that acetaldehyde may hamper DNA function, causing mutations and double-strand breaks. Moreover, acetaldehyde binds to glutathione and hampers its protective effects.
Ethanol has also been linked to a higher induction of oxidative stress in the body, and this process is recognized as a starting point for the development of cancer. One way it produces oxidative stress is by increasing CYP2E1 activity in your system, which produces large amounts of reactive oxygen species (ROS).17
Ethanol also produces ROS in other pathways, such as the mitochondrial respiratory chain. Once enough ROS is produced, it can lead to lipid peroxidation, which is highly mutagenic, suppressing several genes related to tumor suppression.18 Alcohol consumption also increases inflammation, which, in turn, increases the risk of cancer. The authors succinctly summarize this specific process below:19
"Chronic alcohol consumption can recruit specific white blood cells (monocytes and macrophages) to the tumor microenvironment.
These white blood cells produce proinflammatory cytokines, such as tumor necrosis factor α (TNF-α) and the interleukins IL-1, IL-6, and IL-8, which activate oxidant-generating enzymes leading to downstream formation of ROS. NF-κB is also activated by these cytokines, stimulating further ROS-producing enzymes.
In addition to its involvement in downstream ROS-producing pathways, it is hypothesized that IL-8 contributes to further accumulation of white blood cells (neutrophils, specifically) in the liver leading to acute inflammation. Elevated IL-8 levels have been found in patients with acute liver injury such as alcoholic hepatitis."
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Download PDFAlcohol Can Open a Gateway in Your Gut for Cancer
Your gut microbiome plays an enormous role in the prevention and management of your health. If it's not in top shape, your risk for disease increases. In a study20 published in 2021, researchers emphasized that microbiome-induced chronic inflammation can influence the development of liver disease. As you can imagine, alcohol is one such disruptor of the gut microbiome.
According to a report21 by The New York Times, chronic alcohol drinkers often have gut dysbiosis, which is an imbalance of probiotics and pathogenic bacteria in the gut. As a result, there is a greater risk for developing inflammation. Moreover, heavy drinkers have leaky guts, increasing the risk of toxins entering their bloodstream and ending up in the liver. On the other hand, those who drink less frequently tend to have more diverse gut flora.
When the pathogenic bacteria in your gut outnumber the probiotics, your intestinal health is affected, increasing your risk of cancer. In a study published in the Indian Journal of Medical Research, tumors can form because of the way pathogenic bacteria can restructure their environment around host cells.22
As your immune system tries to ward off the infection, the inflammation caused in the process triggers DNA damage, thus promoting further cell proliferation. Moreover, the damage to the epithelial barrier in your intestines is infiltrated by immune cells. When these encounter the tumor, proinflammatory cytokines are produced, which promote chronic inflammation that create a favorable environment for tumor growth.23
Exercise Can Help Ward Off the Effects of Alcohol
Fortunately, you can mitigate the damage and repair your body wrought by alcohol. One of the simplest strategies that you can implement right away is exercising regularly.
In a meta-analysis24 involving 61 studies, researchers noted that exercise not only helps improve fitness, but it may also help decrease alcohol consumption, making it an effective treatment for patients diagnosed with alcohol use disorder.
How can exercise help reduce alcohol consumption? There are several answers to this question. In a study25 published Drug and Alcohol Review, participants noted they drank less when exercising because the intervention focused more on the physical activity itself rather than addressing the issue by learning how to stop drinking.
Moreover, exercising boost their mood, which made them less inclined to consume less alcohol. They also noticed an improvement in fitness, body weight and pain reduction, which served as valuable inspirations to continue exercising more.26
I recommend you engage in moderate-intensity exercise, which is loosely defined as exercising to the point where you're slightly winded but can still have a conversation with someone. Examples include gardening, walking, riding a bike around your neighborhood, yoga, casual swimming and pickleball.
In my interview with cardiologist James O'Keefe, he noted that moderate-intensity exercise cannot be overdone, and that it also improves all-cause mortality better than vigorous exercise. From his research, he observed that excess amounts of high-volume exercise won't get additional benefits compared to those who exercised in a moderate intensity.
Support Your Liver Health to Reduce Alcohol Damage
The best way to protect your health from alcohol-related illness is to stop drinking these beverages in the first place. But, if you absolutely must have a drink, do it responsibly and limit your intake. It's also important to remember these strategies to help protect your liver from alcohol damage:
• Thiamine (vitamin B1) supplementation — It is usually recommended to people struggling with alcohol abuse and addiction. That's because alcohol reduces thiamine absorption in your gastrointestinal tract, and in some cases, your body loses too much.
Either way, a thiamine deficiency may eventually cause symptoms such as fatigue, weight loss, emotional disturbances and nausea. Chronic deficiency may lead to complications such as beriberi and Wernicke-Korsakoff Syndrome.27
• N-acetylcysteine (NAC) supplementation — This can help "pre-tox" your body when taken before alcohol, thereby minimizing the damage caused by drinking. NAC is a form of the amino acid cysteine, which in addition to increasing glutathione, also reduces acetaldehyde toxicity that results in hangover.28
• Drink coffee regularly — Coffee may have a protective effect against HCC (hepatocellular carcinoma), a serious form of liver cancer. According to a 2022 study, caffeine inhibits the NLRP3 inflammasome, and that drinking an extra two cups daily cuts the risk by 35%.29
But don't just drink coffee indiscriminately — high caffeine intake can cause headaches, panic attacks and anxiety. Palpitations, sleep problems and tremors may also develop.30 Listen to your body, and moderate your intake.
• Milk thistle — This ancient herb has been valued for thousands of years to help support liver, kidney and gallbladder health. Today, it's used to treat alcoholic liver disease, acute and chronic viral hepatitis and toxin-induced liver diseases thanks to its active ingredient called silymarin, a flavonoid thought to be the source of its therapeutic benefits. It can help protect your liver by:
◦ Suppressing cellular inflammation31
◦ Increase the production of glutathione in the liver to boost antioxidant capacity in liver tissues32
◦ Protect the liver further by stabilizing membrane permeability by inhibiting lipid peroxidation33
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