Alcohol and Cancer

• The American Cancer Society estimate that 3% of all cancer deaths are alcohol-induced.
• Drinking and smoking makes things worse: many of the fatal cancers attributed to alcohol could be avoided by not smoking.
• In Britain, alcohol consumption is rapidly getting out of hand and the incidence of liver cirrhosis is up by 50 per cent in the last ten years, while hospital admissions due to alcohol-related diseases are up by 90 per cent in men and 150 per cent in women. In the United States there are 27,700 deaths per year from liver cirrhosis. The permitted daily amount regarded as safe health wise, is two glasses of wine for women (or one pint of beer) and three glasses of wine for men (or one and a half pints of beer). The American Cancer Society estimate that 3 per cent of all cancer deaths are alcohol-induced. The total figure for 1985 was 472,000.

Alcohol has a known carcinogenic effect on organs with which it comes in direct contact such as the tongue, mouth, pharynx and oesophagus. Additionally, since it is broken down in the liver cells, its detrimental effect leads to fatty degeneration of the liver leading first to liver cirrhosis and eventually to liver cancer. Reducing alcohol intake therefore provides a rare opportunity for avoiding cancer at these sites.

The detrimental effect of alcohol and the degree of damage it causes, is directly related to its concentration (beer contains 5 per cent alcohol, wine 10 per cent, sherry 15 per cent and spirits 30 per cent). in America, alcoholic mouth-washes have been found to increase the incidence of mouth-cancer in non-smoking women.

However, many of the fatal cancers attributed to alcohol can be avoided by not smoking. Even low consumption of alcohol is particularly damaging when associated with cigarette smoking. The two seem to interact, each stimulating the effect of the other, and can often cause cancers of the mouth, pharynx, larynx and oesophagus. These diseases are found more frequently in men employed in alcohol-associated trades such as the French vineyards, the cider-based liqueurs industry in Brittany and Normandy, in publicans and in employees of distilleries and breweries.

Alcohol-induced illnesses, particularly fatty degeneration of the liver leading to fatal liver cirrhosis, affect all social classes, including the executive ranks of business and the professions, especially the medical profession.

The virtue of alcoholic abstinence has received a setback as a result of a piece of misguided advice, in the form of a definite health recommendation. This says that a small amount of alcohol (such as one to two pints of beer, or two to four glasses of wine) taken daily is actually beneficial to health, because it will reduce the risk of a heart attack. It can actually be shown that the increased stickiness of the blood-clot forming platelets (which tends to predispose to coronary thrombosis) is decreased by small amounts of alcohol. Such increased stickiness occurs as a result of consuming a large fatty meal, which in any case, is never advisable on account of a gain in weight and the increased risk of heart disease. In the absence of large fatty meals, there is no increase in platelet stickiness and therefore, no need for alcohol.

The individual consumption of alcohol in Britain has doubled since it reached its lowest point in 1950, leading to, among other harmful effects, an increase in cancer in men and, though to a lesser extent, in women.

Certain body sites, as already mentioned, are made more susceptible to the development of cancer as a result of an increase in alcohol consumption. The main site is the oesophagus and, although smoking may add to the risk, it has been calculated that regular drinking leads to a 17 times greater incidence of oesophageal cancer in both the USA and France.

As regards oral cancer, heavy drinkers who do not smoke treble their risk of oral cancer and in very heavy drinkers the risk would be even greater. Laryngeal cancer is much more frequent in drinkers than in non-drinkers but this again may be partly due to heavy smoking. The rates of lung cancer and laryngeal cancer in smoking drinkers, however, differ dramatically from those seen in non-drinking smokers; alcohol alone, therefore, may play the more significant role at this particular site.

Liver cancer is much more frequent in alcoholics who had developed cirrhosis first. It is one of the prime functions of the liver to break down alcohol. When an organ as sensitive as the liver is repeatedly bombarded with massive amounts of alcohol, the delicate liver cells first breakdown in the form of fatty degeneration, which then leads to fibrous scarring; that is cirrhosis. The liver function is lost; as a result the patient can no longer deal with the breakdown of food. He or she will become nauseated, jaundiced and will lose all appetite and energy. The liver tissue, damaged by alcohol, is much more susceptible to malignant change.

The general health of alcoholics suffers because of lack of appetite and the resulting under-nourishment and, since alcohol has no nutritional value, malnutrition. In particular there is vitamin and mineral deficiency, especially of Vitamin B, folic acid, magnesium, iron and zinc.

Whereas liver cirrhosis in alcoholics appears to be a precursor of liver cancer, the increased susceptibility to cancer of the upper digestive and respiratory passages is probably due to direct cellular changes resulting from repeated contact of the tissues with alcohol. This may be most harmful in the oesophagus, where the associated decrease in production of saliva will be most damaging.

It has been suggested that our immunological system functions less efficiently as a result of excessive alcohol consumption and thus leaves us more vulnerable to cancer-causing agents. This attractive and plausible theory still awaits statistical confirmation, but what has been confirmed beyond any doubt is that alcohol exerts its most damaging effect in conjunction with smoking. The chances of a heavy smoker developing oral cancer are 150 per cent greater than those of a nonsmoker. But once alcoholic drinks are added, these risks rocket to 1500 per cent. In other words, alcohol enhances the dangerous effects of tobacco and the sites most threatened are the oesophagus and larynx.

Certain geographically-based myths about the special advantages of locally produced drinks are not true. For example, in France it is believed that white wine and the red wine of the south are less damaging, as regards liver cirrhosis, than the red wine of northern France. In Portugal it is said port wine causes cirrhosis but sherry does not. The Germans praise their beer as responsible for the lower incidence of liver cirrhosis. There is no scientific basis to any of these nationalistic claims.

As already stated, the only important determining factor, apart from individual susceptibility, (which, by the way, is greater in women than in men) is the total amount of alcohol consumed, irrespective of the type of drink taken.

Large sums of money have been allocated by the governments of the Western world for an educational campaign to advance public knowledge on the dangers associated with taking drugs. This is important. However, no corresponding campaign is being sponsored in regard to the dangers to life and health from alcohol.

Yet every day £3.5 million are spent on alcohol in Scotland alone.

The annual death toll from drugs in Scotland is 50 deaths, whereas 8,000 die from the over-consumption of alcohol. The corresponding annual figures for the whole of Britain are: 350 deaths from drugs and 60,000 deaths as a result of a national daily spending of £35 million on alcohol.