Alcohol Consumption Among Cancer Survivors Leads to Worse Outcomes

Alcohol consumption among cancer survivors and current patients lead to concerning outcomes, according to a recent study.

A recent study, results of which were published via JAMA Network Open, found that alcohol consumption and risky drinking behaviors were common among survivors of cancer and patients who are currently receiving treatment. The authors of the study advised that doctors should collect alcohol consumption information and communicate with survivors about the risks of alcohol use to spread awareness.

Identifying these modifiable behaviors is necessary, according to the study authors, as it can ultimately improve survivorship. In this study, the authors focused on drawing associations between the frequency of consuming alcohol and the effects it has on cancer survivors.

The authors found that the associations between alcohol consumption and treatment outcomes were negative, as alcohol use could potentially worsen outcomes after surgery — including an increased risk of surgical complications, more surgical procedures, longer recovery time, higher health care costs and a higher mortality rate.

“In the short term, alcohol use worsens post-surgical outcomes. For head and neck cancer patients, alcohol use during and after radiation therapy increases the risk of osteonecrosis (a lack of blood supply, resulting in the death of bone tissue) of the jaw,” said Yin Cao in an interview with CURE®. Cao, who has a research doctorate and master’s degree in public health, is an associate professor of surgery at Washington University School of Medicine in St. Louis, Missouri, and senior author of the current study.

“It’s also known to impair cognition and amplify cardiotoxicity (damage to the heart and/or cardiovascular system that arises because of cancer treatment) in patients undergoing chemotherapy. Long-term, alcohol consumption elevates the risk of (cancer) recurrence, secondary tumors and mortality,” Cao added.

Cao also emphasized that spreading awareness about the harmful effects of alcohol consumption is crucial. “We still need more research to further evaluate the association of alcohol drinking with therapeutic efficacy and treatment outcomes among cancer survivors,” she said. “Given the societal norms surrounding alcohol and the general lack of awareness of alcohol's short- and long-term impact on cancer outcomes, patients are encouraged to consult with their health providers. All providers, including oncologists, nurses, therapists, and counselors, could play a vital role in educating patients/survivors about potential risks while understanding the cultural and societal contexts of drinking.”

The authors of the study provided 15,199 participating cancer survivors with two surveys in their study: a basic survey that included demographic information and an overall health survey. In the cohort, the mean age was 63.1 years, among whom 9,508 of the survivors identified as women and 11,633 survivors identified as non-Hispanic White.

The study authors also found that physical attributes, including sex, race and age all played a role in engaging in risky behaviors related to alcohol consumption.

“For sex, we found that men were more likely to drink over the moderate limits and engage in binge drinking compared with women,” said Cao. “For race, while Hispanic individuals were less likely to drink compared to non-Hispanic Whites, Hispanic individuals who drink tended to consume higher volumes of alcohol. Age of cancer survivors also matters — those younger than 65 years (old) were more likely to exceed moderate drinking or binge drink.”

There were 11,815 participants who were considered current drinkers, and the authors determined that “survivors who were non-Hispanic White, with alcohol-related cancers, without self-reported current medication prescription and/or treatments and who were ever smokers were more likely to be current drinkers.”

Specifically, the authors differentiated the data into two categories regarding current drinkers: moderate drinking and hazardous drinking. There were 1,541 participants who reported that they exceeded moderate drinking (more than two drinks on a typical day when they drink) and 4,527 participants engaged in hazardous drinking.

The data from the study concluded that participants who were more likely to exceed moderate drinking included survivors who were aged 65 years or younger, identified as a man, identified as Hispanic, smoked or received a cancer diagnosis before age 18 years.

Regarding participants in the study who engaged in hazardous drinking, the authors found that survivors who received a cancer diagnosis before age 18 years were more likely to engage in hazardous drinking compared with survivors who received a cancer diagnosis at age 65 years or later.

The authors also established that there could be a correlation between alcohol consumption and smoking.

“We found that ever smokers were more likely to drink and engage in risky drinking behaviors. It’s evident that alcohol and tobacco consumption may have an additive and synergic effect on the development and recurrence of cancer,” Cao explained. “For drinkers who ever smoke, they have higher risks for alcohol- and tobacco-related secondary primary cancers.”

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