Prostate Cancer and Alcohol: What We Need to Know

Categories: Cancer Risk, Cancer Screening, Prostate Cancer

May 22, 2020

It has been established by cancer researchers that alcohol is a risk factor for many types of cancers. What may not be that well known is the fact that alcohol is not a risk factor, maybe even be a risk reducer for other types cancers. So how does alcohol specifically affect prostate cancer? This blog is going to take a look at the relation between alcohol consumption and prostate cancer.

Alcohol and Prostate Cancer

A study on alcohol and cancer by the American Society of Clinical Oncology estimated that 3.5% of all cancer deaths in the US can be related back to alcohol consumption. These deaths are from many types of cancers. The study found that even moderate use of alcohol may increase the risk of many cancers; heavy and long term drinkers were at a higher risk than moderate ones.

An article dated September 2018 on Alcohol and Cancer Risk by the National Cancer Institute found that "for cancers of the ovary, prostate, stomach, uterus, and bladder, either no association with alcohol use has been found or the evidence for an association is inconsistent".

A more recent study published in June 2019 in the Journal of Clinical Oncology on Alcohol Intake and Risk of Lethal Prostate Cancer found that drinking alcohol may be a risk reducer for prostate cancer. Comparing cancer-free alcohol users and non-users, the study found that the risk of prostate cancer was lower in drinkers than non-drinkers. And for men who already were suffering from prostate cancer, moderate use of red wine helped slow the progression of the disease. The researchers hailed from these institutions: Harvard T.H. Chan School of Public Health, Boston, MA, Brigham Women's Hospital in Boston, Harvard Medical School in Boston, and University of California in San Francisco, CA

Does this study prove that alcohol is a risk reducer for prostate cancer? No.

It is worth emphasizing that even though the cancer researchers were encouraged by the beneficial effects of alcohol, they concluded that the topic needs additional research. In other words, the findings are not strong enough to recommend drinking alcohol to those who have a hereditary bias towards developing prostate cancer.

Also, it is important to note that alcohol is a risk factor for many other types of cancers. So, non-drinkers must not start drinking alcohol, and it will be beneficial for drinkers to reduce consumption.

Can alcohol mask symptoms of prostate cancer?

Testing for elevated levels of prostate-specific antigen (PSA) in blood plasma is one of the techniques used for diagnosing prostate cancer. A study on Alcohol Consumption and PSA-detected Prostate Cancer Risk by NIH researchers found that excessive drinking can depress PSA levels, thus reducing the reliability of PSA based tests for heavy drinkers. Therefore, if the patient has a history of heavy drinking, other techniques like biopsy and medical imaging must be used to diagnose prostate cancer.

Heavy drinking can also contribute to many symptoms that overlap with prostate cancer. This can mask prostate cancer symptoms, make them worse, or potentially delay receiving appropriate treatment. These overlapping symptoms are:

  • More frequent urination at night and weak urine flow
  • Erectile dysfunction 
  • Fatigue and weight loss
  • Swelling of the legs or feet (edema)
  • Shoulder, thigh, or hip pain
  • Constipation or diarrhea

Drinking alcohol after prostate surgery

Even though there are several prostate cancer treatment options, surgery is very common. Surgery is recommended for patients who are in good health and with a relatively long life expectancy. The technical term for prostate surgery is prostatectomy and it involves removing the cancer cells in and around the prostate gland.

There are two types of prostatectomy:

  • Simple prostatectomy in which the surgeon removes only a part of the prostate. It is also called subtotal prostatectomy and is usually done when the cancer is benign.
  • Radical prostatectomy, also called total prostatectomy is appropriate when the cancer is malignant but is still low risk. It removes the whole prostate gland along with the neighboring seminal glands and sperm ducts.

There are multiple ways in which both types of prostatectomies are performed. There is the classical "open" surgery which requires large incisions. Modern, robot-assisted, minimally invasive surgery uses small incisions and computer-controlled instruments. Open prostatectomy requires a longer recovery time than the minimally invasive one.

Abstaining from alcohol for several weeks after prostatectomy is recommended to avoid irritating the bladder. Drinking alcohol soon after prostatectomy may lead to urinary incontinence. Those who were used to drinking alcohol in a social setting may find it hard to avoid drinking after surgery in friendly gatherings and during celebratory events. They may find it difficult and awkward to talk about their prostatectomy as the reason for their abstention. So they may try using "doctor's orders for a recent medical procedure" or some such phrasing to avoid discussing specifics. Or they can try drinking an alcohol free version of their favorite cocktail.

In any case, in order to avoid irritating the bladder and the urinary incontinence result from it, patients must consult their prostate cancer specialists about the use of alcohol, or any other diet and exercise-related questions, after any prostate cancer treatments, including surgery.

Risks May Outweigh Any Benefits

In conclusion, even though drinking alcohol increases the risk of many cancers, some studies like the one on "Alcohol Intake and Risk of Lethal Prostate Cancer" mentioned above, indicate that moderate consumption of alcohol, especially red wine, seems to reduce the risk of prostate cancer. But this finding must not be taken as permission for alcohol use by those with a history of prostate cancer among their ancestors. Research must conclusively prove the beneficial effects of alcohol before it can be considered a risk reducer for prostate cancer.

There is also the well documented fact of alcohol increasing the risk for other types of cancer. So even when additional research proves that red wine or any other type of alcohol is beneficial for prostate cancer, in the larger scheme of thing, it might be better to not drink alcohol.

To learn more about life with prostate cancer, please visit our prostate cancer section.

 

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