Alcohol Blamed for 1 in Every 30 Cancer Deaths: Study

By Steven Reinberg
HealthDay Reporter

THURSDAY, Feb. 14 (HealthDay News) -- For anyone who still thinks that drinking does not contribute to cancer, a new report finds that alcohol is to blame for one in every 30 cancer deaths each year in the United States.

The connection is even more pronounced with breast cancer, with 15 percent of those deaths related to alcohol consumption, the researchers added.

And don't think that drinking in moderation will help, because 30 percent of all alcohol-related cancer deaths are linked to drinking 1.5 drinks or less a day, the report found.

Alcohol is a cancer-causing agent that's in "plain sight," but people just don't see it, said study author Dr. David Nelson, director of the Cancer Prevention Fellowship Program at the U.S. National Cancer Institute.

"As expected, people who are higher alcohol users were at higher risk, but there was really no safe level of alcohol use," he stressed.

Moderate drinking has been associated with heart benefits, Nelson noted. "But, in the broader context of all the issues and all the problems that alcohol is related to, alcohol causes 10 times as many deaths as it prevents," he said.

The best thing people who believe they are at risk for cancer can do is reduce their alcohol consumption, Nelson said. "From a cancer prevention perspective, the less you drink, the lower your risk of an alcohol-related cancer and, obviously, if one doesn't drink at all then that's the lowest risk," he said.

The report was published online Feb. 14 in the American Journal of Public Health.

To determine the risks related to drinking and cancer, Nelson's team compiled data from a variety of sources, including the 2009 Alcohol Epidemiologic Data System, the 2009 Behavioral Risk Factor Surveillance System and the 2009-2010 National Alcohol Survey.

Along with breast cancer in women, cancers of the mouth, throat and esophagus were also common causes of alcohol-related cancer deaths in men, accounting for about 6,000 deaths each year.

Each alcohol-related cancer death accounted for an average of 18 years of potential life lost, the researchers added.

Previous studies have shown drinking is a risk factor for cancers of the mouth, throat, esophagus, liver, colon, rectum and, in women, breast cancer, the researchers noted.

According to the American Cancer Society, it's not entirely clear how alcohol might raise cancer risk. Alcohol might act as a chemical irritant to sensitive cells, impeding their DNA repair, or damage cells in other ways. It might also act as a "solvent" for other carcinogens, such as those found in tobacco smoke, helping those chemicals enter into cells more easily. Or alcohol might affect levels of key hormones such as estrogen, upping odds for breast cancer.

One expert says the findings in this study are consistent with what has been shown before.

"Nobody is recommending that if you do not drink to start drinking for any reason," said Susan Gapstur, vice president of epidemiology at the cancer society. "If you do drink, limit your consumption."

Gapstur did point out that smoking is a much more powerful factor in cancer deaths than alcohol. Although some 20,000 cancer deaths can be attributed to alcohol each year, more than 100,000 cancer deaths are caused by smoking, she said.

To strike a balance between the cancer risk of drinking and its possible benefit in preventing heart disease, Gapstur suggested talking with your doctor about the risks and benefits of drinking.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: David Nelson, M.D., M.P.H., director, Cancer Prevention Fellowship Program, U.S. National Cancer Institute; Susan Gapstur, Ph.D., M.P.H., vice president of epidemiology, American Cancer Society; Feb. 14, 2013, American Journal of Public Health, online

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Cancer Chemotherapy Tied to Slight Rise in Risk for Leukemia

THURSDAY, Feb. 14 (HealthDay News) -- Chemotherapy can be a lifesaver for thousands of cancer patients, but a new study suggests that it might slightly raise the odds for a type of leukemia later in life.

Over the past 30 years, the risk for acute myeloid leukemia (AML) has increased for patients who underwent chemotherapy for certain forms of cancer, particularly non-Hodgkin lymphoma, the new study found.

On the other hand, the researchers from the U.S. National Cancer Institute said other cancer survivors may have a reduced risk for AML due to a change in chemotherapy agents that occurred decades ago.

One expert not connected to the study stressed that cancer patients need to put the findings into perspective.

"It's important to realize that the risk of developing acute myeloid leukemia related to prior chemotherapy is small and increases with the number of chemotherapy treatments given over time," said Dr. Jonathan Kolitz, chief of hematologic oncology at the North Shore-LIJ Cancer Institute in Lake Success, N.Y.

The study was published online Feb. 14 in the journal Blood.

The findings aren't a big surprise to oncologists.

"It has long been known that some types of chemotherapy are associated with a high risk of developing subsequent leukemia," explained study lead author Lindsay Morton, in NCI's Radiation Epidemiology Branch in the Division of Cancer Epidemiology and Genetics, in an NCI news release. "The goal of this study was to better understand how cancer patients' risk of developing leukemia has changed over time."

In conducting the study, the researchers assessed the risk for leukemia of more than 426,000 adults who received chemotherapy for cancer diagnosed between 1975 and 2008. Of these patients, 801 went on to develop AML.

Patients who survived non-Hodgkin lymphoma were at greater risk for AML, the team found. According to the researchers, that may be due to prolonged survival for forms of the disease that require multiple courses of chemotherapy.

Since 2000, patients treated for esophageal, prostate and cervical cancer were also found to be at greater risk for AML, the researchers say. The study also showed that those treated for cancer since the 1990s for cancers of the bones and joints, as well as the endometrium (uterine lining), are also at increased risk for AML.

Meanwhile, patients treated for ovarian cancer, myeloma, and possibly lung cancer may be at reduced risk for AML. The researchers suggested the lower risk among patients with these forms of cancer may be linked to a treatment switch that occurred in the early 1980s from an agent called melphalan to newer, platinum-based chemotherapy.

More research is needed to determine the risks associated with various chemotherapy agents, the researchers said.

For his part, Kolitz said that it is "gratifying to see that the likelihood of developing leukemia from the treatment of several of the studied cancers actually fell over the last decade, very likely because of decreased use of drugs that are most potently [linked to leukemia risk]."

Another expert agreed that the overall risk to any one cancer patient is small.

"This study confirms that a very small number of patients may be at risk for the development of a second cancer due to the effects of chemotherapy," said Dr. William Carroll, a pediatric oncologist at NYU Langone Medical Center, in New York City.

"Patients should always ask their doctor about the risk of serious side effects associated with particular parts of therapy, and whether agents with fewer side effects can be substituted without compromising the best chance for cure," said Carroll, who is also director of the NYU Cancer Institute and a professor at the NYU School of Medicine.

"Finally," he added, "it is increasingly clear that certain patients may be more likely to experience certain side effects based on their own genetic makeup. The ability to determine who is at greatest risk [via genetic testing], thereby allowing therapy to be tapered is one of the fundamental goals of personalized medicine."

-- Mary Elizabeth Dallas
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Jonathan Kolitz, M.D., associate chief, hematologic oncology, North Shore-LIJ Cancer Institute, Lake Success, N.Y.; William L. Carroll, M.D., pediatric oncologist, NYU Langone Medical Center, and director, NYU Cancer Institute, and professor, NYU School of Medicine, New York City; U.S. National Institutes of Health, news release, Feb. 14, 2013

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