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Alcohol’s Cancer Risk — What Every Kentuckian Should Know · Talking FACS

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  Welcome to Talking FACS, and thank you for tuning in to Cancer Conversations
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  on Talking FACS, a podcast collaboration between the University of Kentucky
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  Markey Cancer Center and the UK Martin Gatton College of Agriculture,
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  Food and Environments Cooperative Extension Service.
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  We will share with you the latest developments in cancer prevention,
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  diagnosis, treatment and research from the experts at Markey Cancer Center,
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  Kentucky's only National Cancer Institute designated Comprehensive Cancer Center.
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  Talking FACS is hosted by the UK Family and Consumer Sciences Extension Program.
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  Our educators share research knowledge with individuals, families,
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  and communities to improve quality of life.
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  In January, the Surgeon General issued an advisory that stated that alcohol
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  consumption is one of the leading preventable causes of cancer.
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  Welcome to Cancer Conversations on Talking FACS, where we share research news
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  you can use to improve your quality of life.
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  I'm your host, Mindy McCulley, Extension Specialist for Instructional Support
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  with Family and Consumer Sciences Extension.
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  My guest today is Dr. Leah Winer.
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  Assistant Professor of Surgery in the Division of Surgical Oncology.
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  And she is going to help us unpack what this advisory means for us. Welcome, Dr. Winer.
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  Hi, thank you so much. Thank you for having me. I am really interested in talking
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  about this connection because I know that we think about or we know that,
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  of course, there is a connection between smoking and cancer.
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  And we know that there is a connection between some of our other lifestyle behaviors,
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  such as being overweight or not getting enough exercise.
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  But this connection between alcohol and cancer might be something that people haven't heard about.
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  So can you just share with us a little bit more?
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  And you've hit the nail on the head. Part
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  of the kind of motivation for this national advisory from the Surgeon General
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  was really born out of the fact that we have data showing that less than 50%
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  of Americans are even aware of the connection between alcohol and cancer risk.
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  And so it's very important to make the public aware of some of the dangers of
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  alcohol or cancer development. And so.
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  Just to explain a little bit more, you know, cancer is one of,
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  obviously, a really major public health concern, and especially in Kentucky and in Appalachia.
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  So it's really important to think about what kinds of modifiable risk factors
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  you can control or try to improve in your life, as you mentioned,
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  smoking and, you know, other lifestyle factors we know about already.
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  But alcohol is now considered one of the highest levels of carcinogens that
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  can contribute to cancer forming in us and that's because it can break down
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  and those breakdown products can damage our DNA.
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  The breakdown products can cause reactive oxygen species that can cause inflammation
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  and oxidative stress on our body and it can actually contribute to hormone dysregulation.
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  It can contribute to increased absorption of other carcinogens and kind of have a synergistic effect.
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  And so, definitely, you know, we have better data now showing that there is this risk.
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  So, in talking with our substance abuse or substance use specialist who works in prevention,
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  we have learned that youth are not beginning use of alcohol as early as they once were.
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  So our message is just don't start, right? Mm-hmm.
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  Yes. So definitely, you know, it's not something, even if you only drink one
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  or two drinks a day, that really is still a problem, right?
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  Right. And that's one thing that, that's kind of one of the newer pieces of advice. So.
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  There were previous dietary guidelines stating that, to your point,
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  if you don't drink alcohol, don't start,
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  and really focused on advising less than one alcoholic beverage for women per
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  day, you know, at the most,
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  and two or fewer per day at the most for men as sort of a health advisory,
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  and less is always better.
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  But the newer data involved in generating this new surgeon's general warning
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  is actually questioning whether those previous guidelines are actually sufficient.
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  Because our data now is showing that there's an incrementally increased risk,
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  measurable risk for developing cancer the more you drink.
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  And that even that one beverage per day versus nothing is putting you at increased
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  relative risk for developing cancer.
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  And so, I think that's one of the next steps kind of in, you know,
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  this advisory is sort of how do we update our recommendations and, you know,
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  kind of give people the best information possible that can influence their day-to-day decision making.
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  So if you already have some of the other risk factors, like if you're a smoker
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  or if you're overweight or are exposed to other carcinogens already,
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  and then you also are drinking alcohol, does that compound the effect?
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  I have you know very good data
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  on that as far as you know I can't cite a specific study but the kind of mechanism
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  by which alcohol can increase your risk of of cancer I think that it would be my
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  suspicion is that it would only be additive you know so for like some of the,
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  oral cavity and throat and, you know, voice box cancers that we know smoking
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  contributes to, if you add alcohol in the mix with that kind of increased carcinogen
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  absorption capacity that it can have,
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  you know, I would imagine that would only make your risk for developing cancer more.
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  But I don't have off the top of my head data for that. Okay.
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  So, as you mentioned, we do want to encourage people just to not start if they haven't already?
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  And is there benefit from stopping?
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  If you are, I mean, of course, we know that for your mental health,
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  there is the benefit of stopping.
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  Do we see that same effect if you stop on cancer?
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  I think, again, that's an area of future research focus.
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  I don't think we have that information at the moment, but one or
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  two of the areas that need further research efforts
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  is understanding kind of the
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  natural history of how alcohol consumption
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  contributes to cancer development so long-term studies
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  that can also look at how you know
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  drinking patterns as well so you know one a
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  day versus you know large volumes and isolated so like everyday drinking versus
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  binge drinking starting earlier versus starting later those different nuances
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  in terms of how people consume alcohol is kind of yet unknown for cancer development.
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  We know from smoking cessation studies that quitting smoking can degrade cancer
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  risk for lung cancer over time.
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  And so hopefully there would be similar effect for alcohol in cancer development,
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  but I don't believe we have that information yet. Right.
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  So what are some implications, I guess, for this advisory?
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  What do you think we're going to see coming down the pipe? Right.
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  Well, I think one of the kind of big public health efforts is going to be the
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  adding of warning labels onto alcoholic products.
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  And I'm not sure if that started already or more kind of in the works.
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  But, you know, as I mentioned at the very beginning, public awareness on the
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  negative effects of alcohol for cancer development, the awareness in the public is quite low.
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  And so one way to have that information brought directly to a consumer is to
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  put it very clearly on the bottle.
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  That's been done, you know, cigarettes, that's been done for other black box
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  warnings for certain kinds of medications.
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  Like, that's a pretty important way to disseminate information.
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  So making sure that beverages have labeling that very clearly states the relationship
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  between alcohol use and cancer risk, I think is going to be a next step.
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  And as I already mentioned, kind of reassessing the recommendations and the
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  guidelines for alcohol consumption for kind of, you know, everyday dietary guidelines.
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  As we mentioned earlier, if you don't already drink, don't start.
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  And some of the safety guidelines regarding the volume per day are probably
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  going to need to be readdressed.
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  And then, of course, future and continued research efforts to understand the
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  additive risk of alcohol with all the other cancer risks, knowing kind of more
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  about drinking patterns.
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  Age of consumption, some of the other areas you've already highlighted.
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  Well, and I think that having a label on alcohol for someone who...
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  Already knows that they're at risk you know if they have a family history or
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  or whatever that risk might be that might
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  help to deter them because you don't want
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  to write yourself a death sentence right
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  absolutely and and i of course
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  give lots of you know credence to the fact that
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  for people who are heavy drinkers or you develop dependence i
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  mean that's a true disease like that is a hard habit
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  to beat and it's very complex
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  and I empathize with
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  that journey people are on to try to reduce their alcohol consumption
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  but you know for more especially
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  for the more casual drinker and I know it's hard in bourbon country to really
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  ask people to not imbibe sometimes but it I agree with you I mean I think you
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  know if you're kind of prioritizing your health and thinking about your own
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  family history of cancer and potentially what other risk factors you have.
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  And in conversation with your doctors, I think coming up with a plan to try
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  to reduce how much you consume is really a great thing to try.
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  And one thing I didn't mention yet that I meant to mention, just to make it
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  really concrete, the cancers that alcohol is directly linked to.
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  I think And it's important to see that.
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  So these are oral cavity cancers or mouth cancers, cancers that affect the throat and the voice box.
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  Breast cancer, which is going to be where we see more of this impact on women,
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  liver cancer, which is where we're going to see more of the impact of alcohol
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  on men, especially esophageal cancer, and then cancers of the colon and rectum.
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  And so as far as knowing your family history and your risk factors and what
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  other health screenings you can get,
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  I think it's important to know which actual disease sites are most affected
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  by alcohol use. Yes, definitely.
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  I really have found this conversation very fascinating.
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  And I do hope that our listeners have as well and will take it to the bank,
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  so to speak, and really take it to heart.
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  Before we wrap up, do we have any last thoughts that we need to make sure that
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  we share with listeners?
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  You know, I just would encourage everybody to, you know, get all of your cancer
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  screenings and make sure that you're kind of following your doctor's orders
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  in terms of, you know, common cancer screenings at the appropriate intervals.
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  And, you know, anything you can do to try to keep yourself healthier and out
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  of trouble is always great.
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  I know for me personally, reading these warnings and really thinking about them
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  has even influenced my own thought on,
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  you know, it's just very important to try to be as healthy as possible and not,
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  if there's a casual drink here and there, that's fine.
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  But, you know, to really try to not do anything extra, especially,
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  as we mentioned, if you know you have perhaps even higher risk for certain of
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  the cancers that we named. So good luck to everybody.
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  I think it's good to have knowledge. it's good to try to kind of optimize your health as best you can.
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  Well, I think that is excellent advice. And you're right, we do live in bourbon
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  country, but we have enough to share with everyone so we don't have to drink
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  it all ourselves, right? Yes, that's excellent, yes.
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  Thank you so much for your time, Dr. Winer I appreciate you.
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  I had a great time being here. And if you are just tuning in,
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