Oct 6, 2014 - October 2014 asked T&T to 'get serious about cancer'. It starts ... colorectum and the female breast a
Want to Prevent Cancer: Watch your alcohol intake! Your editorial of 6th. October 2014 asked T&T to 'get serious about cancer'. It starts by focusing on prevention, but then spends a significant portion of the column talking about care. I wish to add to your debate by focusing on one often under-appreciated component of prevention of cancers, alcohol. Allow me to share a few paragraphs assembled from reputable organizations. The International Agency for Research on Cancer (www.IARC.fr) is an intergovernmental organization and an arm of the World Health Organization. "The IARC reviewed the epidemiological evidence on the possible association between alcoholic beverage consumption and cancer at 27 anatomical sites, and re-affirmed the previous conclusion (IARC, 1988) that cancers of the upper digestive tract (oral cavity, pharynx, larynx, oesophagus) and the liver are causally related to the consumption of alcoholic beverages. In addition, the IARC considered that there is sufficient evidence to conclude that cancer of the colorectum and the female breast also belong in this list. Regular consumption of alcoholic beverages is associated with an increased risk for cancers at different sites along the upper digestive tract: daily intake of around 50 g of ethanol (1 bottle or 12 oz of beer, 1 glass or 5 oz of wine or 1.25 oz of hard alcohol all are about 14 g of alcohol. Therefore roughly 3.5 average drinks per day puts you at 50g) increases the risk for these cancers two- to three-fold, compared with the risk in nondrinkers. For these cancer types the effects of drinking and smoking seem to be multiplicative, which demonstrates the harmful effect of the combination of these two habits. Many Trinidadian patients tell me, 'I only smoke when I am drinking with my friends'. Consumption of alcoholic beverages was confirmed as an independent risk factor for primary liver cancer. Cirrhosis and other liver diseases often occur before the cancer becomes manifest and patients with these disorders generally reduce their alcohol intake. The IARC reviewed more than 100 epidemiological studies that assessed the association between alcoholic beverage consumption and female breast cancer. An analysis of studies on more than 58 000 women with breast cancer showed that daily 1
consumption of about 50 g of alcohol is associated with a relative risk of approximately 1.5 compared with that in non-drinkers. Similar analyses of studies on colorectal cancer demonstrated an increased relative risk of about 1.4 for colorectal cancer resulting from regular consumption of about 50 g of alcohol per day, compared with that in non-drinkers. This association seems to be similar for colon cancer and for rectal cancer." How does alcohol cause cancer (see: www.cancerresearchuk.org)? There are several theories for this, for example in our bodies, "alcohol (ethanol) is converted into a toxic chemical called acetaldehyde. It can cause cancer by damaging DNA and stopping our cells from repairing this damage. The IARC have classified acetaldehyde formed as a result of drinking alcohol as being a cause of cancer, along with alcohol itself. Alcohol can increase the levels of some hormones, such as oestrogen. Hormones act as messengers in the body, giving our cells instructions such as when to divide. Unusually high levels of oestrogen increase the risk of breast cancer. Drinking lots of alcohol can damage the cells of the liver, causing a disease called cirrhosis. Cirrhosis can make you more likely to develop liver cancer. Alcohol makes it easier for the tissues of the mouth and throat to absorb the cancer-causing chemicals in tobacco. This is one reason why people who drink and smoke multiply the damage they receive and have especially high risks of cancer. Folate is an important vitamin that helps our cells produce new DNA correctly. People who drink alcohol tend to have lower levels of folate in their blood and some studies have found that some cancers are more common in people with low folate levels. Alcohol can cause highly reactive molecules, called Reactive Oxygen Species (ROS), to be produced in our cells. These molecules can damage the DNA, which could cause cancer to develop." So in conclusion, any preventative approach to cancer needs to involve a dialogue with our population about alcohol. Dr. Rohan Maharaj The University of the West Indies, St. Augustine and The Healthy Caribbean Coalition.
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