Is It Safe to Drink Alcohol During Chemotherapy?

The Risks and Benefits

Whether it is safe drink alcohol during chemotherapy depends on several factors. Potential risks include medication interactions, worsening of chemotherapy side effects, and the depressant effect of alcohol when combined with a disease that can lead to depression. It's important to talk to your oncologist for recommendations based on your specific situation.

Glass of alcohol on wooden table
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There are a few larger issues to keep in mind. Several types of cancer are linked with alcohol intake, and those who have an alcohol use disorder or alcoholism should clearly abstain.

Whether alcohol use after diagnosis may have an impact on cancer progression or survival is less well understood. It's likely that the impact of drinking with cancer may vary based on the type of cancer and specific treatments used.

Potential Risks

There are several potential risks to consider before imbibing during chemotherapy. Some of these include medication interactions, worsening of side effects, sleep disturbance, depression, dependence, and more.

Drug Interactions

When evaluating possible interactions, it's important to look at all medications, not just the particular chemotherapy drugs used.

Interactions with Chemotherapy Drugs

Alcoholic beverages do not appear to interact with most chemotherapy medications, but there are exceptions. Drinking alcohol along with the chemotherapy drug Matulane (procarbazine) can increase the central nervous system side effects. Similarly, combining alcohol with Gleostine or CeeNu (lomustine) can lead to very unpleasant symptoms.

It's also important to be aware that newer drugs or particular combinations of chemotherapy drugs may lead to interactions that have not yet been documented.

Interactions with Other Drugs Used During Chemotherapy

Perhaps of greater concern are a number of medications that may be used along with chemotherapy. Drugs such as painkillers, anti-anxiety drugs, sleep aids, and anti-nausea medications frequently cause adverse reactions when combined with alcohol.

Metabolism by the Liver

It's noteworthy that many chemotherapy drugs are metabolized by the same enzymes in the liver as alcohol. The use of alcohol may interfere with the ability of the liver to properly metabolize toxins such as chemotherapy drugs, especially for those who already have liver damage.

Worsening of Chemotherapy Side Effects

There are a number of chemotherapy-related side effects that could be exacerbated by drinking alcohol. Some of these include:

  • Dehydration: The dehydrating effect of alcohol could worsen any dehydration you are experiencing due to your treatment.
  • Mouth sores: Chemotherapy-induced mouth sores are very common, and alcohol could both worsen the sores and cause more pain.
  • Nausea and vomiting: Alcohol can irritate the stomach and could worsen symptoms of chemotherapy-induced nausea and vomiting.
  • Blood counts: Drinking alcohol could potentially interfere with the production of white blood cells, red blood cells, and platelets, potentially worsening bone marrow suppression due to chemotherapy. This effect is unlikely to occur with a moderate intake of alcohol but could be of concern with heavy drinking.
  • Peripheral neuropathy: Chemotherapy-induced peripheral neuropathy is an annoying symptom that leads to tingling and burning and the hands and feet. Chronic alcohol use (usually in excess) can also cause neuropathy and has been shown to worsen neuropathy related to chemotherapy.

More Risks

These risks should also be considered:

  • Sleep disturbance: Alcohol use can cause sleep disorders. Sleep issues are more than a nuisance for those who have cancer; having been linked with a lower quality of life, and possibly even poorer survival.
  • Depression: Alcohol is a known depressant, and depression is more common in people with cancer. Attention has been drawn to the high rate of suicide in people with cancer, with the first few months after diagnosis (at a time when many people may be receiving chemotherapy) being the time of greatest risk.
  • Secondary cancer: Since some chemotherapy drugs (as well as radiation therapy) can raise the risk of a secondary cancer (another type of cancer developing in the future), adding the risk factor of alcohol could theoretically increase the risk further.
  • Alcohol dependence: Alcohol addiction can cause serious health problem that hinders treatment. If you struggle with alcohol along with the roughly 23 million Americans who battle alcoholism, talk to your healthcare provider. This may be an excellent time to beat your addiction and focus on fighting your cancer.
  • You may not enjoy it: While not really a risk, many people simply don't enjoy alcohol while on chemotherapy. Whether from the common taste changes that can occur or the alcohol-induced sleepiness that adds to cancer fatigue, you may not find drinking relaxing or enjoyable.

Potential Benefits

For those who aren't receiving chemotherapy drugs that interact with alcohol and don't have other concerns mentioned above, there may be a few benefits to having a drink during chemotherapy:

  • Anxiety relief: While it has been debated, some people find that a glass of wine can reduce anxiety and improve the ability to relax.
  • Healthy phytonutrients: Talking about nutrients in alcoholic beverages as a benefit of drinking is stretching it. Yet red wine does contain the healthy phytonutrient resveratrol, and beer contains B vitamins.

Effect on Cancer Growth and Survival

In theory, alcohol could lead to progression of cancers fed by estrogen such as breast cancer, as alcohol can raise estrogen levels. That said, the studies don't appear to support this.

A 2014 meta-analysis looking at almost 30,000 people with breast cancer found that alcohol intake after diagnosis is unlikely to have a significant effect on survival. The effect, however, may vary between different cancer types or what treatments a person is receiving.

A 2017 study looking at the effect of alcohol intake after diagnosis in people with head and neck cancers found that alcohol did have an effect (negative) on survival in people who had surgery for tongue cancer, but not those who had surgery for other oral cancers.

Certainly, not all cancer types and treatments have been studied, so it's important to ask your oncologist about her recommendations based on your specific tumor and treatments.

A Word From Verywell

There are several potential risks and benefits to consider if you are wondering if you can drink alcoholic beverages during chemotherapy. Every cancer and every person is different, and only you and your oncologist can determine what is best for you.

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Article Sources
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