The link between alcohol and cancer is fairly well-established but the heart benefits of the daily tipple has always overshadowed this.

The much-touted benefits of a daily measure of red wine and its cardio-protective effect are passe. With the latest research studies from the West now suggesting that even low to moderate consumption of alcohol can elevate the risk of breast cancer, may be, it is time to take a hard look at that bottle of red again.

The link between alcohol and cancer, especially cancers of the mouth, larynx, oesophagus, or the organs like stomach and liver is fairly well-established. But somehow, rather than the alcohol-cancer link, it is the heart benefits of the daily drink which has always received a lot of attention. The World Health Organisation (WHO) attributes about 30 per cent of all cancers to tobacco and four percent of all cancers to alcohol. There is very little that is known about the ‘safe' limits of alcohol consumption and there are few studies where risk adjustment for alcohol alone has been done. Yet, most researchers seem to be in agreement when they observe that along with unhealthy diet, sedentary lifestyle and tobacco use, the spiralling levels of alcohol consumption has contributed to the increasing number of cancers diagnosed every year across the globe. An estimated 35,000 new cases of cancers are reported every year in Kerala and among males, cancer of the oral cavity stands at second place with an incidence rate of 11 per 1,00,000. (In India, the number one cancer among males is oral cancer). And 50 percent of these oral cancers are due to the lethal combination of tobacco and alcohol. “Alcohol is primarily linked to the risk of oral cancers. Tobacco is the main risk factor but a chunk of our patients are habitual drinkers also. Alcohol aggravates the effect of the carcinogens in tobacco,” points out K. Ramdas, Professor of Radiotherapy, Regional Cancer Centre. Alcohol is broken into acetaldehyde in the body, a carcinogen. Various studies have shown acetaldehyde content to be more in the mouths of heavy drinkers. The carcinogenic impurities in alcohol — nitrosamines — also damage the linings of the mouth. Acetaldehyde has been shown to damage the DNA, which is why women who are even planning to be pregnant should stay away from all alcohol-containing beverages. “There is no doubt that alcohol is indeed a risk factor for head and neck cancers and cancers of the liver and stomach. But a person's susceptibility to cancer is dependent on the individual's metabolic conversion rate of alcohol into acetaldehyde, genetics, the quality and quantity of alcohol consumed etc.,” Dr. Ramdas says.

All those who drink and smoke need not necessarily develop cancer but the public should be warned about how traumatic and disfiguring oral cancers can be, doctors say. Even if diagnosed and treated early, the loss of a part of one's face or tongue in surgery can affect the quality of life. In the long term, regular consumption of alcohol affects one's immune system, leaving the body weaker to fight off infections, points out Mathew Thomas, former Professor of Internal Medicine.

In fact, there is no organ in the body which alcohol does not affect because only a portion of it is metabolised by the liver, leaving the rest to freely circulate in the body. Liver diseases — cirrhosis, carcinoma and fatty liver, alcoholic hepatitis, peptic ulcers in the stomach, and cardiomyopathy are only some of the diseases that have a direct link to alcohol. Heavy drinking affects male fertility levels also. Contrary to popular belief, it does not matter how ‘hard' or soft' a drink is, it is the alcohol content in the drink, rather than the type of the drink — beer, wine, whiskey — which matters.

In the U.K., the National Health Service guidelines say that men should not have more than 24 gm of alcohol a day and women, 12 gm a day. In the U.S., the recommendation is no more than 28 gm a day for men. “While there is no safe recommended limit, regular consumption of over 60 gm of alcohol a day in say, five to 10 years, could seriously show the deleterious effects on the body,” Dr. Thomas says.

And for those who still believe in the French way of maintaining heart health, it might be interesting to know that the so-called protective benefits of moderate drinking seem to be the preserve of the French alone. For South Asians, especially, Indians, even light or moderate drinking seem to do more harm than good. In a multi-site study conducted across India among 12,000 men in the 20-69 age group, it was observed that alcohol did not have any protective effect. The study (Roy A,, Impact of alcohol on coronary heart disease (CHD) in Indian Men, Atherosclerois 2010), defined regular alcohol consumption as once or more in a week. Binge drinking was defined for the study as four or more standard drinks at a time. One standard drink was 30 ml spirits, 285 ml regular beer or 120 ml wine. The prevalence of CHD among alcohol users was 3.3 per cent and among non-users 2.4 per cent. The researchers said alcohol consumption in Indian men did not give any protective benefits against CHD and this trend was observed in alcohol users classified as occasional and regular, and light/moderate/heavy drinkers.