When, How Soon, and How Much?
NOPE ... we are not talking about your sex life after prostate cancer treatment. This is about C2H5OH … commonly known as grain alcohol.
Asking about alcohol's impact
Considering over 50% of men consume alcohol in some form or other in the United States, it is puzzling that men are often hesitant to ask doctors about the relationship between adult beverage consumption and prostate cancer (PCa). Is the consumption of alcohol a possible cause for developing PCa? And what about continued adult beverage consumption following my prostate cancer treatment? All good questions that are seldom asked.1
While the question may not come up when men meet with physicians, it does come up in our support groups but often in an indirect way. Given the reluctancy of men to speak about this topic, why not give the topic a bit of time here?
Exploring possible links
A study done several years ago that appeared in the American Journal of Public Health estimated that less than 4% of all cancer deaths in the United states could be directly related to alcohol consumption. At the same time, the study suggested that higher consumption can increase cancer risk. Drinking in excess can also elevate blood pressure, promote weight gain, and increase the risk of heart disease and stroke.2,3
Naturally, it goes without saying that the heavier consumption of alcohol can affect male hormone production and contribute to erectile dysfunction.1
Things get more confusing when you read other research. Some has suggested there is no direct association with alcohol and PCa. I found that puzzling to say the least!
If that was not confusing enough, a study that appeared in the 2019 Journal of Clinical Oncology compared non-alcohol users with users and found that the incidence of PCa was lower in those who consumed alcohol. The study suggests that the moderate use of red wine could slow the progression of the disease in those men already diagnosed.4
Wow, what is going on?
There is research suggesting that alcohol consumption can suppress PSA levels, particularly if one falls into the category of being a heavy drinker.5 It would not be farfetched to see how this might impact the outcome of a PSA blood test.
Following my prostatectomy in 2013, the urologist mentioned that I might want to avoid alcohol, as it is an irritant and could result in increased urinary incontinence. The advice took away my desire for a glass of wine with dinner. Fortunately, the restriction did not cause personal concern. That said, avoiding alcohol, particularly in social situations, is rather difficult if not impossible for some men.
A suggestion we offer men in the group is to substitute a non-alcoholic beer for the real thing. You still have the “look” of real beer and some of the flavor while avoiding C2H5OH. The regular consumption of alcoholic beer in particular can raise uric acid levels and trigger painful gout flare-ups.6 Excessive alcohol consumption in any form can also lead to decline in bone density.
We also point out to attendees that caffeine drinks can also irritate the bladder and cause incontinence. Few give up their AM coffee, and most say they have cut back on the number of cups. We never ask if the cups magically got larger.
Making a decision
When it comes to the questions of WHEN, HOW SOON, and HOW MUCH, we all make our individual decisions. Some research has suggested that moderate consumption of alcohol, especially red wine, MAY offer some reduced risk of prostate cancer.7
The “good news” is not a license to drink large quantities. If a person currently enjoys a glass of wine, they may be able to presume it is safe to continue. If they do not consume alcohol currently, it may also be safe to continue that well-worn path.
Have you gone to a pelvic floor physical therapist?