Alcohol and cancer

• There is no doubt that alcohol can cause seven types of cancer
• The less alcohol you drink, the lower the risk of cancer
• Overall, the risk of developing cancer is smaller if you stay within the government guidelines, about one standard drink a day for women or two for men
• Drinking and smoking together are even worse for you.

Not everyone who drinks will develop cancer. But on the whole, scientists have found that some cancers are more common in people who drink more alcohol than others. Read more about the evidence that alcohol causes cancer.

Every year, alcohol causes 4% of cancers in the UK, around 12,500 cases.

Which cancers are affected?

Drinking alcohol regularly can increase the risk of:

• Mouth cancer
• Pharyngeal cancer (upper throat)
• Oesophageal cancer (food pipe)
• Laryngeal cancer (voice box)
• Breast cancer
• Bowel cancer
• Liver cancer

The risk isn't just increased for heavy drinkers

Alcohol can increase the risk of cancer at levels far too low to make an average person drunk. It's not just people who drink very heavily who have higher risks.

Regularly drinking a pint of premium lager or a large glass of wine a day or less can increase the risk of mouth, throat, oesophageal (gullet or foodpipe), breast and bowel cancers. (They both include about 3 units of alcohol.)

Each unit of alcohol has a weaker effect on the risk of breast cancer than on cancers of the head and neck, but because breast cancer is the most common cancer in the UK and because so many women drink small amounts of alcohol regularly, a large number of women are affected - around 3,100 cases of breast cancer each year in the UK are linked to alcohol.

The more alcohol you drink, the higher the risk of developing cancer and other diseases. Heavy drinking can cause cirrhosis of the liver, which can in turn cause liver cancer. Heavy drinking can also lead to stroke, high blood pressure, pancreatitis and injuries.

Overall, the risk of developing cancer is smaller if you stick within the guideline amounts, which are around:

• one standard drink a day for women e.g. a glass (175ml) of wine or a pint of beer or cider
• two standard drinks a day for men e.g. 2 glasses (175ml) of wine or 2 pints of beer or cider.

But remember that:

• as the amount of alcohol increases, so does the risk
• some drinks may contain more alcohol than you think.

Find out more about reducing the risk from alcohol.

Alcohol and heart disease

Drinking small amounts of alcohol has been shown to offer some protection for people at risk of heart disease, which normally applies to people over the age of 40. However, drinking more alcohol doesn't reduce the risk further - in fact it can increase the risk of stroke and high blood pressure as well as other conditions. Increasing the amount of alcohol you drink in order to improve your health is unlikely to work.

Dr Mike Knapton, Associate Medical Director at the British Heart Foundation, said: "Moderate drinking - between 1 and 2 units a day - has been shown to offer some protection against heart disease.

"However, this should not be seen by people as a green light to start drinking - as there are better ways to protect your heart. Eating a sensible diet, exercising regularly and stopping smoking are all much better ways to keep your heart healthy."

Which is worse: binge drinking or spreading my drinking across the week?

Research has looked mainly at the amount of alcohol people drink in total and the effect in cancer risk. Drinking a lot of alcohol increases the risk of cancer whether you drink it all in one go or a bit at a time.

Do all types of alcohol increase the risk of cancer? 

All types of alcohol increase the risk of cancer. It is the alcohol itself that leads to the damage, regardless of whether it is in wine, beer or spirits.

Does drinking matter if you smoke?

People who smoke and drink multiply the risk for certain cancers, because tobacco and alcohol work together to damage the cells of the body. For example, research suggests that alcohol makes it easier for the mouth and throat to absorb the cancer-causing chemicals in tobacco, making the risk of these cancers much bigger compared to either drinking or smoking alone.

Smoking and cancer

Thanks to years of research, the links between smoking and cancer are now very clear. Smoking is by far the most important preventable cause of cancer in the world. Smoking accounts for one in four UK cancer deaths, and nearly a fifth of all cancer cases.

In the UK, smoking kills five times more people than road accidents, overdoses, murder, suicide and HIV all put together.

Which cancers are caused by smoking?

Smoking causes more than four in five cases of lung cancer. Lung cancer has one of the lowest survival rates of all cancers, and is the most common cause of cancer death in the UK. The good news is that most of these deaths are preventable, by giving up smoking in time.

Smoking also increases the risk of over a dozen other cancers including cancers of the mouth, larynx(voice box), pharynx (upper throat), nose and sinuses, oesophagus (food pipe), liver, pancreas,stomach, kidney, bladder, cervix and bowel, as well as one type of ovarian cancer and some types ofleukaemia. There is also some evidence that smoking could increase the risk of breast cancer.

Not all smokers get cancer. Why?

You may know someone who smoked all their lives but lived to a ripe old age. Or you may know someone who never smoked but got cancer anyway. Does this mean that smoking doesn’t really cause cancer?

Not at all. Years of research have proven that smoking causes cancer. But this doesn’t mean that all smokers will definitely get cancer or that all non-smokers won’t. It means that smoking greatly increases the risk of this disease. Smokers are, on average, much more likely to get cancer than non-smokers.

In a similar way, we can say that eating sugary foods is a cause of tooth decay. This doesn’t mean that all children who eat sugary foods will end up with decayed teeth. It means that, on average, children who eat lots of sugary foods are more likely to develop tooth decay than those who avoid such foods.

The fact is that half of all smokers eventually die from cancer, or other smoking-related illnesses. Anda quarter of smokers die in middle age, between 35 and 69.

Our How do we know? page has more information on the evidence linking smoking to cancer.

How does smoking cause cancer?

Tobacco smoke contains more than 70 different cancer-causing substances. When you inhale smoke, these chemicals enter your lungs and spread around the rest of your body.

Scientists have shown that these chemicals can damage DNA and change important genes. This causes cancer by making your cells grow and multiply out of control.

Giving up makes a difference

Thanks to research, health campaigns and new policies, the number of smokers in the UK has halved in the last 50 years. Because of this, the number of people who die from lung cancer has also halved. Clearly, giving up smoking saves lives.

But there is still a long way to go. Lung cancer is still the second most common type of cancer in the UK and kills over 35,000 people every year. And there are signs that the number of people who are quitting is starting to match the number who are taking it up.

If you are a smoker, giving up smoking is the best present you can give yourself. There are many techniques you can try to help you join the increasing numbers of smokers who are quitting for good. You can find more advice on quitting in this section.

Finding it hard to quit? Get involved with Stoptober. Research shows that if you can stop smoking for 28 days, you are five times more likely to stay smokefree, and Stoptober leads smokers through a detailed step-by-step programme to help them achieve this goal.

All cancer types

• ·         Anal cancer  
  ·         Bile duct cancer (cholangiocarcinoma)
  ·         Bladder cancer
  ·         Bone cancer
  ·         Bone cancer, secondary
  ·         Bowel cancer
  ·         Brain tumours
  ·         Brain tumours, secondary
  ·         Breast cancer in women
  ·         Breast cancer, DCIS
  ·         Breast cancer in men
  ·         Breast cancer, secondary
  ·         Colon and rectal cancer
  ·         Cervical cancer
  ·         Children's cancers
  ·         Endocrine tumours
  ·         Eye cancer (ocular melanoma)
  ·         Fallopian tube cancer
  ·         Gall bladder cancer  
  ·         Head & neck cancers
  ·         Kaposi's sarcoma
  ·         Kidney cancer
  ·         Larynx cancer
  ·         Leukaemia
  ·         Leukaemia, acute lymphoblastic
  ·         Leukaemia, acute myeloid
  ·         Leukaemia, chronic lymphocytic
  ·         Leukaemia, chronic myeloid
  ·         Liver cancer
  ·         Liver cancer, secondary
  
  
  ·         Lung cancer
  ·         Lung cancer, secondary
  ·         Lymph node cancer, secondary
  ·         Lymphoma
  ·         Lymphoma, Hodgkin
  ·         Lymphoma, non-Hodgkin
  ·         Melanoma
  ·         Mesothelioma
  ·         Myeloma
  ·         Neuroendocrine tumours
  ·         Ovarian cancer
  ·         Oesophageal (gullet) cancer
  ·         Pancreatic cancer
  ·         Penis cancer
  ·         Primary peritoneal cancer
  ·         Prostate cancer
  ·         Pseudomyxoma peritonei
  ·         Skin cancer
  ·         Small bowel cancer
  ·         Soft tissue sarcomas
  ·         Spinal cord tumours
  ·         Stomach cancer
  ·         Testicular cancer
  ·         Thymus cancer
  ·         Thyroid cancer
  ·         Trachea (windpipe) cancer
  ·         Unknown primary cancer
  ·         Vagina cancer
  ·         Vulva cancer
  ·         Womb (endometrial) cancer  
  
  
  
  

Investing in cancer research boosts economy as well as heath

'Cancer research saves lives as well as creating jobs and skills too. So it's good for patients and good for the economy.

Each pound invested in cancer research generates a continuous stream of benefits equal to earning 40 pence a year thereafter, according to a report by three leading research institutions.

The report – commissioned by the Academy of Medical Sciences, Cancer Research UK, the Department of Health and the Wellcome Trust, and published in BMC Medicine today – is the first ever estimate of the economic gains from investment in publicly-funded UK cancer research.

"What this report shows is that the benefits of research don’t just stop with cancer patients. They extend to everyone living here in the UK." - Harpal Kumar, Cancer Research UK 

Some of the greatest economic benefit was from efforts to reduce smoking rates, investment in breast cancer treatments, such as tamoxifen, and the cervical screening programme.

The study, led by researchers from Brunel University, Kings College London and RAND Europe, looked at the economic returns from cancer research in the UK between 1970 and 2009.

It involved developing a cutting-edge bottom up approach to estimating the ‘net monetary benefit’ from investing in medical research - the health benefit valued in monetary terms, minus the cost of delivering that benefit. They also worked out the time lag* between a piece of research being funded and the resulting health gains, associated with seven key developments in cancer treatment.

This builds on an earlier study looking at investment in heart disease and mental health research, which reported similar results. Together these areas represent 45 per cent of the UK disease burden, suggesting that this level of return can be applied to UK investment in biomedical research as a whole.

The study is being launched today (Monday) at the All Party Parliamentary Group on Medical Research’s Summer Reception where Universities and Science Minister Rt Hon David Willetts MP and leading figures from the medical research community will highlight the health and economic returns that have been delivered by Government and charitable investment into medical research.**

Study leader Professor Jonathan Grant, from King’s College London, said: “This return of 40 pence a year for each pound invested in cancer research includes health benefits equivalent to around 10 pence, plus a further 30 pence, which is the best estimate of the ‘spillover’ effect from research to the wider economy.  An internal rate of return of 40p easily meets the UK Government’s minimum threshold of 3.5 pence per pound for investments, showing that money spent on cancer research is good for the society as a whole, as well as benefitting patients.

“Estimating economic return from biomedical research is notoriously complicated, but we’re confident that our new approach provides the most accurate picture to date of the impact cancer research has on our national wealth.”

Jeremy Hunt, Health Minister, said: “Innovation is essential for improving treatments and finding new cures that can make a difference to patients, and this report is more evidence that investing in UK medical research has wider economic benefits.

“The UK life sciences sector is one of the strongest and most productive in the world, and is a valued partner in the Government’s plans for a strong economy and an NHS that is equipped for future challenges.”

Professor Sir John Tooke PMedSci, President of the Academy of Medical Sciences, said: “In difficult financial times, it is vital to show the monetary return of research alongside the health benefits for patients and their families. This study helps make the case for sustained investment in medical research. It demonstrates that past support for cancer research not only helps create a healthier society but aids the health of the economy now and into the future. Continued investment in the people who will make the advances in cancer care possible and the facilities and technologies that support them is vital if we are to continue to reap that double benefit.”

Dr Jeremy Farrar, Director of the Wellcome Trust, said: “When we invest in medical research, we win twice over: we make discoveries that lead to better health, while also generating wealth. This study shows that every pound of investment in research generates benefits equal to 40p each year thereafter, confirming that the research ecosystem in the UK – which includes government, charities and industry - is one of the most important contributors to the economy. A long term, stable commitment to research is needed to ensure advances in the nation’s future health, and its economic prosperity.”

Dr Harpal Kumar, chief executive of Cancer Research UK, said: “This study highlights the significant returns that have been realised as a result of the huge generosity of the British public, who in the last 40 years have contributed an astounding £15 billion to cancer research through their taxes and charitable donations. This has helped pay for research which over the same time period has helped double cancer survival rates.

“Only the UK has the unique combination of internationally outstanding scientists, funded through charitable donations and working in partnership with world-leading universities and the NHS, that creates an ideal platform for making progress against cancer. As a result three life-saving national screening programmes for breast, cervical and bowel cancers now exist in the UK, so patients are being diagnosed earlier. And thanks to research that is leading to new ways to diagnose and treat cancer, more people than ever are surviving the disease with fewer long term side effects. What this report shows is that the benefits of research don’t just stop with cancer patients. They extend to everyone living here in the UK.”

ENDS

For media enquiries contact the Cancer Research UK press office on 020 3469 8300 or, out of hours, on 07050 264 059.

New targets that could increase effectiveness, reduce side effects in breast cancer treatments

Sientists from the Florida campus of The Scripps Research Institute (TSRI) have found new targets for potential intervention in breast cancer. These new targets could eventually increase effectiveness and reduce the undesirable side effects associated with current treatments.

The study was published online ahead of print on June 5, 2014 by the journal Structure.

Approximately two out of three breast cancers are driven by receptors that bind the hormones estrogen and estrogen —when the hormones bind to these receptors in cancer cells, they signal the cancer cells to grow. What makes the progesterone receptor therapeutically interesting is that it has two activation domains—AF1 and AF2. Normally, both are needed for full activation of the receptor.

“Using hydrogen-deuterium exchange technology, our study pinpoints just how AF2 communicates with AF1—the first evidence of the long-range interaction between these two functional domains,” said Patrick R. Griffin, a TSRI professor who led the study. “These findings support further research to look for promising small molecules that block that interaction.”

The findings are especially important because in some mutations AF2 is deleted, yet the receptor still drives the cancer using its AF1 domain. Current drugs used for treating these cancers only target the AF2 domain, so with nothing to bind to, they do not work at all. While several studies have shown the importance of AF1, its binding domain is remarkably dynamic, frequently shifting shape and making it difficult to target with drugs.

In the new study, the scientists used an advanced technology known as hydrogen-deuterium exchange mass spectrometry (HDX) to measure the intricate interactions between the AF1 and AF2 domains of the progesterone receptor.

HDX mass spectrometry is a high-precision, high-sensitivity mapping technique that enabled the scientists to determine the specific regions of the receptor that are altered upon interaction. This information was used to infer structural changes that result from the interaction and to probe the conformational flexibility of intact multidomain proteins.

In addition to exploring potential new drugs for breast cancer, the researchers also hope to investigate the implications for prostate cancer, another hormone-driven disease.

“Many features of the androgen receptor are similar to progesterone receptor, as they belong to the same subfamily of steroid receptors,” said Devrishi Goswami, the first author of the study and a member of the Griffin laboratory. “It could work the very same way. So these new insights may also help in finding new approaches to treating hormone-therapy-resistant prostate cancer.”

Diet soda helps weight loss, industry-funded study finds

Most people choose artificially-sweetened soda over regular soda to avoid packing on extra pounds. But what if you already choose diet? Would it be helpful to quit that too?

Dr. Jim Hill says he gets this question all the time from patients in his weight loss program at the University of Colorado's Anschutz Health and Wellness Center.

Nutritionist: Diet soda studies unclear

Are diet sodas dangerous to your health?

10 reasons to give up diet soda

With funding from the American Beverage Association, Hill helped design a study that divided approximately 300 adults into two groups: One group would continue drinking diet, and the other group -- referred to in the study as the "water group" -- would go cold turkey. The study was published in the journal Obesity.

Both participant groups received intensive coaching on successful techniques for weight loss, including regular feedback on the meals they logged in journals. Participants weighed, on average, just over 200 pounds at the start of the study.

"The results, to us, were not at all surprising," says Hill.

While the typical participant banned from drinking diet sodas lost 9 pounds over 12 weeks, those allowed to continue drinking diet soda lost, on average, 13 pounds in the same time period. That's a 4-pound difference.

Hill says that in his clinical experience, many people who have successfully lost significant weight "are heavy users of noncaloric sweeteners."

But why was the diet soda group more successful? The most likely reason is that this group had the easier task.

Cutting calories and boosting exercise takes a lot of willpower. Trying to simultaneously give up something else you regularly enjoy -- such as diet soda -- taxes your ability to stay the course. Most psychologists agree that our willpower is a limited resource.

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So while this study did not track calorie consumption, the group blocked from drinking diet sodas most likely ate (or drank) more calories over the course of the 12-week diet.

Since the study lasted just 12 weeks, it remains to be seen whether artificial sweeteners are beneficial in the long-term, says Susan Swithers, a professor of Behavioral Neuroscience at Purdue University. Swithers authored a report last year that found that diet soda drinkers have the same health issues as those who drink regular soda. It found that people who drink diet soda may be "at increased risk of excessive weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease," according to the study.

Artificial sweeteners and health

Extend your life through diet

Fad diet crackdown

MORE: Study: Diet soda may do more harm than good

"What the prospective studies actually suggest is that if you go out 7 years, 10 years, 15 years, 20 years, the cohorts of individuals who are consuming diet sodas have much worse health outcomes," says Swithers.

Those studies show a correlation, and are not designed to show causation. But some researchers like Swithers suspect artificial sweeteners ultimately increase the desire for sweets.

"Doing these short-term studies that look at weight can't really tell us anything about whether or not these products are contributing to these increased risks," says Swithers. "And it's really hard to look at the (long-term) data and come up with any argument that they're helping."

Hill, who along with four other researchers, designed the study, which was selected for funding by the American Beverage Association from among multiple competing proposals. The American Beverage Association's membership includes numerous Coca-Cola and Pepsi-Cola bottling companies.

"It makes sense that it would have been harder for the water group to adhere to the overall diet than the (artificially-sweetened beverage) group," says Hill.

He added, "The most likely explanation was that having access to drinks with sweet taste helps the (artificially-sweetened beverage) group to adhere better to the behavioral change program."

Real or fake sugar: Does it matter?

How to juggle sweets in your diet

What is a cheat meal?

In short, this study addresses the question of whether a regular diet soda drinker should attempt to kick his or her habit while also attempting to lose weight, not whether we should all drink more diet soda in order to lose weight.

Artificially-sweetened beverages "are not weight-loss enhancers, so it's not anything in the compounds themselves that are promoting weight loss," says Hill.

Kristi Norton, a regular diet soda drinker before the study began, was assigned to the group that required her to kick the habit. At the time of her CNN interview, she was not aware of the study's findings.

She says she lost 12 pounds during the course of the study, but the real difference is in how she feels.

"I feel like I could 1000% tell the benefit of drinking water only. I felt better, I had more energy, I felt healthier, I just generally felt way better," says Norton. "And I can feel the difference now when I drink a diet drink, I can feel this 'heaviness'."

Using new gene therapy to potential hemophilia treatment

Researchers at the UNC School of Medicine and the Medical College of Wisconsin found that a new kind of gene therapy led to a dramatic decline in bleeding events in dogs with naturally occurring hemophilia A, a serious and costly bleeding condition that affects about 50,000 people in the United States and millions more around the world.

Before the gene treatment, the animals experienced about five serious bleeding events a year. After receiving the novel gene therapy, though, they experienced substantially fewer bleeding events over three years, as reported in the journal Nature Communications.
"The promise and the hope for gene therapy is that people with hemophilia would be given a single therapeutic injection and then would express the protein they are missing for an extended period of time, ideally for years or even their entire lifetimes," said Tim Nichols, director of the Francis Owen Blood Research Laboratory at UNC and co-author of the paper. The hope is that after successful gene therapy, people with hemophilia would experience far fewer bleeding events because their blood would clot better.
People with hemophilia A lack the coagulation factor VIII in their blood plasma - the liquid in which red, white, and platelet cells are suspended.
"Bleeding events in hemophilia are severe, and without prompt factor VIII replacement, the disease can be crippling or fatal," said Nichols, a professor of medicine and pathology. "The random and spontaneous nature of the bleeding is a major challenge for people with hemophilia and their families."
In underdeveloped countries, people with hemophilia and many undiagnosed people typically die from bleeding in their late teens or early 20s. In developed countries, patients usually live fairly normal lives, as long as they receive preventive injections of recombinant protein therapy a few times a week. The disease requires life-long management that is not without health risks. The annual cost of medications alone is about $200,000 a year.
However, about 35 percent of people with hemophilia A develop an antibody response that blocks the factor VIII therapy. They require continuous infusions of various protein factors and they face a higher mortality rate. Also, the cost of treatment can easily rise to $2 million or more a year per patient.
Nichols and David Wilcox from the Medical College of Wisconsin figured out a potential way around the antibody response in dogs with naturally occurring hemophilia A.
Using a plasmapheresis machine and a blood-enrichment technique, the research team isolated specific platelet precursor cells from three dogs that have hemophilia A. The team then engineered those platelet precursor cells to incorporate a gene therapy vector that expresses factor VIII. The researchers put those engineered platelet precursors back into the dogs. As the cells proliferated and produced new platelets, more and more were found to express factor VIII.
Then, nature took over. Platelets naturally discharge their contents at sites of vascular injury and bleeding. In this experiment, the contents included factor VIII.
In the 2 1/2 years since the dogs received the gene therapy, researchers found that factor VIII was still being expressed in platelets that were coursing throughout the vascular systems of all three dogs. All three experienced much less bleeding. In the dog that expressed the most factor VIII in platelets, the bleeding was limited to just one serious event each year over the course of three years. And such bleeding events were easily treatable with current standard therapies.
"This has been very successful," Nichols said. "And now we want to explore the possibility of moving it into human clinical trials for people with hemophilia A, similar to what Paul Monahan and Jude Samulski at UNC are currently doing for people with hemophilia B, which is a deficiency of factor IX."
If approved, the platelet-targeted therapy would likely be restricted to patients who develop the antibody that stifles factor VIII therapy through normal injections. But as the gene therapy is refined, it could become a viable option for people with blood disorders who don't have inhibitory antibodies.