Can You Drink Alcohol With Metastatic Bladder Cancer?

Note: While research on alcohol is evolving, the World Health Organization says drinking less or not at all is better for your health.

“I tell my patients that there isn't a one-size-fits-all answer,” says Larry Ladi, MD, the medical director of inpatient operations at City of Hope Cancer Center in Phoenix. “For some people with advanced bladder cancer, an occasional drink may be reasonable. I encourage patients to check with their care team because the right answer depends on their medications, overall health, and treatment plan.”

How Alcohol Affects Metastatic Bladder Cancer

For people who are already living with bladder cancer, the risks of drinking depend on your individual circumstances. “For many patients, occasional light alcohol consumption may be acceptable, but it depends on several factors,” says Fernando Maciel Barbosa, MD, a medical oncologist with University of Iowa Health Care in Iowa City.

These include:

• The type of treatment you’re receiving
• Liver function
• Medications you’re taking
• Overall health

“Alcohol does not appear to directly accelerate metastatic bladder cancer progression, but it can worsen dehydration, fatigue, poor nutrition, and liver problems, all of which may affect quality of life and tolerance of treatment,” says Dr. Barbosa. “Patients recovering from surgery should generally avoid alcohol until healing is complete, since alcohol may interfere with recovery and increase certain complications.”

Ladi says alcohol also impacts how well you handle other types of metastatic bladder cancer treatment. “During chemotherapy or other systemic treatments, alcohol can sometimes make side effects such as nausea, fatigue, dehydration, or poor appetite worse,” he says.

Is It Safe to Drink During Remission?

Once treatment has been completed, you may choose to consume alcohol in moderation. “However, patients should understand that alcohol remains a carcinogen, and reducing or avoiding alcohol is generally recommended from a cancer-prevention and survivorship perspective,” says Ladi.

“For cancer survivors in general, there is a 17 percent increase in cancer recurrence and 8 percent increased overall mortality with regular alcohol consumption,” says Douglas Dow, MD, a urological surgeon at Memorial Hermann Medical Group in Houston.

Does Alcohol Interact With Bladder Cancer Medications?

Barbosa says alcohol may interact with the following:

• Pain medications, especially opioids, and can increase sedation
• Sleep medications and anti-anxiety drugs
• Certain anti-nausea medications
• Steroids
• Medications that affect liver function

Because of its role in processing both medications and alcohol, the impact on your liver is a particular concern.

“In bladder cancer specifically, many modern treatments — including antibody-drug conjugates and targeted therapies — can affect the liver,” Barbosa says. “Alcohol may add additional stress on the liver, making monitoring more difficult.”

“Since many chemotherapy agents are metabolized in the liver, drinking alcohol may impair drug clearance and worsen the toxicities.” says Dr. Dow.

Are Some Alcoholic Drinks Safer for Bladder Cancer Than Others?

“There is no convincing evidence that one type of alcoholic beverage is safer than another,” says Barbosa. “Standard drink sizes are more important than beverage type.”

Safe Drinking Practices for People With Metastatic Bladder Cancer

If you are going to drink, Ladi advises:

• Limit your alcohol intake.
• Stay well hydrated.
• Avoid alcohol on days when treatment side effects are more pronounced.

“I also suggest not drinking on an empty stomach and making sure your oncology team knows about your alcohol use so they can identify any potential medication interactions,” he says.