What Happens If You Drink Alcohol With Metastatic Breast Cancer?

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

While every person is different and must make their own risk assessment when making decisions about alcohol consumption, experts agree it’s best to steer clear.

“It’s hard to be absolute about alcohol consumption for a specific individual with cancer,” says Naomi Y. Ko, MD, MPH, a medical oncologist at NYU Langone Perlmutter Cancer Center. “But, given what we know thus far, it would be best to avoid and decrease usage, if at all possible."

How Alcohol Affects Metastatic Breast Cancer

“While there is robust evidence in the medical literature that alcohol increases risk of cancer, the data on alcohol in patients after a diagnosis is less clear,” Dr. Ko says. “But it remains concerning, given what we know about how alcohol works.” It’s possible that alcohol consumption could speed up or worsen tumor growth, or make you more susceptible to other health conditions.

Researchers believe alcohol influences breast cancer through a number of mechanisms.

Damage to DNA

“Acetaldehyde is a known carcinogen causing damage to both DNA and cellular functions throughout the body,” says Ajaz M. Khan, MD, chief of medical oncology at City of Hope Chicago.

Increased Estrogen

Therefore, drinking alcohol with ER-positive breast cancer is strongly discouraged, Dr. Khan says.

Suppressed Immune System

Does Alcohol Interact With Breast Cancer Medications?

Drinking alcohol while undergoing treatment for metastatic breast cancer, including chemotherapy and hormone therapy like tamoxifen and aromatase inhibitors, can cause liver strain and even affect how these drugs work, Khan says.

“It is important to note that many medications are metabolized by the liver, which also metabolizes alcohol,” says Katie McLean, RDN, a senior oncology dietitian at Houston Methodist Neal Cancer Center at Sugar Land.

Are Some Alcoholic Drinks Safer for Breast Cancer Than Others?

No single alcoholic drink is safer than others when it comes to metastatic breast cancer.

“Regardless of drinking a lite craft beer, organic red wine, or a distilled spirit, it is the total volume of ethanol consumed which increases the risk of biological damage,” Khan says.

Safe Drinking Practices for People With Metastatic Breast Cancer

Again, no amount of alcohol is considered safe for breast cancer.

Experts recommend experimenting with alcohol-free beverages instead. “Make them feel special by serving them in a fun glass such as a champagne flute and include a garnish,” McLean says.

Some of her favorites include:

• Nonalcoholic beers or wines
• Sparkling water flavored with fresh herbs or fruit
• Water infused with mint and cucumbers or berries and mint
• Herbal teas
• Mocktails

Ultimately, whether to drink alcohol with breast cancer is an individual decision.

“There is a need to balance living your life and knowing what the current scientific evidence shows,” Ko says. “We make choices every day on how to live our own best lives. Special occasions and social connections are important, too. Despite what we know about the risks and concerns surrounding alcohol and breast cancer, I would encourage someone with cancer to take the risks they are most comfortable with.”

However, “given the current data and emerging data, the less alcohol the better,” she continues.

Additionally, staying hydrated is essential for digestion, kidney function, medication metabolism, circulation, and energy levels, McLean says.

“Alcohol acts as a diuretic, which can increase fluid losses and contribute to dehydration,” she explains. “At the same time, some cancer treatments and their side effects can increase a person’s risk of dehydration.”

Adequate hydration may help reduce both treatment-related side effects and some of the negative effects associated with alcohol consumption, she says.

Monitoring symptoms while drinking alcohol is important. “Individuals should pay attention to how alcohol affects them for 24 to 48 hours after consumption,” McLean says. “Symptoms to monitor include fatigue, nausea, dehydration, dizziness, reflux, headaches, [and] sleep disruption, among others. Any concerns should be discussed directly with a person’s oncology care team.”