In an analysis from the Health Professionals Follow-up Study, the investigators evaluated the relation of alcohol consumption in their more than 45,000 study participants to the development of lethal prostate cancer. They related alcohol first to the overall risk of prostate cancer among all subjects, and then focused on the 5,182 men who developed non-metastatic prostate cancer to judge their risk of developing lethal prostate cancer or mortality. They judged the alcohol intake both prior to the diagnosis and after a diagnosis of prostate cancer. For reported alcohol consumption among subjects prior to the initial diagnosis of prostate cancer, there was a small (16%) but significant reduction in the risk of lethal prostate cancer among subjects reporting any alcohol consumption, but no significant effects of specific beverages on the risk of lethal prostate cancer. However, total mortality was lower for consumers of total alcohol intake and for most categories of intake for all types of beverage.
When they then related post-diagnosis alcohol intake (after the diagnosis of non-metastatic prostate cancer), the investigators found that red wine consumption was associated with a 50% reduction in the risk of developing lethal prostate cancer or mortality. There were no significant relations between total alcohol consumption or between the intake of other specific beverages and lethal disease.
The authors describe a number of hypotheses by which red wine, with its combination of high levels of polyphenols in addition to alcohol, may have lowered the risk of lethal prostate cancer. And there are numerous basic science experiments that have shown how polyphenols impede the development and growth of cancer cells. Presumably, it was not due to the alcohol in red wine, as similar amounts of alcohol in other beverages did not show a protective effect. While the effects of various polyphenols may play a role, at present the mechanisms of such an effect are not known.
Forum reviewers considered this to be a very well-done study and analysis, with repeated assessments of alcohol intake and essentially complete ascertainment of lethal prostate cancer and mortality. Forum members agree with the conclusions of the authors: “Our results indicate that moderate alcohol intake among men with prostate cancer is not associated with a higher risk of progression to lethal disease or overall mortality. The potential benefit of red wine on prostate cancer progression merits additional research.”
Reference: Downer MK, Kenfield SA, Stampfer MJ, Wilson KM, Dickerman BA, Giovannucci, EL, et al. Alcohol Intake and Risk of Lethal Prostate Cancer in the Health Professionals Follow-Up Study abstract. J Clin Oncology 2019 Pre-publication: : DOI https://doi. org/10.1200/JCO.18. 02462