Fighting cancer with red wine? Molecular mechanisms of resveratrol. PDF Print E-mail

Crit Rev Food Sci Nutr. 2009 Oct;49(9):782-99.

Kraft TE, Parisotto D, Schempp C, Efferth T.
University of Heidelberg, Institute of Pharmacy and Molecular Biotechnology, Heidelberg, Germany. thomas This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Resveratrol, a red wine constituent, has been known for its cardioprotective effects. Recent data give ample evidence that resveratrol can act as a chemopreventive agent as well. Tumor initation, promotion, and progression are affected by resveratrol via multiple pathways, which are discussed in this review. Resveratrol has anti-inflammatory effects by counteracting NF-kappa B and AP-1 transcription and can prevent bioactivation of procarcinogens by interacting with drug metabolizing enzymes. Furthermore, resveratrol exerts antioxidant activities, hence contributing to the prevention of tumor initiation. Growing or metastasizing carcinomas are inhibited by resveratrol through prevention of angiogenesis by inhibiting VEGF and matrix metalloproteases. Induction of apoptosis and cell cycle arrest, important mechanisms for cancer therapy, are stimulated by resveratrol through different mechanisms, e.g., activation of p53 and modulation of cell cycle proteins. Although there has been remarkable evidence for resveratrol as a potent chemopreventive agent in vitro, it seems that the low bioavailability of resveratrol in humans could interfere with a successful in vivo treatment. Nevertheless, resveratrol offers two major advantages over conventional chemotherapy. The cytotoxic effects of resveratrol on healthy cells can be neglected, and, as several pathways leading to chemotherapeutic effects are activated by resveratrol, chemoresistance-inducing mutations in cancer cells can be overcome.
PMID: 20443159 [PubMed - in process]

No association between alcohol consumption and pancreatic cancer PDF Print E-mail

Cancer Causes Control. 2010 Apr 7. [Epub ahead of print]

Alcohol intake and pancreatic cancer: a pooled analysis from the pancreatic cancer cohort consortium (PanScan).

Michaud DS, Vrieling A, Jiao L, Mendelsohn JB, Steplowski E, Lynch SM, Wactawski-Wende J, Arslan AA, Bas Bueno-de-Mesquita H, Fuchs CS, Gross M, Helzlsouer K, Jacobs EJ, Lacroix A, Petersen G, Zheng W, Allen N, Ammundadottir L, Bergmann MM, Boffetta P, Buring JE, Canzian F, Chanock SJ, Clavel-Chapelon F, Clipp S, Freiberg MS, Michael Gaziano J, Giovannucci EL, Hankinson S, Hartge P, Hoover RN, Allan Hubbell F, Hunter DJ, Hutchinson A, Jacobs K, Kooperberg C, Kraft P, Manjer J, Navarro C, Peeters PH, Shu XO, Stevens V, Thomas G, Tjønneland A, Tobias GS, Trichopoulos D, Tumino R, Vineis P, Virtamo J, Wallace R, Wolpin BM, Yu K, Zeleniuch-Jacquotte A, Stolzenberg-Solomon RZ.

Division of Epidemiology, Public Health and Primary Care, Imperial College London, London, UK, This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


The literature has consistently reported no association between low to moderate alcohol consumption and pancreatic cancer; however, a few studies have shown that high levels of intake may increase risk. Most single studies have limited power to detect associations even in the highest alcohol intake categories or to examine associations by alcohol type. We analyzed these associations using 1,530 pancreatic cancer cases and 1,530 controls from the Pancreatic Cancer Cohort Consortium (PanScan) nested case-control study. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated using unconditional logistic regression, adjusting for potential confounders. We observed no significant overall association between total alcohol (ethanol) intake and pancreatic cancer risk (OR = 1.38, 95% CI = 0.86-2.23, for 60 or more g/day vs. >0 to <5 g/day). A statistically significant increase in risk was observed among men consuming 45 or more grams of alcohol from liquor per day (OR = 2.23, 95% CI = 1.02-4.87, compared to 0 g/day of alcohol from liquor, P-trend = 0.12), but not among women (OR = 1.35, 95% CI = 0.63-2.87, for 30 or more g/day of alcohol from liquor, compared to none). No associations were noted for wine or beer intake. Overall, no significant increase in risk was observed, but a small effect among heavy drinkers cannot be ruled out.

PMID: 20373013 [PubMed - as supplied by publisher]


Low to Moderate Alcohol Intake Is Not Associated with Increased Mortality after Breast Cancer. PDF Print E-mail

Low to Moderate Alcohol Intake Is Not Associated with Increased Mortality after Breast Cancer.

Flatt SW, Thomson CA, Gold EB, Natarajan L, Rock CL, Al-Delaimy WK, Patterson RE, Saquib N, Caan BJ, Pierce JP. Cancer Epidemiol Biomarkers Prev. 2010 Feb 16. [Epub ahead of print]

Authors' Affiliations: 1Cancer Prevention and Control Program, Moores UCSD Cancer Center, University of California, San Diego, La Jolla, California; 2Arizona Cancer Center, University of Arizona, Tucson, Arizona; 3Department of Public Health Sciences, University of California, Davis, Davis, California; and 4Division of Research, Kaiser Permanente Northern California, Oakland, California.

BACKGROUND: Both alcohol consumption and obesity have been linked with breast cancer morbidity and mortality. An inverse association between alcohol intake and obesity suggests possible confounding between these variables (and perhaps other factors) with breast cancer outcomes. METHODS: Alcohol intake (beer, wine, spirits, and total) was examined in 3,088 women previously diagnosed and treated for breast cancer within an intervention trial that targeted vegetables, fiber, and fat but not alcohol or weight loss. Factors associated with baseline alcohol intake were included in Cox proportional hazards models for recurrence and mortality. RESULTS: Alcohol intake was significantly associated with higher education and physical activity levels. Neither light alcohol intake nor obesity was significantly associated with breast cancer recurrence, but moderate alcohol intake >300 g/mo was protective against all-cause mortality (hazard ratio, 0.69; 95% confidence intervals, 0.49-0.97) in a proportional hazards model adjusted for obesity. Obese women were 61% more likely to be nondrinkers than drinkers, and 76% more likely to be light drinkers than moderate/heavy drinkers. In nonobese women, alcohol intake >10 g/mo was associated with lower risk of all-cause mortality (hazard ratio, 0.68; 95% confidence intervals, 0.51-0.91). CONCLUSION: Light alcohol intake, regardless of body weight, did not increase the risk of breast cancer recurrence or all-cause mortality in this cohort of middle-aged women previously diagnosed with breast cancer. Alcohol intake was associated with other favorable prognostic indicators, which may explain its apparent protective effect in nonobese women. Cancer Epidemiol Biomarkers Prev; 19(3); OF1-8.

Alcohol and Gynecologic cancers: an overview PDF Print E-mail

Eur J Cancer Prev. 2010 Jan;19(1):1-10.

Alcohol and gynecological cancers: an overview.

Hjartåker A, Meo MS, Weiderpass E.  Department of Etiological Research, Cancer Registry of Norway, Oslo, Norway. This e-mail address is being protected from spambots. You need JavaScript enabled to view it

The objective of the paper was to summarize the literature findings on alcohol consumption with regard to risk of various gynecological cancers. A Medline search was performed considering available cohort and case-control studies published until 31st March 2009 examining the association between the consumption of alcoholic beverages and cancers of the cervix uteri, corpus uteri, endometrium, ovaries, vagina, and vulva. The number of prospective population-based studies with adequate information on confounding factors is low, particularly for cancers of the cervix, corpus uteri, vulva and vagina. Several register studies have found a higher risk of cervical, vulvar, and vaginal cancers among alcoholics than in the general population. However, these findings have not been confirmed in population-based studies in which confounding factors have been adjusted for. Endometrial, corpus uteri, and ovarian cancers do not seem to be related to alcohol consumption. Analyses regarding the dose-response relationship, source of alcohol (wine, beer, spirits) and interaction with other risk factors have not revealed any further associations. In conclusion, the current body of evidence, which is inadequate for several sites, suggests no association between alcohol consumption and risk of gynecological cancers.

PMID: 19926999 [PubMed - in process]

Ellen Mahoney, MD PDF Print E-mail
October is Breast Cancer Awareness Month

Ellen Mahoney, MD trained as a surgeon at Stanford University School of Medicine after graduating with her MD degree from there in 1981. By 1986 she had risen to become Chief Resident in Surgery at Stanford, before going on to become a board–certified Fellow of the American College of Surgeons in 1993. In 2000 she moved to Arcata and opened her own practice in breast cancer surgery. She speaks frequently on breast cancer to community groups and serves as medical editor and expert contributor to the website of the Susan Love Foundation, a non–profit organization dedicated to the prevention of breast cancer through innovation, education, research and advocacy.

We asked Dr. Mahoney her opinions on wine consumption and Breast Cancer as a leader in her field, and here are her answers.

Wine is good for you!

The most important risk factors for breast cancer—being female and getting older—are not modifiable. Our literature is replete with papers searching for risk factors that are more under our control. These “modifiable” risk factors are generally weak and uncertain, and largely based on observed associations or self-reported data. These associations primarily serve as clues from the epidemiologists to the basic researchers, i.e. as challenges for the basic researchers to explore and explain. Unfortunately, when they get into the popular press, they are interpreted as causation by the general public and by less sophisticated clinicians. Alcohol use and breast cancer is an observed association still waiting for a mechanism to explain whether and how this can be the case. And the more rigorous the statistical methods used, and therefore the better the data, the weaker this association seems to be.

Associations have to be interpreted creatively and carefully. People who get lots of headaches use more aspirin. Does aspirin use cause headaches? Does the lack of aspirin cause headaches? Can any differences between premenopausal women and postmenopausal women be separated from the effects of age in epidemiologic studies? The mechanism of any association between breast cancer and alcohol has never been explained, though a hormone-based mechanism has been proposed, even though the link between hormones and breast cancer remains controversial. Excessive alcohol use can be linked to neglect of screening and health maintenance and to obesity. Is a slender and athletic drinker at equal risk of breast cancer as an obese alcoholic? Probably not.

One way of find risk factors for developing a disease is to look at the effect of that factor on patients who already have the disease. An Italian study published in the August 2008 issue of the Annals of Epidemiology (Dal Maso et al) showed that obesity, poor diet and smoking history were associated with risk of death in women diagnosed with breast cancer, but other factors such as hormone use, alcohol use, fat intake, and exercise were not risk factors. Another study (Reding et al)published recently also showed that women who regularly consumed a glass of alcohol (3-7 drinks a week) in the 5 years prior to a diagnosis of breast cancer had improved survival. A third recent study, published in the Journal of Clinical Oncology in July 2008 found that regular alcohol use was associated with improved prognosis in breast cancer patients.

But even if regular wine drinking does not worsen the prognosis of breast cancer survivors, it is still theoretically possible that alcohol could be associated with a greater incidence of the disease, and there are older studies which indicate this might be the case. There are problems with methodology with these older studies, though. In most, alcohol use depended entirely on the patients’ memory of their intake in the past and self-reporting on a questionnaire (Viel, Willett, Deandrea, Longnecker). In at least one case, re-analysis of the raw data has led to a reversal of the association (Zhang).

Another hint that this association is weak or indirect in the studies that show a positive relationship between the risk of breast cancer and low to moderate alcohol consumption is the inconsistency in the details of the supposedly significant influence. Some studies say that it is the lifetime consumption that is most important, not recent consumption, and others say the opposite. Results for the age of the patient, type of alcohol used or menopausal status are contradictory from study to study. If the effect of alcohol on breast cancer risk were important, it would likely be consistent, and it isn’t.

Bessaoud and Daures, reporting in the June 2008 issue of Annals of Epidemiology, looked at 437 newly-diagnosed French breast cancer patients matched with 922 residence- and age-matched controls. They found that women who consumed 1.5 drinks a day, or less, had a significantly lower risk of breast cancer than non-drinkers. Specifically, women who consumed a glass of wine a day had about 50% less breast cancer than non-wine drinkers. With more than 2 glasses of wine a day, the rate of breast cancer went up, but did not reach significance. This is a recent paper with fairly good methodology, and it is very reassuring to the wine lover.

There are other papers which show a clear association between heavy drinking and breast cancer, but as the alcohol consumption rises the confounding factors and complexity also increase, including the ability of the liver to clear other substances from the bloodstream. No one would ever argue that heavy drinking of any alcoholic beverage is beneficial. Light to moderate use seems to be associated with either lower risk of breast cancer, or a very slightly increased risk which is not statistically significant.

Basic scientists, trying to figure out the possible associations, have looked at resveratrol, a chemical found naturally in red wine, and found that it may have anticancer effects. This work is early, however, and wine is a complex liquid with many components.

Most women who get breast cancer in the US these days are treated and live out a normal life span, only to die of cardiovascular disease like most American women. There are some compelling associations showing that alcohol use, especially wine, is associated with a lower risk of cardiovascular disease and death. The same 1-2 glasses of wine a day that may lower breast cancer risk also lowers the risk of death from cardiovascular disease, and the evidence for that relationship being causal is stronger than the evidence that wine drinking raises risk.

The net finding of all of this effort is that the better the data, the better the evidence that a glass or two of wine a day is actually good for you. And a happy attitude resulting from a life well-enjoyed is especially good for you. If you decide that a glass of wine taken regularly fits into your life plan, make sure that it is the best wine you can obtain, then sit back and enjoy it thoroughly, hopefully in the company of good friends.

Bon appetit!

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