Can You Drink Alcohol While on Chemotherapy?

Chemotherapy is a challenging experience — it’s physically taxing, mentally draining, and the side effects seem to seep into just about every area of life. From physical changes to mood changes and strains on work and family life, it’s not controversial to say: chemotherapy (and cancer in general) sucks.

It’s plausible, then, that we might reach for a few drinks to relax when the stress of chemo has us feeling down. Unfortunately, that’s likely going to do more harm than good. Besides the fact that alcohol fuels depression and anxiety, cancer and excessive drinking have a somewhat reciprocal relationship. Over the years, more research has been done to show a more definitive link between alcohol as a cause of cancer. That being said, surveys also show that excessive drinking is common for cancer patients, even during chemotherapy.

Information online about the safety of drinking alcohol while on chemotherapy is a bit unclear, making it difficult to make our own informed decisions. That’s where we come in. This article will unpack the science behind the effects of alcohol on chemotherapy and come up with a clear answer. Let’s dive in!

The Relationship Between Alcohol and Cancer

Research has extensively linked alcohol to cancer. Recent changes to the American Cancer Society guidelines recommend avoiding alcohol in order to reduce the risk of developing cancer. While many factors are theorized to cause cancer, drinking alcohol directly leads to an increased risk of developing all different types of cancer.

What types of cancer, exactly? Well … all of them. To learn about specific threats, check out our blogs about alcohol-related risks of developing cancer in the throat, colon, liver, breast, and more.

Underneath Alcohol’s Cancer Risk

Alcohol’s cancer threat stems from the metabolism of ethanol, the main component of alcohol. Ethanol is broken down by our liver into a toxic compound called acetaldehyde (ACH). ACH is classified as a carcinogen, or a substance that can cause cancer. The International Agency for Research on Cancer (IARC) classifies carcinogens into four different categories based on the strength of evidence for their cancer-causing properties: known carcinogens, probable carcinogens, possible carcinogens, and non-classifiable. ACH is a known carcinogen — confirming alcohol’s role in the risk of developing cancer.

Alcohol also disrupts the hormones that promote cell division and growth, depletes essential vitamins and nutrients, and damages the immune system’s innate cancer-fighting power. Drinking during chemo is incredibly common, either in spite of this information or because we aren’t aware of it. To understand the negative effects of drinking while on chemotherapy, let’s first take a look at what chemo is.

Basics of Chemotherapy

Although often described under the umbrella term “chemotherapy” (or “chemo,” for short), this treatment frequently consists of a range of different drugs that attack our cells in different cycles to prevent cancer cells from reproducing. Chemotherapy drugs are cytotoxic, meaning they’re toxic to cells. They are also systemic, which means that they affect all the cells in the body — including healthy ones.

The same property that makes chemo effective at destroying cancer cells makes it dangerous to our healthy cells. This explains why chemo famously causes a reduction in our immune system function, making those of us undergoing chemo treatment immunocompromised. It also comes with a long list of uncomfortable side effects:

• Fatigue 
• Hair loss
• Infection
• Oral pain and sores
• Mood changes
• GI symptoms 
• Anemia
• Nerve issues 

Through the long list of potential side effects, we can see the extensive impact that chemo has on our body. Treatment typically lasts anywhere from six months to a year, but sometimes runs longer. Because cancer can be pesky to treat, chemo is often used in conjunction with other approaches and supporting therapies that help to attack cancer from multiple angles and alleviate chemo side effects. 

We know that chemotherapy and alcohol both have significant impacts on our body. Let’s see what experts suggest regarding drinking during chemo.

Can You Drink Alcohol While on Chemo Treatment?

Every chemotherapy regimen is different, using a different combination of drugs delivered on a strict schedule. Following the schedule of chemo cycles is crucial, as the effectiveness of the treatment depends on having sufficient levels of chemo in our body to fight cancer cells. If there are known interactions between alcohol and our chemo medication, treatment cycles may need to be pushed back.

Research shows that missing doses of chemo is associated with increased mortality — which drinking can certainly play a role in. Even though not all chemo or supporting medications have direct interactions with alcohol, drinking can still open the door to many complications (which we’ll get into).

Since alcohol is so heavily tied to the risk of developing cancer, drinking during and after chemo can also increase the risk of recurrence. Chemo causes extreme strain on our body as evidenced by its sometimes debilitating side effects. Drinking alcohol on top of that adds additional strain, pushing our body even harder and adding to our discomfort.

The Interaction Between Cancer Treatments, Chemo, and Alcohol

Cancer treatment requires an exhaustive approach that combines different methods and treatments. Alcohol can disrupt chemo in many different ways.

Alcohol and Chemo Drug Interactions

Chemo consists of a combination of different drugs to provide the best chance to eliminate cancer, and alcohol has many known interactions with common drugs used during chemo treatment. It also interacts with other medications used to support cancer treatment including pain relievers, anti-nausea medication, and anti-anxiety drugs.

Let’s take a look at how alcohol interacts with some of the most common chemo drugs:

• Gleostine (lomustine). Drinking alcohol with Gleostine, commonly used for metastatic brain cancer, can cause serious GI side effects, including nausea and vomiting.
• Matulane (procarbazine). Mixing alcohol with Matulane causes a range of serious side effects on our central nervous system. Symptoms include dizziness, headaches, drowsiness, or loss of balance.
• Ultram (tramadol). Ultram is an opioid used as a supporting medication to relieve pain. When combined with alcohol, it can seriously slow our heart rate, suppress our blood pressure, and cause confusion. 
• Antiemetics. When mixed with alcohol, some anti-nausea medications can cause severe dizziness, loss of coordination, and drowsiness. On top of that, alcohol is known to cause nausea — just like chemo drugs.
• Anxiolytics. Xanax, Ativan, and other anti-anxiety medications can cause abnormal drowsiness, trouble concentrating, and extremely slowed breathing when combined with alcohol.

It’s best to consult with our oncology treatment team regarding specific interactions within our personalized medication regimen. Alcohol may not have direct interactions with all chemo treatment medications, but it can still cause negative effects. Medication and alcohol are metabolized in our liver — putting it into overdrive. This can lead to severe side effects and reduce the effectiveness of the chemo drugs. 

Other Cancer Treatments 

Much like the link between alcohol and chemotherapy, drinking also causes harmful impacts on non-chemo cancer treatments. The following therapies are impacted by the negative effects of alcohol:

• Radiation therapy. This cancer treatment uses high doses of radiation to kill cancer cells. Drinking further dehydrates our body, making it more difficult to recover after treatment. It also increases the risk of oral pain and sores, which are common with radiation therapy.
• Immunotherapy. This type of cancer treatment boosts our immune system to help eliminate cancer, which alcohol directly works against by dampening our immune system.
• Hormonal therapy. Alcohol disrupts our hormones, which can make hormone therapy ineffective. This type of treatment blocks or alters specific hormones that cancer cells use to grow.
• Targeted therapy. This precision treatment primarily uses drugs that attach to specific cancer cells or genes that help cancer survive. Common examples include crizotinib for lung cancer or lapatinib for breast cancer. These drugs can cause liver issues; drinking adds to an increased risk of damage and disease.

We can see that interactions between cancer treatments, chemotherapy, and alcohol can cause negative symptoms. As it turns out, the timing of our drinking has a lot to do with how alcohol affects our treatment.

Timeline of Alcohol and Chemo Interactions

Chemo is primarily administered in medical settings such as a doctor’s office or outpatient clinic. It’s usually given intravenously, but it can also be in the form of an injection or pill. While drinking is not recommended for cancer patients at any stage (even those in remission), let’s dive deeper into the guidelines for drinking immediately after receiving chemo and after all cycles of treatment are completed.

Alcohol During Chemo

If there are no direct interactions between alcohol and our panel of chemo drugs, drinking immediately after a treatment session may not pose immediate risks or symptoms. However, it’s still not recommended as drinking can further aggravate the side effects of chemo. 

Chemo drugs typically stay in our system for 3-7 days, depending on the drug. If we choose to drink, it’s best to wait until the chemo medication exits our system to minimize any adverse effects. Treatment schedules also vary between patients, so it’s important to keep in mind when our next round will be.

Fitting in a drink while on chemo is a balancing act that only adds to the burden of treatment. If you do decide to drink during your treatment plan, be sure to communicate clearly with the treatment team so they can account for all elements.

Alcohol After Chemo

After all cycles of chemo are completed, drinking is still not recommended. Chemo may help some types of cancer, but, for more advanced cancers, it may only stop the cancer from spreading. This means that the cancer will require ongoing maintenance and therapy to delay progression. 

For patients who are cancer-free after chemo is completed, drinking is still not a good idea. Although the correlation between drinking and increased risk of cancer recurrence is still being studied, alcohol is clearly correlated with an increased risk of cancer.

If we do choose to drink, it’s best to wait until chemo symptoms subside, and thereafter follow recommended guidelines for drinking in moderation. Choosing to drink during and after chemo opens up “Pandora’s box,” leading to a host of potential complications and consequences.

How Much Is Too Much

Cancer and chemo are extremely taxing on our body. Cancer cells attack from inside, and chemo can destroy healthy cells that decrease our immune defenses. During this vulnerable state, even having one standard drink is not recommended. 

If our chemo medication and supporting treatments have direct interactions with alcohol, any amount will cause negative harm to the way the drug works in our system. If our chemo medication doesn’t have direct interactions, we may not see or feel immediate symptoms, but alcohol still stresses out our body when it’s fighting to heal. As such, it’s generally best to avoid alcohol entirely while on chemo.

What Happens If You Drink Alcohol While on Chemo?

Drinking during chemo can lead to direct and indirect effects on our health and our fight against cancer. It can make cancer treatment more demanding on our body given these consequences:

• Decreased effectiveness of treatment. Chemo drugs act on all the cells in our body. Since alcohol also affects all the systems in our body, the two can interact and decrease the effectiveness of cancer treatment.
• Exacerbated side effects. Drinking is commonly accompanied by unpleasant hangover symptoms. This can add to the discomfort of common side effects of chemo.
• Low blood counts. Chemo can often cause low blood cell counts, which lead to risk of infection, anemia, and excessive bleeding. Alcohol also interferes with the production of blood cells, further complicating and postponing chemo treatment.
• Depression and anxiety. Alcohol is a depressant that can further exacerbate poor mental health associated with cancer diagnoses. 
• Increased chance of complications. The toxins in alcohol affect all systems in our body, impacting their efforts to fight cancer cells. Alcohol may affect us in ways that we aren’t able to see directly, or that aren’t immediately apparent. 
• Sleep disturbances. Our body needs rest to have the best chance to beat cancer. Chemo is also taxing on the body, requiring proper rest for recovery. Alcohol causes sleep disturbances that rob us of the restorative rest we need.
• Dangerous medication interactions. As previously mentioned, direct interactions with certain chemo medications and supporting treatments can cause serious side effects that warrant immediate medical attention and can impact our chances of recovery. 

Drinking isn’t recommended in any amounts while on chemo, but hiding our drinking can cause even greater harm. Our treatment team will be better equipped to support us if we communicate honestly about our drinking habits. We can also make more intentional choices to help diminish the chances complicating our treatment. 

Navigating a Healthy Relationship With Alcohol After Chemo

Chemo can be an arduous journey that deserves celebration once completed. We can celebrate the end of chemo and a future of good health by implementing these intentional drinking habits:

• Consult with a doctor. When choosing to drink, it's best to consult with a professional. Your treatment team will be most familiar with your needs and specific treatment regimen. Be honest about your drinking habits and follow recommended guidelines from health professionals.
• Quit or cut back on alcohol. Alcohol is a known carcinogen. Quitting or cutting back on alcohol can only help. Luckily, there are many options for treatment that fit into every lifestyle. Reframe, for instance, offers science-backed support right in your pocket.
• Focus energy elsewhere. Positive distractions such as physical movement, mindfulness practices, and social activities can help our physical and emotional well-being. Connecting with others, trying a new hobby, meditating, and walking are all great ways to channel our energy into more positive habits.
• Reach out for support. Chemo is mentally and physically taxing. Navigating alcohol dependence can also be a challenge. Reaching out to family and friends, exploring online resources such as Reframe, and seeking professional treatment can help the journey feel less daunting. 

The Bottom Line

While guidelines for the safety of drinking during chemo aren’t cut and dry, medical professionals are unlikely to recommend drinking during cancer treatment. Whether or not drinking increases the chance of cancer recurrence is still inconclusive. However, alcohol has a direct correlation with an increased risk of developing cancer.

Not all chemo medications have interactions with alcohol at face value, but many do, and alcohol can interfere with treatment success in the long run. Cancer treatment can be a long and arduous road — alcohol only makes it more difficult. Quitting or cutting back on alcohol helps keep chemo on track!