Drugs Of Abuse And Cancer

Alcohol. Animal data do not show that administering ALCOHOL alone causes cancer although there is sufficient evidence for the carcinogenicity of acetaldehyde (the major metabolite of alcohol). When alcohol was administered to animals who were also exposed to known carcinogens, the animals who were given the alcohol had a higher rate of tumors of pituitary and adrenal glands, pancreatic islet cells, esophagus, and lungs. They also had higher levels of liver-cell (hepatocellular) carcinomas, liver angiosarcomas, and neoplastic nodules of the liver, as well as benign tumors of the nasal cavity and trachea.

Cancers of the Digestive Tract. Epidemiological studies in humans have shown a causal relationship between alcohol consumption and cancer of the digestive tract, primarily cancer of the oral cavity, the pharynx (nasopharynx excluded), and the larynx—all two to five times more likely in alcoholics; the esophagus—two to four times more likely; and the liver—liver cancer was increased 50 percent, with primary liver cancer increasing twofold to threefold. These findings persisted, even after adjusting for the effects of smoking, with the relative risk for cancer increasing with the amount of alcohol consumed.

There may be a possible causal link between alcohol, especially beer, and cancer of the large bowel. The risk for colon cancer was increased between 15 percent and threefold depending on the study; that for rectal cancer was increased up to twofold. Unfortunately, these studies did not control for differences in diet.

The mechanism of carcinogenic action appears to be that alcohol acts as a local irritant to the upper gastrointestinal tract, whereas chronic excessive drinking affects the liver, because of the accumulation of the alcohol metabolite acetaldehyde. Breast Cancer. A strong association exists between alcohol and breast cancer, and there appears to be a dose-response relationship with an apparent relative risk of 1.5 to 2. This relationship holds even after controlling for a number of other factors known to affect breast cancer. As the full etiology (cause) of breast cancer is not yet known, an as-yet-unrecognized factor may account for some of these findings. Overall, it has been estimated that as many as 10 percent of all cancer deaths are due to alcohol.

Tobacco and Illicit Drugs. The role of TOBACCO as a carcinogen is well established and is discussed elsewhere. The role of other drugs as a cause of cancer is still unclear. Some drugs may have a role in cancer development because of mode of administration or degree of carcinogenicity. In vitro studies have shown mutagenic properties in a number of drugs—LYSERGIC ACID DIETHYLAMIDE (LSD), Opium and its derivatives such as MORPHINE, synthetic narcotics such as METHADONE, and some compounds found in MARIJUANA. There have been clinical reports of cancers in the respiratory tract, primarily the lungs, in heavy marijuana users, of the nasal passages in cocaine users, and in a number of organs in LSD users. Higher rates of esophageal cancer have been reported in opium smokers.

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