The other night I was watching David Letterman interview Michael Douglas about his diagnosis for throat cancer. During the interview, Michael Douglas admitted he was a drinker and that his cancer was a type caused by alcohol. There is no question that alcohol does increase the risk of various cancers, including throat and esophageal cancers: There are certainly enough reports in the medical and scientific literature saying so. However, whether anyone can categorically state that Michael Douglas’s cancer was due to alcohol alone is doubtful because cancer is a complex disease with many contributing factors. For example, Michael Douglas is also a smoker. Smoking itself is a cancer risk factor and the combination of smoking and alcohol increases the risk even further. What was particularly interesting was when the reporter commented on the level of alcohol consumption required to cause cancer. By the end of the interview the audience may well have thought even moderate drinking would increase their risk of cancer. And it didn’t matter what form the alcohol was in either: Beer, wine, whisky or whatever else. As long as it had alcohol in it, it was a risk. The final part of the story was devoted to speculation on how alcohol may increase the risk of cancer. The chemical acetaldehyde was suggested as the likely culprit. Acetaldehyde is a known carcinogen and is formed from alcohol in the body.
Now if Michael Douglas’s cancer was caused by moderate amounts of alcohol, then the people who watched the interview or who read the news items may well be thinking:
“Wait a minute.”
“I’ve been told for years that a glass or two of red wine was good for my heart.”
“And now you tell me if I drink my risk of cancer goes up!”
“What do I do?”
“Am I better off having the occasional red wine with dinner to reduce my risk of heart disease but increase my risk of cancer?”
“Or am I better off not drinking at all to reduce my risk of cancer and possibly having a heart attack?”
We are not surprised people are confused by the conflicting messages! Conflicting messages relating to diet, health and lifestyle are very common and it is easy to see why. The beneficial effects on the heart of drinking red wine have been enthusiastically endorsed by the wine industry. Hardly surprising: It’s both human nature and is good for business. But the beneficial effects of red wine aren’t just marketing spin. Hints that red wine had beneficial effects came from studies on the “French paradox”. The French have a diet high in saturated fats from butter and cream and yet, paradoxically, have a relatively low incidence of heart disease. As the French are great wine consumers and start at an early age, it was speculated components in the wine they were drinking may be protecting their hearts. Scientists later confirmed there was something in red wine, a substance called resveratrol that may be the active component protecting the heart. These initial reports led to many studies from a variety of reputable and not-so-reputable sources claiming resveratrol was a magic bullet and assigning it almost mythical properties. Whether these claims turn out to be true or not will have to wait for further research.
It is not surprising we are bombarded with conflicting messages. On the one hand, business is keen to use any piece of scientific information to validate or endorse their product. On the other, scientists are increasingly looking at business to provide them with funds to carry out their research. This sort of relationship can be problematic as commercial and financial interests and pressures are potentially tied to the research, even if unwittingly. It creates a potential conflict of interest for everyone involved. So next time you hear someone make a claim for a product or treatment, look closely at who is making that claim and whether there may have a conflict of interest. It is worth noting that some of the major scientific and medical journals have recognized the potential dangers of conflicts of interest and have introduced measures to control it. One of these measures is the requirement to disclose the sources of any funding a scientist may have received for their research.
Progress relies on quality science and quality science relies on research data that is free of any commercial or financial pressures, particularly as it relates to drug development. In a word increasing driven by economics, it is becoming a difficult line to walk.
Until next time, stay happy and healthy.