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Alcohol and Tamoxifen: 8 Facts To Know

Medically reviewed by Jazmin N. McSwain, PharmD, BCPS
Written by Maureen McNulty
Posted on August 15, 2023

Can your drinking habits affect your cancer treatment? Many members of MyBCTeam have wondered about this. “Has anyone been told not to drink alcohol while taking tamoxifen?” asked one member.

Tamoxifen (Soltamox) is a hormonal therapy used to treat cases of breast cancer that are hormone receptor-positive. Here are some things to know about mixing alcohol with this medication.

1. Alcohol Might Make Tamoxifen Less Effective

Hormone receptor-positive breast cancer cells use hormones like estrogen to grow. Tamoxifen prevents estrogen from interacting with cancer cells, which slows or stops tumor growth and reduces the chances that your breast cancer will recur (come back).

Alcohol may get in the way of tamoxifen’s effect. One study found that when alcohol was present, tamoxifen didn’t work as well to prevent cancer cell growth. Other research has found that alcohol can increase the body’s levels of estrogen, which may help fuel cancer cells.

The effect of alcohol on tamoxifen isn’t well studied in people with breast cancer, although one clinical study found that alcohol didn’t lead to worse outcomes for participants with breast cancer who used hormonal therapy. Overall, more research is needed to clarify whether alcohol interferes with tamoxifen’s effectiveness and, if so, how much it may affect prognosis.

Some health experts, but not all, recommend not mixing tamoxifen and alcohol. MyBCTeam members have also reported getting conflicting information from their health care teams. “My breast surgeon told me to stop drinking, but my oncologist told me I could drink in moderation and to ‘go live my life,’” wrote one member.

If you like to occasionally drink while on tamoxifen, talk to your health care team about whether it’s safe. Your doctor understands your personal health history and can provide personalized advice that cuts through the confusion.

2. Alcohol Could Worsen Tamoxifen Side Effects

Tamoxifen and heavy alcohol use share some side effects, such as insomnia, hot flashes, digestive problems, headaches, and memory problems. This may mean that these side effects get worse when both substances are in your body at the same time.

“Every time I have a drink since I started tamoxifen, I get hot flashes and have trouble sleeping,” reported a MyBCTeam member.

“Here’s a thought,” posted another member. “Why would anyone want to drink and feel worse [than they already do]?”

Read more about potential side effects of hormone therapy for breast cancer.

3. It’s Risky To Stop Taking Tamoxifen or Skip Doses

People who don’t take their tamoxifen or miss doses have an increased risk of having their breast cancer recur and are more likely to have a poor prognosis (outlook).

Make sure to follow the treatment plan that your health care team has laid out. Don’t avoid tamoxifen on days you’d like to have a drink. If you’re finding it hard to stick to your medication schedule, talk to your doctor before making any changes.

4. It’s Not Clear Whether Alcohol Raises the Risk of Relapse

Many studies have established that the more you drink, the higher your risk of breast cancer. However, it’s not entirely clear whether drinking after being diagnosed affects recurrence.

Studies looking into this issue are limited and show inconsistent results. For example, one study found that people who had just three or four drinks per week were more likely to relapse and die from their cancer — but this was true only for those who had already gone through menopause and had a higher body weight.

However, other researchers found that how much alcohol people drank after a breast cancer diagnosis didn’t affect survival rates. Again, more research is needed to better understand the relationship between alcohol and breast cancer relapse.

5. Quality of Life Is Important Too

If you’ve been an occasional or regular drinker, it may not be realistic to try to stop drinking altogether.

Many members of MyBCTeam have discussed their attitudes toward alcohol consumption and their health, such as in this post: “Honestly, after not wanting to drink for five months during chemo, I was so happy to be able to enjoy a nice drink. Moderation is what I try to stick to. Life is too short — I have to enjoy the NOW, within reason.”

“I SO agree with the philosophy of enjoying yourself. I’m not going to deprive myself,” one member replied. “If the cancer comes back, it comes back. Life is such a crapshoot!”

Another member shared this philosophy: “I was health-conscious before all of this and still got cancer. I’m just going to exercise daily, eat well, and enjoy a glass of wine when out to dinner. Treating myself with kindness and enjoying life are what I focus on now.”

This comment by a member summed it up well: “There is absolutely something to be said for quality of life.”

6. Limiting Alcohol Is Better Than Drinking Heavily

Although some questions surrounding alcohol use after a breast cancer diagnosis remain unanswered, it’s clear that it’s not a good idea to drink too much.

In general, health experts suggest a moderate alcohol intake, unless your doctor recommends otherwise. According to the Centers for Disease Control and Prevention (CDC), women should have no more than one drink per day, and men shouldn’t have more than two drinks daily. One alcoholic drink consists of:

  • 12 ounces of beer that contains 5 percent alcohol
  • 8 ounces of malt liquor or beer containing 7 percent alcohol
  • 5 ounces of wine
  • 1.5 ounces of distilled spirits or liquor such as vodka, whiskey, or gin

Regularly consuming high amounts of alcohol can raise your risk of developing other types of cancer, including cancers of the liver, colon, mouth, and throat. It also increases your chances of developing other chronic (ongoing) health conditions like heart disease, stroke, liver disease, depression, and anxiety.

Drinking in moderation or not at all can help protect your health, especially during cancer treatment. Ask your health care provider for recommendations regarding how much alcohol is likely safe for you. Some members described having this conversation with their doctors. “My oncologist suggested not [having] more than three drinks per week in general, regardless of cancer,” reported one person.

As always, individual health conditions vary, and your doctor may have different recommendations based on their knowledge of your overall health.

7. It’s Easier Than Ever To Cut Back on Drinking

If you’d like to limit or stop drinking during your breast cancer treatment, you have options.

The healthiest thing to drink is water. If you’re bored with regular tap water, try flavored sparkling water or flavoring packets that you can mix into water.

Bars are also increasingly offering mocktails — cocktails without the alcohol. Served in a nice glass and with a fancy garnish, a mocktail can feel like a treat. You can make your own at home by mixing and matching ingredients such as:

  • Sparkling water
  • Soda
  • Coconut water
  • Simple syrup
  • Fruit juice
  • Apple cider
  • Fresh fruit
  • Fresh herbs
  • Edible flowers
  • Nonalcoholic liquor

More companies than ever are making alcohol-free drinks that taste like the spiked versions. You may be able to find alcohol-free wine and beer locally or buy them online and have them shipped to you.

8. You Should Talk to Your Doctor if It’s Hard To Reduce Drinking

Many people drink more than the recommended alcohol limits and find it hard to cut back. However, drinking a lot doesn’t automatically suggest alcoholism. For many people, drinking less is a matter of breaking old habits and creating new ones.

If you find it hard to stop or limit your alcohol use on your own, your health care team can offer extra help and support. You may want to bring up your drinking habits to your doctor if you have signs of alcohol use disorder, which may include:

  • Not being able to cut down on how much you drink even if you want to
  • Craving alcohol
  • Spending a lot of time drinking or hungover
  • Continuing to drink even though it causes problems at work, at school, in your relationships, or with your health
  • Engaging in unsafe behaviors while drinking, including driving after drinking
  • Experiencing symptoms of withdrawal, such as sweating, rapid heartbeat, and anxiety, when you try to stop or cut back on drinking

Various types of counseling and rehab programs can help you quit or limit drinking. For example, a therapist may be able to help you learn new techniques for changing your behavior and deal with problems caused by drinking. Some types of medications may also help you drink less. Your doctor can help you figure out the approach that will work best for you.

Connecting With Your Team

MyBCTeam is the social network for people with breast cancer and their loved ones. On MyBCTeam, more than 64,000 members come together to ask questions, give advice, and share their stories with others who understand life with breast cancer.

Have you changed your drinking habits while taking tamoxifen? Do you have a favorite nonalcoholic drink that others might want to try? Share your experiences in the comments below, or start a conversation by posting on your Activities page.

    Posted on August 15, 2023
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    Jazmin N. McSwain, PharmD, BCPS completed pharmacy school at the University of South Florida College of Pharmacy and residency training at Bay Pines Veterans Affairs. Learn more about her here.
    Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here.

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