Dr. Parsons is professor of urology, division of urologic oncology, department of urology, Moores UCSD Comprehensive Cancer Center, La Jolla, CA.
Patients have become voracious consumers of the medical literature. Each week, a flurry of new urology studies surface in the popular media to feed public interest. Many of the high-profile articles focus on prostate disease and lifestyle factors. Popular topics include associations of prostate cancer and BPH with diet, exercise, vitamins, and supplements. Many present contradictory results; all have the potential to provoke anxiety and/or confusion among our patients.
A recurring topic is alcohol. Excessive alcohol consumption is, of course, unhealthy and should be discouraged. But what about moderate alcohol intake, such as a glass of red wine each day? Is moderate alcohol intake beneficial or harmful to the prostate, or neither?
Numerous observational studies have addressed this question with respect to prostate cancer, BPH, and lower urinary tract symptoms (LUTS). Here are some take-aways (summarized in the table).
For prostate cancer, the answer appears to be: neither.
A large number of studies and several meta-analyses have failed to turn up any consistent patterns of moderate alcohol consumption with prostate cancer risk. While some studies have observed dose-dependent, modestly increased risks of incident disease (BMC Cancer 2016; 16:845; Int J Cancer 2014; 134:971-8), others have not (Cancer Epidemiol Biomarkers Prev 2008; 17:1282-7). Still others have arrived at mixed results. For example, a meta-analysis of 17 observational studies (611,169 participants) concluded that, while there were no overall associations between wine intake with prostate cancer, moderate white wine consumption increased while red wine decreased incident cancer risk (Clinical Epidemiology 2018; 10:431-44).
Keeping with the theme of red wine, patients may ask about resveratrol, a polyphenolic, antioxidant compound found in red wine and grape skin. Despite some pre-clinical in vitroand animal studies suggesting antineoplastic activity, there are no conclusive clinical data to demonstrate resveratrol prevents or protects against prostate cancer.