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Can Substance Abuse Lead to a Cancer Diagnosis?

Substance use and abuse poses many health risks, one of which is an increased risk of cancer. Chronic tobacco, alcohol, and marijuana use exposes users to an increased risk of receiving a cancer diagnosis. Likewise, illicit drugs are unregulated and often contain cancer-causing chemicals.

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Tobacco & Cancer

Tobacco use refers to cigarettes, cigars, pipes, and smokeless tobacco products. All tobacco products contain harmful chemicals. 

Thousands of chemicals are found in tobacco smoke, including at least 70 that are known carcinogens, or chemicals that cause cancer. These chemicals are produced from the combination of burning tobacco and the additives that are found in most tobacco products. 

Studies have found that individuals struggling with substance abuse are less likely to comply with treatment protocols.

A sample of carcinogens found in tobacco products includes the following:

  • Hydrogen cyanide
  • Formaldehyde 
  • Lead 
  • Arsenic 
  • Ammonia 
  • Radioactive elements 
  • Carbon monoxide 

There is no safe type of tobacco use, asserts the American Cancer Society. Approximately one in five deaths in the United States is caused by smoking. 

Even natural or herbal cigarettes, which are often marketed as safer, contain significant health risks. Herbal cigarettes without tobacco, though they are still considered a tobacco product, emit tar, particulates, and carbon monoxide that are highly toxic and linked to cancer. 

Nicotine & Cancer

Nicotine is the chemical found in tobacco products that makes them so addictive. The cancer-causing nature of tobacco products has been well established, but the carcinogenic effects of nicotine are less clear. 

It is generally accepted that nicotine alone does not cause cancer. In fact, nicotine replacement therapy is a form of treatment for tobacco use disorder prescribed by doctors. 

Nicotine does, however, play an important role in cancer caused by the use of tobacco products. In addition to its addictiveness, studies have found that nicotine can affect cancer by enhancing the growth of negative cells. It can also decrease some of the body’s natural ability to fight cancer as well as reduce the effectiveness of cancer treatments. 

More information is needed on the link between nicotine and cancer. In small doses, nicotine appears to be relatively harmless, while larger doses taken over time can be poisonous to cells in the body. As nicotine replacement therapy can be used for years, researchers are striving to gain a better understanding of the carcinogenic effects of nicotine.  

Alcohol & Cancer

Chronic long-term consumption of alcohol has been linked to an increased risk of developing many types of cancer. The more a person regularly drinks, the higher their risk of getting cancer. Even light drinking, defined as up to one drink per day, can modestly increase the risk of cancer. 

Heavy drinking, defined in women as four or more drinks per day or eight or more per week, and in men as five or more per day and 15 or more per week, is associated with a much greater risk of alcohol-related cancer. 

According to the National Cancer Institute, cancers associated with alcohol consumption include the following:

  • Head and neck cancer
  • Esophageal cancer
  • Liver cancer 
  • Breast cancer 
  • Colorectal cancer 

A 2013 study found that approximately 3.5 percent of all cancer deaths were related to alcohol consumption. Women who developed alcohol-related cancer primarily died from breast cancer. Among men, upper airway and esophageal cancer associated with alcohol use were the leading cause of cancer deaths. 

Up to 35 percent of the alcohol-related cancer deaths were in people who had consumed less than a drink and a half per day of alcohol.  

Tobacco and alcohol consumption are among the top risk factors for developing cancer

The World Health Organization

The risk of certain cancers, such as head and neck, increase substantially when alcohol and tobacco use are both present. Abstaining from such substances, in conjunction with maintaining a healthy lifestyle and minimizing exposure to harmful substances and pollution, can greatly reduce the risk of cancer. 

Marijuana & Cancer Risk

Research studies are beginning to recognize a link between marijuana use and an increased risk of cancer. Similar to tobacco smoke, marijuana contains harmful chemicals and tar that are inhaled into the lungs. Individuals who regularly smoke marijuana report more respiratory problems, lung infections, and reduced immune function than people who do not smoke.  

Marijuana contains many carcinogenic chemicals, some in even greater concentration than cigarette smoke. Carcinogens found in marijuana smoke include the following:

  • Benzopyrene (50 percent more than in cigarettes)
  • Benzanthracene (75 percent more than in cigarettes)
  • Phenol, vinyl chloride, and nitrosamine

Several small, uncontrolled studies have identified a clear link between regular marijuana smoking and an increased risk for respiratory cancer. Larger, controlled population studies are needed to confirm such findings. 

In addition to an increased risk of lung cancer, some studies have found a connection between marijuana use by teenagers and an increased risk of testicular cancer. Young adult males who regularly consume marijuana are at risk for an early onset of such cancers after just a few years of marijuana use. 

Cancer & Anabolic Steroid Use

Anabolic steroids are a type of performance-enhancing drug used primarily by males striving to build muscle mass and improve their athletic performance. Women also use such steroids, though not as commonly. 

Regular use of anabolic steroids poses many health risks, including heart attack and stroke, liver tumor, kidney failure, depression, and substance use disorder. 

In addition to the above conditions, anabolic steroids impact the hormone system. They disrupt the normal production of hormones and can increase the risk of testicular cancer in men. When used in combination with insulin-like growth factors, the risk of testicular cancer is even greater. 

Many side effects of anabolic steroid use can be reversed once steroid use is stopped. Other side effects, such as cancer, may be semi-permanent or never fully treated. 

Illicit Drug Use & Cancer Risk

Illicit drug use exposes individuals to an unknown amount of highly dangerous chemicals. As unregulated substances, illicit drugs, such as heroin, cocaine, morphine, and illegal marijuana, are often laced with a myriad of chemicals. Risk of cancer increases even more when illicit drugs are taken in combination with alcohol and tobacco. 

Researchers have identified links between substance abuse and a variety of cancers. Cancers linked to substance abuse include the following: 

  • Breast cancer
  • Prostate cancer
  • Cervical cancer 
  • Oral cancer
  • Liver and colon cancer

Additionally, intravenous drugs users put themselves at greater risk for developing cancer due to infections that can occur. Chronic infections increase the risk of cancer, explains WHO. In 2018, approximately 13 percent of cancer diagnoses were related to a carcinogenic infection. 

Hepatitis B and C viruses have been linked to an increased risk of liver and cervical cancer. An HIV infection increases the risk of cervical cancer by six. 

How a Cancer Diagnosis Can Impact Substance Abuse

Individuals with a substance use disorder can develop cancer, just as patients with cancer can develop a substance use disorder. 

Pain, one of the most common symptoms in cancer patients, is often treated with opioid pain relievers. As opioids are highly addictive, even when consumed as directed by a doctor, cancer patients can become at risk for opioid dependence and a subsequent opioid use disorder. 

As the risk of cancer increases with substance abuse, individuals may also receive a cancer diagnosis secondary to a pre-existing substance use disorder. People in this population can have a particularly challenging time accessing and adhering to treatment recommendations. 

Studies have found that individuals struggling with substance abuse are less likely to comply with treatment protocols. As a result, their cancer prognosis is lowered, and the success of treatment and quality of life for such individuals are reduced. 

For individuals with cancer, the role of and potential for substance abuse must be considered. Receiving a cancer diagnosis is a life-changing event that can be psychologically challenging to deal with. Without the proper support in place, one may be tempted to turn to substance use to cope with the psychological stress caused by receiving a cancer diagnosis. 

Updated April 23, 2023
Resources
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  10. Steroids and Other Appears and Performance Enhancing Drugs (APEDs) Research Report: Introduction. (February 2018). National Institute on Drug Abuse.
  11. What Are Marijuana’s Effects on Lung Health? (July 2020). National Institute on Drug Abuse.
  12. What Are Marijuana’s Effects on Other Aspects of Physical Health? (July 2020). National Institute on Drug Abuse.
  13. What Are the Side Effects of Anabolic Steroid Use? (February 2018). National Institute on Drug Abuse.
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