Should a Person with Liver Cancer Stop Drinking Alcohol?

Consuming alcohol is dangerous when you have liver cancer or cirrhosis.

The risk of dying rises dramatically if you have liver cancer (hepatocellular carcinoma) or cirrhosis and drink alcohol.

Memorial Sloan Kettering medical oncologist Ghassan Abou-Alfa often hears one particular question from people who come to him for treatment of primary liver cancer: Can I keep drinking alcohol? If so, how much?

More than a half-million people around the world get this cancer each year. Also referred to as hepatocellular carcinoma, primary liver cancer can have a variety of causes including alcohol overuse, chronic hepatitis B or C virus infection, morbid obesity with diabetes that causes non-alcoholic fatty liver disease, or a metabolic disease such as hemochromatosis.

Whatever the cause, Dr. Abou-Alfa counsels primary liver cancer patients to steer clear of the bottle.

The Reality: Stiffer than a Drink

Medical oncologist Ghassan Abou-Alfa counsels patients with liver cancer on making smart lifestyle choices.

Ghassan Abou-Alfa

Alcohol can act like a poison to liver cells, killing them on contact, he explains. In the presence of cancerous cells already rapidly dividing, the addition of this toxin causes ever-larger parts of the normally soft, blood-rich organ to die and turn tawny or yellow — a condition known as cirrhosis. Sometimes, it’s the cirrhosis that occurs first, and then cancer follows.  

In time, it becomes increasingly difficult for the liver to perform its many critical tasks. These include producing bile that helps digest fats, storing and releasing energy from food, and clearing harmful substances from the bloodstream.

As the cancer or cirrhosis (or both) worsens, fluid may start to build up in the abdomen and legs. Jaundice (yellowing of the skin and the whites of the eyes) may develop as bile clogs the bile duct — the tube that drains bile from the liver and into the intestines. Bile then builds up in the liver and flows back into the bloodstream. Over time, a person may experience confusion, memory problems, and loss of balance.

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Diminishing Treatment Options

Another risk of consuming alcohol for a person who already has liver cancer, says Dr. Abou-Alfa, is that treatment options dwindle. For example, surgery to remove cancerous liver tissue is off the table if too little of the normally functioning parts of the liver remain.

While some people may be eligible for a liver transplant, doctors usually consider this option only if the amount of cancer in the liver is limited — and the person commits to staying alcohol free. Participation in a clinical trial may not even be a possibility if there’s concern about the liver’s impaired function and ability to process and get rid of drugs being tested.

For people who had cirrhosis before they were diagnosed with liver cancer, continuing to drink can make the cirrhosis even worse. Once advanced cirrhosis sets in, localized therapies such as hepatic artery embolization — designed to block blood flow to the artery that feeds liver cancer cells — may no longer make sense.

The same is true for oral drugs that block key tumor signals and limit the formation of new blood vessels that the cancer relies on to grow. Advanced cirrhosis also can remove the possibility of using immunotherapy drugs, which boosts the body’s natural defenses to fight the cancer.

“Basically, once cirrhosis or liver cancer develops, a person’s risk of dying is much higher if he or she continues to drink,” explains Dr. Abou-Alfa. “But even if a person has one or both of those diagnoses, stopping drinking has a beneficial effect. It’s never too late to stop drinking.”

MSK patients can reach out to the counseling center for help with alcohol addiction. “Most patients with primary liver cancer get help — once they hear what alcohol can do or has already done to their liver,” Dr. Abou-Alfa says.  
Patients at other hospitals should talk to their doctors about additional resources available to them.

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Commenting is disabled for this blog post.

Is the risk the same for triple negative Brest cancer that has metastasized to the liver and is responding to treatment with xeloda?

Dear Eileen, we forwarded your question to Dr. Abou-Alfa and he responded:

“The blog focuses primary on liver cancer with associated liver cirrhosis. The liver functions and condition in the setting you are referring to may vary. I strongly recommend you check with your doctor.”

Thank you for reaching out to us.

Have chronic hep b-what about having food made with wine-as I understand the alcohol is burned off in cooking?

Dear Dorothy we are sorry to hear about your diagnosis. We forwarded your inquiry to Dr. Abou-Alfa, and he responded:

“This should be less of an issue, especially if your liver function is appropriate as it seems.”

We encourage you to discuss any specific concerns with your physician. Thank you for reaching out to us.

I would like to take this opportunity to thank Dr. Abou-Alfa for the extraordinary professional medical care which he continues to provide to me as his patient at MSKCC.
Being under his care gives me great comfort because I know he very closely monitors my medical condition. He is an outstanding and expert doctor- a true leader in liver oncology, and a kind and compassionate gentleman.
He also has a talented and dedicated staff- his nurse Natasha Pinhiero and his office assistant Jaime Ryan.

I just wanted to take this opportunity to thank Dr. Abou-Alfa for being such an extraordinary and expertly talented medical professional. It gives me great comfort knowing that he is closely monitoring my condition. He is a true leader in liver oncology and a compassionate gentleman. I know I could not be in better hands.
I would also like to thank his dedicated staff- nurse Natasha Pinheiro and his office assistant Jaime Ryan. They are always helpful and very responsive to my needs and my concerns.
I am very grateful to the entire team!!

Dear Raymond, we are glad to know you felt well-cared for by Dr. Abou-Alfa and nurse Pinheiro, and that you had a good experience with the rest of our staff. We will forward your kind note to them. Thank you for sharing your experience. Wishing you all our best in the new year!

It probably is true that alcohol is bad for liver cancer, but many doctors impose their personal beliefs into the issue. They also make no distinction between moderate red wine with dinner and straight hard liquor.

Dear Elliot, we forwarded your comment to Dr. Ghassan Abou-Alfa and he responded:

“Thank you for input. I would not argue about the value of moderate red wine and its ingredient resveratrol to the heart. By all means please enjoy and stay healthy. The subject matter discussed in this posting on liver cancer relates to a very particular situation where the liver reserve is so limited so that any form of alcoholic drink may further damage the liver. In a situation like this, the heart-related value of red wine unfortunately takes the back seat. Thus the focus on alcohol as an element regardless of the drink.”

We hope this information is useful. Thank you for your comment.

My sister has breast cancer and this has spread to liver bones and lung. These are small metasteses. Us it OK for her to have a daily glass if red wine?

Dear Linda, we are sorry to hear about your sister’s diagnosis. It’s best if she speaks with her physician, who can offer specific advice and recommendations around what’s appropriate for her. Thank you for reaching out to us.

"Once advanced cirrhosis sets in, localized therapies such as hepatic artery embolization — designed to block blood flow to the artery that feeds liver cancer cells — may no longer make sense." I can infer from this statement my brother did not have advanced cirrhosis when he had the embolization at MSK. Why, when the cancerous liver tumor is continuing to shrink, is his liver function failing?

Dear Kitty, we are sorry to hear about your brother. His oncologist, who is aware of the specific details of his condition, medical history, and treatment, is the most appropriate person to ask about this. We recommend that you discuss your concerns with your brother’s physician at MSK. Thank you for reaching out.

I have had Hep C, for a while now, then I found out, it had turned to Cancer, and has spread to my bile duct. I am on Chemo, but actually, haven't eaten more in my life, which is strange, after I had a stent put in, between the bile duct and liver. I as wondering, how do you know, when your time is getting near, as I fell pretty good. I haven't drunk alcohol for years, ever since I found out I had Hep C

Dear Mitchell, we are sorry to hear about your diagnosis. We cannot tell you exactly when end of life is near or what will happen because people have different symptoms and needs during that time.We recommend you discuss your specific concerns with your physician. You may also find the following patient education materials on our website helpful. This resource will help you understand some of the symptoms people may experience toward the end of life and the options that are available to them:…. We hope this information is useful. Thank you for reaching out to us.

Is wine just as dangerous as is alcohol is

The subject matter discussed in this blog post on liver cancer relates to a very particular situation where the liver reserve is so limited so that any form of alcohol (regardless of the type of drink) may further damage the liver. Thank you for reaching out to us.

I have advanced cirrhosis- some stage 3 symptoms and some stage 4 symptoms. My heptologist told me that every drink was like taking days or weeks off of my limited life span. And that drinking would make it harder to get a transplant... so for most of us with cancer and/or advanced cirrhosis, drinking is just not worth it. The cost is too high.

Thank you for sharing your thoughts, and best wishes to you.

Hello, My father has liver cancer, Hepatitis C, and cirrhosis. He was told to stop drinking but continues to do so. So now he hides his medical information from everyone in the family (no one is on HIPPA). I want to know if it would be helpful to inform his doctor of the drinking? He has chemo beads in and is supposed to be taking a pill that restores his liver. I suspect to continue drinking while being treated could have adverse effects? Your thoughts from a doctor's perspective?

Dear Danielle, it sounds like you are in a very difficult situation. Unfortunately, we are not able to advise you on how to deal with this situation. It may be beneficial for you to speak with a counselor who specializes in working with children of parents who drink. Thank you for your comment, and best wishes to you.

Just had left liver lobe successfully resected due to 10mm HCC mass. 64 years old with no underlying liver disease or Hep B or C; normal liver enzyme tests. Used to drink 1 to 2 glasses of wine with dinner. Do I need to quit or would 1 glass of red wine with dinner be fine. Don't want to increase recurrence rates for HCC. Your thoughts most appreciated.

We recommend you discuss this with your healthcare team. Thank you for your comment, and we’re glad to hear your surgery was successful.

Say an individual with primary liver cancer was invited to a party, evidently an environment in which alcohol is consumed rapidly - and they’ve for whatever reason been pressured to drink along with their peers, ultimately drinking an excessive amount. In a situation such as this one in particular, where the ill individual has drinken such a large quantity, would said person experience any immediate, or generally quick responding symptoms? If so, would any of them be life threatening?

We recommend that you discuss this with your physician. Thank you for your comment.

Hi, your wonderful hospital saved my life, over 24 yrs. ago I had lung cancer, I was under the care of Dr. Dorethy White, she has passed and I miss her a lot. Years ago I was diagnosed with having hep C, I began the treatment with the med they had back then, but it was too painful due to my advanced arthriris, after one tretment I had to stop. My doctor was Dr. Kurtz. My GP said I should try it again, the med now is not as harsh as back then. Can you please advice me on how to proceed, who I should see, where to go? I was to re-try it again, but it didn't work out, I wasn't called from the docs. Thank you in advance..I live in Staten Island.

My husband was told his liver enzymes are high after having a blood test. He was diagnosed with a fatty liver. Should he consume alchohol?

Dear Mary, we’re sorry to hear about your husband’s diagnosis. This is something that he should discuss with his doctor. Thank you for your comment, and best wishes to both of you.

Our great friend was just diagnosed with secondary liver cancer. Should he still consume alcohol?

Dear Anita, we’re sorry to hear about your friend’s diagnosis. We recommend that he discuss this with his healthcare team. Thank you for your comment, and best wishes to you and your friend.

I was diagnosed with HCC in Dec 2017. I was a moderate & social consumer of alcohol. After this diagnosis, I am off the "bottle". I have undergone TARE twice, once in Dec 2017 and second time in July 2018. In Dec 17, the Cancer was in the portal vein and right lobe of my liver. I was on Sorafenib, after TARE from Jan 2018 to end June 2018. I was unable to tolerate doses of more than 400 mg of Sorafenib. I also suffered from side effects such as blisters on the sole of both feet, high blood pressure, loss of appetite etc. Hence my hepatologist stopped this drug. By end Jun 18, the cancer had spread to the left lobe & the portal veins on both left and right, TARE was repeated in mid July 2018. My doctor is now planning alternative drugs such as Regorafenib or Nivolumab after assessment (due 12 weeks after TARE done in July-18). Well, do I have any other options? What about clinical trial etc? , I understand that my life expectancy is limited, with no chance of liver transplant.


Diagnosed with Primary HCC in 2010, liver resection and 5 years of careful follow up-no recurrence and NASH is well controlled. Still monitored every 6 months with annual imaging.
I know I dodged a bullet and I'm grateful. No alcohol since 2009. Wondering if a small glass of wine now and then is possible or if its crazy to consider. (I'm thinking wine for Passover or a toast at a wedding with Champagne, not even monthly-more like a single SMALL drink quarterly...)

We’re glad to hear you’re doing well. We recommend that you discuss this with your doctor. Thank you for your comment, and best wishes to you.

My son hard HCC at age 3 that extended through his IVC and occupied his entire right atrium. Open heart surgery right away then 1 year of systemic chemo along with 4 courses of chemoembolyzation, then a major liver resection with a year of post op chemo. He has many side effects from all the chemo. Currently still HCC free. Has C1Q Nephropathy, Adrenal Insufficiency, Cardiomyopathy and is on several medications. He is now 29 years old. My question is does his body process alcohol normally or does it take a while for it to clear his body? Thank you!

Dear Dorothy, we’re sorry to hear about all your son has been through. We recommend that his discuss with a doctor who is familiar with his full medical history. Thank you for your comment and best wishes to both of you.

In 2011 I was diagnosed and treated with radiation for ocular melanoma, or eye cancer. Such cancers often metastasize to the liver. It has now with me. There is no real curative treatment. I have had an ablation and will be getting some immunotherapy. I am 73 and a social drinker. Is alcohol a significant danger?


Dear John, we’re sorry to hear that your cancer has spread. We recommend that you discuss this with your medical team. Thank you for your comment and best wishes to you.

I have Hep B since childhood. currently 46 yrs old. have been on tenefovir since 2008 and the viral load had been undetectable since been on medication. other tests are normal except that my liver has been fatty. want to know efficacy of tenefovir in preventing liver cancer. and what role does a fatty liver play in increasing the risk of HCC if any. thank you

We recommend that you discuss this with your doctor. You may also want to reach out to the National Cancer Institute’s Cancer Information Service at 800-4CANCER. Thank you for your comment and best wishes to you.