My husband with cancer, has quit alcohol. Why is he so low?

Question

Hello doctor,

My husband is 56 years old and was diagnosed with stage 4 lung cancer four months ago, with metastasis to the liver and adrenal glands. He is currently on Pembrolizumab, and we are three cycles in.

Ever since the diagnosis, he has been drinking heavily, sometimes half a bottle of rum in a single evening, which he never did before to this extent.

His oncologist has already raised concerns that the alcohol may be interfering with his immunotherapy and worsening his liver numbers; his ALT came back at 134 U/L last week.

He agreed to try to quit drinking last week and has not had alcohol for nine days now, but he is emotionally very, very low, barely speaking, staring at the walls for hours, and not eating well.

The palliative care team visits once a week, but he refuses to talk to the counselor.

Can quitting drinking while facing terminal cancer help a 56-year-old patient emotionally, because I honestly do not know if this sudden withdrawal, plus the grief of his diagnosis, is making things worse for his mental state?
Is there medication that can help him through alcohol withdrawal safely while he is already on cancer treatment?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have read your query.

I understand how difficult this situation is, and it is good that you are looking for ways to support him. Let me explain this clearly and practically.

Depression is quite common in people dealing with serious or terminal illnesses, but it can be managed effectively. Medications like Sertraline or Escitalopram (both are SSRIs, selective serotonin reuptake inhibitors, which help balance mood-related brain chemicals) are usually preferred because they are safe and have minimal interaction with chemotherapy drugs.

If he is also experiencing pain, Duloxetine (a serotonin-norepinephrine reuptake inhibitor that helps with both mood and nerve-related pain) can be a good option.

Alongside this, alcohol dependence needs careful handling. Lorazepam (a benzodiazepine that helps calm the brain and prevents alcohol withdrawal symptoms like anxiety, tremors, or agitation) can be used, especially since it is relatively safe for the liver. A dose of 2 to 4 mg at bedtime, or in divided doses, is usually enough to prevent withdrawal symptoms.

To further reduce alcohol cravings, Baclofen SR 20 to 30 mg (a muscle relaxant that also acts on brain pathways to reduce the urge to drink) can be given at bedtime.

Emotional support is equally important. If he has not yet started, counselling or psychotherapy (structured sessions with a trained professional to help process emotions and cope better) can make a meaningful difference. In addition, support group therapy (interacting with others going through similar illnesses) often helps patients feel less alone and more understood.

Finally, your role is extremely important. Your presence, patience, and reassurance matter more than any medication. Spending time with him, encouraging small routines like short walks if he is able, and even simple gestures like holding his hand can provide a deep sense of comfort and security.

All of these should ideally be done under the guidance of his treating doctor, so that treatment can be adjusted based on his overall condition and ongoing therapies.

I hope this answers your query.

Please let me know if I can assist you further.

Thank you.