Dear Dr. Roach • I’d like to know what kind of damage to look out for after being a heavy drinker between the ages of 19 and 40, at which age the drinking slowed to a comparative trickle. I used to have many binge events plus regular consumption three to four nights a week and now have a couple of glasses on weekends. The data on alcohol-related cancers seems to be everywhere. I’m concerned there’s little I can do to stop the inevitable. — S.
Answer • Deaths in the United States attributed to excess alcohol are estimated to be nearly 100,000 per year. Many are due to motor vehicle accidents or other accidental deaths, but long-term alcohol use does increase the risk for some types of heart disease, liver disease and cancers.
Looking at cancer in particular, women should be concerned about breast cancer, while both men and women should be concerned about cancers of the head and neck, as well as GI cancers (esophagus, stomach, pancreas, liver and colon). Once excess alcohol intake has ceased, the ongoing risk begins to decrease. Liver cancer, for example, is extremely rare unless cirrhosis is present, and the progression of liver disease to cirrhosis is greatly slowed or halted by stopping excess alcohol.
There are good screening programs for breast and colon cancer, and you should be meticulous in following those guidelines. I would advise you to choose the most aggressive screening guidelines when there is disagreement among experts. Regular dental visits will help identify any oral cavity cancers early. Stomach and pancreas cancers do not have well-validated screening programs, unfortunately.
