Thursday, November 26, 2015

Esophageal Cancer Risk and Alcohol Flush Reaction

In this article, we will discuss the link between esophageal cancer and alcohol flush reaction:
  • Alcohol flush reaction
    • is redness or flushing in the face or neck after consuming alcohol.
  • Esophagus cancer[17]
    • Esophagus is the muscular tube that connects the throat and stomach.
    • Cancer can form in the tissues that line the esophagus.

Higher Esophageal Cancer Risk If You Flush Easily

One Japanese study has found that: you're at higher esophageal cancer risk if you flush easily with drinking. The study found that about 1/3 of Japanese, Korean, and Chinese are "aldehyde dehydrogenase" deficient which make them flush easily with drinking and people who flush easily have 6-10 times higher risk of getting esophageal cancer than individuals who don't flush easily.

Alcohol Flush Reaction

Alcohol is metabolized by several enzymes. It is first broken down into acetaldehyde, a harmful substance that is then converted to harmless acetic acid (or vinegar). When high levels of acetaldehyde occur in the blood, the following “hangover” symptoms occur:
  • Facial flushing
  • Light headedness
  • Palpitations
  • Nausea

These symptoms are indicative of a disease known as the Alcohol flush reaction, also known as “Asian Flush” or “Oriental Flushing Syndrome”.[16]

Enzyme and Gene

Aldehyde dehydrogenase (ALDH2) plays a crucial role in maintaining low blood levels of acetaldehyde during alcohol oxidation. Unfortunately, there is a mutant form of aldehyde dehydrogenase, termed ALDH2*2,

A gene is a locus (or region) of DNA that encodes a functional RNA or protein product, Genes can acquire mutations in their sequence, leading to different variants, known as alleles, in the population. These alleles encode slightly different versions of a protein, which cause different phenotype traits.

ALDH2 gene contains instructions for producing aldehyde dehydrogenase. A variant called ALDH2*2 in this gene results in an inactive enzyme. For individuals with the mutant allele:

Esophageal cancer

Esophageal cancer [6] is one of the common malignancies, with an increasing incidence and a high mortality in both developed and developing countries. Esophageal cancer exists in two main forms with distinct etiological and pathological characteristics:
Whereas adenocarcinoma is more prevalent in the USA and some other Western countries, ESCC is the predominant type in the other parts of the world, especially in Asia, accounting for >90% of esophageal cancer worldwide.

How to Lower Your Risk

Most of esophageal cancer patients are over 60 and more common in men. If you're at higher risk, pay attention to the following advice:
  1. Don't eat foods that are burning hot. Wait until it cools down a little bit.[5]
  2. Stop smoking.[4, 9]
    • Cigarette smoking and heavy drinking are the two major causes of esophageal cancer, especially when combined.
  3. If you have Gastroesophageal reflux disease (GERD), treat it immediately. The acid burns the tissue and makes it rough and scarred, which is where the cancer begins to grow.[12]
    • Place a tall book (of the same thickness) underneath both posts of your bed frame on the side of your headboard. This will keep your bed at a slight angle so that the acid will go down instead of up into your esophagus.
    • Avoid red sauces like tomato sauce, garlic, and things with caffeine like peppermint tea or chocolate.
    • Do not wear control top underwear, because it is very tight and squeezes the acid up into your esophagus.
  4. Avoid swallowing lye or other caustic substances.
  5. Avoid dietary substance such as nitrosamine. High temperatures, as in frying, can enhance the formation ofnitrosamines.
  6. Don't overweight.
    • Obesity increases the risk of adenocarcinoma fourfold.
    • When you gain weight, the stomach gets pulled down from the extra weight and the kink that is usually between the esophagus and the stomach gets pulled out. This results in that connective area getting very thick, which can lead to Esophageal Cancer.[12]
  7. Avoid alcohol[19]
    • There is strong evidence that alcohol causes cancer of the liver, colon, rectum, esophagus, larynx, pharynx and female breast.
  8. If you have been infected with the Helicobacter pylori bacterim, treat it immediately.[9]
  9. Reducing radiation exposure to the chest.[9]
  10. Avoid red sauces like tomato sauce, garlic, and things with caffeine like peppermint tea or chocolate.
  11. Take a vitamin E supplement
    • High blood levels of alpha-tocopherol, a form of vitamin E, may lower the risk of developing cancer of the stomach and esophagus, according to new research from China.
  12. NSAIDs
    • Risk appears to be less in patients using aspirin or related drugs (NSAIDs).[2, 6] 
    • However, be warned that aspirin is a blood thinner and overdosing can cause excessive bleeding (see [10] for more side effects). 
  13. Consuming more cruciferous foods
    • According to the National Cancer Institute, diets high in cruciferous (cabbage, broccoli[11], cauliflower) and green and yellow vegetables and fruits are associated with a decreased risk of esophageal cancer[2] 
  14. Moderate coffee consumption
    • Moderate coffee consumption is associated with a decreased risk too.[2, 7] 
  15. Zinc
    • Zinc can protect us against esophageal cancer.[3, 8]


  1. 日本研究发现:喝酒易脸红易罹食道癌
  3. "Younger you" by Eric R. Braverman, M.D.
  4. Factors associated with carcinoma of the oesophagus at Mulago Hospital, Uganda.
  5. An Epidemiological Study of Precursor Lesions of Esophageal Cancer among Young Persons in a High-Risk Population in Huixian, China
  6. Expression of macrophage migration inhibitory factor in esophageal squamous cell carcinoma and effects of bile acids and NSAIDs
  7. Coffee and tea intake and risk of oral, pharyngeal and esophageal cancer
  8. Zinc Deficiency Linked to Increased Risk of Less-Common Form of Esophageal Cancer
  9. American Medical Association Complete Guide to Prevention and Wellness
  10. Pros and Cons of Aspirin
  11. Boosting Broccoli's Anti-Cancer Effect
  12. Dr Oz: What Causes Heartburn?
  13. ERCC1 Levels Strongly Associated with Survival in Esophageal Cancer
  14. Digestive System
  15. Red face after drinking suggests high blood pressure
  16. Thomasson HR, Edenberg HJ, Crabb DW; et al. (April 1991). "Alcohol and aldehyde dehydrogenase genotypes and alcoholism in Chinese men". American Journal of Human Genetics 48 (4): 677–81.
  17. The top 10 deadliest cancers -- and why there is no cure
    • 1. Lung Cancer 2. Colon Cancer 3. Breast Cancer 4. Pancreatic Cancer 5. Prostate 6. Leukemia 7. Non-Hodgkin lymphoma 8. Liver Cancer 9. Ovarian Cancer 10. Esophageal cancer
  18. Spitting up in babies: What's normal, what's not
    • Normally, a muscle (lower esophageal sphincter) between the esophagus and the stomach keeps stomach contents where they belong. Until this muscle has time to mature, spitting up might be an issue — especially if your baby is relatively full.
  19. Alcohol's cancer risks outweigh any health benefits, study shows

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