I saw this article in a couple of places before it dawned on me what
the implication is:
Red Face May Signal Cancer Risk
By NICHOLAS BAKALAR
Published: March 20, 2009
The flushing response, which may be accompanied by nausea and a rapid
heartbeat, is caused mainly by an inherited deficiency in an enzyme
called ALDH2, a trait shared by more than a third of people of East
Asian ancestry — Japanese, Chinese or Koreans. As little as half a
bottle of beer can trigger the reaction…
The article is base on a study published in PLOS Medicine: The
Alcohol Flushing Response: An Unrecognized Risk Factor for Esophageal
Cancer from Alcohol Consumption.
The alcohol in beverages is ethanol: two linked carbon atoms with an
hydroxyl group on the end, and all the remaining bonds linking to
hydrogen atoms. The first step in breaking down the alcohol is to
convert it to acetaldehyde, which is toxic. This is done by an
enzyme, alcohol dehydrogenase. Most people quickly convert the
acetaldehyde into acetic acid, using the enzyme, acetaldehyde
dehydrogenase. (ALDH2 is one type of acetaldehyde dehydrogenase.)
Acetic acid is the acid in vinegar. It is not toxic, at least in
modest quantities such as would be seen after drinking ethanol.
If the second conversion takes place slowly, then the toxic
acetaldehyde hangs around, causing problems.
The point they make in the article, is that this accumulation of
acetaldehyde increases the risk for cancer. So, people who are
genetically deficient in acetaldehyde dehydrogenase need to avoid
alcohol, in order to avoid increasing their risk for cancer.
The thing is, Antabuse
acetaldehyde dehydrogenase. I know this sounds strange, but there
are people out there who take Antabuse, but still drink alcohol.
They simply learn how much they can get away with. Based upon the
study, it would appear that they are increasing their risk for cancer
when they do this.
Note that the study does not directly prove that there is such a risk
Antabuse; it merely gives a strong theoretical reason to believe that
the risk exists.
Now, this may not matter in the long run. Presumably, they would
not be prescribed Antabuse unless the risk from their alcoholism is
life-threatening. Antabuse already is known to be risky.
Thus, the risk of cancer might not change the outcome of the
risk-benefit equation. That is, even with this newly-recognized
risk, it is likely that the benefits still would outweigh the risks.
However, when the risks and benefits are being compared, it would be
good to include this risk in the overall balance.