Some people’s faces flush after drinking. In fact, at least one third of East Asians (Japanese, Chinese and Koreans) develop was has been coined “Asian flush” or “Asian glow” because of their tendency to develop facial flushing after consuming just a few alcoholic drinks.
The reason is due to a genetic enzyme deficiency that affects their ability to break down the alcohol they consume. What is not well known is that those individuals who lack this needed enzyme are also at increased risk for esophageal cancer, one of the deadliest forms of cancer worldwide.
Alcohol is broken down by the body into acetaldehyde which is normally metabolized by an enzyme called aldehyde dehydrogenase 2 (ALDH2). Asian drinkers who are missing this enzyme are unable to break down acetaldehyde, which is toxic to the body and accumulates causing facial flushing. Facial flushing can be accompanied by nausea, dizziness, headache and increased heart rate.
Esophageal cancer is more common in other parts of the world than the U.S. but because it is hard to detect, often goes unnoticed until it is too late. Esophageal cancer found early can be removed by an endoscopy procedure. However, if the cancer grows into the deeper tissue and spreads to the lymph nodes then “only about 20% of esophageal cancer patients survive three years after diagnosis” according to a Public Library of Science(PLoS) research article.
Many Asians and health professionals are aware that some people experience this flushing response to alcohol but most are not aware that those individuals are at greater risk of developing esophageal cancer.
It is suggested that physicians ask their Asian patients two screening questions when they perform yearly physicals.
1. Do you have a tendency to develop flushing immediately after drinking a glass of beer?
2. Did you have a tendency to develop flushing after drinking a glass of beer the first year or two after you started drinking?
The second question is important because some people have built up a tolerance to the facial flushing effect. A ‘yes’ to either question indicates a strong likelihood, as high as a 90% accuracy, of being ALDH2 deficient. In those who are too young to drink, an alcohol patch test placed on the skin will show a skin reaction that indicates they do not possess the genetic ability to break down alcohol.
Researchers want increased warnings made to physicians so that those at risk are alerted to not consume excessive amounts of alcohol and should possibly have an endoscopic evaluation. It is estimated that if Japanese men who were heavy drinkers were to reduce their consumption and become light drinkers then their incidence of esophageal cancer could be reduced by 53%.
It is important to note that non drinkers who have this deficiency are not at increased risk of developing esophageal cancer.
Brooks PJ, Enoch M-A, Goldman D, Li T-K, Yokoyama A (2009) The Alcohol Flushing Response: An Unrecognized Risk Factor for Esophageal Cancer from Alcohol Consumption. PLoS Med 6(3): accessed at www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000050
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele can be read at www.helium.com/users/487540/show_articles