Dr. Vivek Murthy has been U.S. Surgeon General twice, for two presidents, but I have gotten to know him best in his second term, where I have had the privilege of interviewing him multiple times, coordinated with each of his advisories, and I have learned firsthand about the relationship of these advisories to real world trends and health crises. From anxious teens to anxious parents, to the loneliness epidemic, to excess violence, to the negative impact of social media, Murthy has had an important impact on public perception.
In his new advisory, just released this week, Murthy warns about the relationship between alcohol and several types of cancer, mainly involving the gastrointestinal tract and the breast.
This is particularly important because earlier generations have been led to believe that some alcohol may actually be good for you, at least in small amounts. But Murthy points out that alcohol is, in fact, the third leading preventable cause of cancer, behind tobacco and obesity. "Alcohol is a well-established, preventable cause of cancer responsible for about 100,000 cases of cancer and 20,000 cancer deaths annually in the United States," he said in the advisory on Friday.
ALCOHOL LINKED TO CANCER RISK IN US SURGEON GENERAL'S NEW ADVISORY
As usual, in addition to pointing out a health problem, Murthy also analyzes not just the causes but puts forth helpful suggestions for what to do about it. In terms of causes, as Murthy points out, alcohol leads to more estrogen, which increases the risk of breast cancer.
Alcohol is metabolized in the body into aldehyde, which can damage DNA, impairing its repair mechanisms and leading to cancer. Alcohol also induces "oxidative stress," which can also damage DNA and cause inflammation, and inflammation is associated with cancer. Like tobacco, alcohol is a Group One carcinogen.
In terms of what we can do about it, Murthy asks us, doctors and health professionals like myself, to help increase awareness of the problem while at the same time having the government reassess guideline limits for consumption. Less is more when it comes to alcohol.
Murthy points out that the majority of Americans are unaware of this risk, especially problematic when you consider that the pandemic saw at least 25 percent of Americans increasing their drinking due to stress, https://covid19.nih.gov/news-and-stories/risky-drinking-alcohol-use-epidemic-inside-covid-19-pandemic, and stress is a well-known cause of seeking alcohol for comfort.
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Alcohol is both physically and psychologically addictive, which is why Murthy’s warning is coming at the right time. The evidence is building up that true prevention is a lifestyle choice that occurs before you ever reach the doctor's office. This promises to be the focus of Health and Human Services under the incoming Trump administration. If you drink less, exercise and sleep more, and eat healthier foods, the chances that you will need to see me or another internist for chronic health problems, including cancer, go way down.
From the days when Surgeon General C. Everett Koop advised that cigarette smoking is hazardous to your health, and many millions of lives ended up being saved as a result, the Surgeon General position has functioned best as a place for health care advocacy, rather than as a political appointment.
By my estimation and others, Dr. Vivek Murthy has fulfilled this role admirably. Based on his own important book on loneliness, he has seized the post-pandemic mental health crisis to put out important advisories on loneliness, social media, depression, violence, parenting, and now alcohol.
We would be wise to heed his warnings before we are dealing with sickness rather than health.
