Heavy drinking increases health risks

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. 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: 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.

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. Regular dental visits will help identify any oral cavity cancers early. Stomach and pancreas cancers do not have well-validated screening programs, unfortunately.

Dear Dr. Roach: I’m an 80-year-old male in good health. I take medication (lisinopril, atenolol, spironolactone and rosuvastatin). My wife and I still enjoy sex, and I take 100 mg of sildenafil about one hour before we have sex. It doesn’t seem to give me the results I would like. Can I safely take a higher dose?

S.W.

Answer: There are several causes of erectile dysfunction, and sometimes no particular cause is found.

Medications can be a forgotten cause of erectile dysfunction. Of all the medications you take, spironolactone is the most likely to be causing a problem with sexual function. It would be worth discussing alternatives with your doctor.

The maximum dose of sildenafil (Viagra) is 100 milligrams. However, one hour may not be long enough for the drug to reach its peak effect. Be sure to take this medicine on an empty stomach and try giving it two or three hours to get fully absorbed.