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Alcohol Abuse and Alcoholism

Doctor to Patient

The Relationship of Chronic Viral Hepatitis, Alcoholism, and Cirrhosis to Liver Cancer

Medical Author: Jay W. Marks, MD
Medical Editor: Leslie J. Schoenfield, MD, PhD

Discover the connection between viral hepatitis, alcoholism, cirrhosis, and liver cancer. Cancer can start within the liver (primary liver cancer or hepatocellular cancer) or spread to the liver (metastatic liver cancer) from other sites, such as the colon. Cancer that starts in the liver, which I will refer to simply as liver cancer, is the fifth most common cancer in the world. In the U.S., it is among the 10 most common cancers. This cancer is more frequent among Native Americans, Asians, Pacific Islanders, and Hispanics than among Caucasians.

Liver cancer is a bad cancer. It has frequently spread beyond the liver by the time it is discovered, and only 5% of patients with liver cancer that has begun to cause symptoms survive even five years without treatment. The only hope for patients who are at risk for liver cancer is regular surveillance so that the cancers can be found early. Early cancers can be treated by surgical removal (resection), destruction of the individual tumors, or liver transplantation. Although the current techniques for surveillance are not very good at detecting early liver cancer, newer techniques are being tested and appear to be better.

The most common diseases associated with liver cancer are chronic viral hepatitis, alcoholism, and cirrhosis (scarring of the liver). Moreover, chronic viral hepatitis is common in alcoholism, and both viral hepatitis and alcoholism cause cirrhosis which usually precedes the development of cancer. Therefore, the contributions and interrelationships of alcohol abuse, viral hepatitis, and cirrhosis in the development of liver cancer are complex. Despite the complexity, it is important to try to understand the contributions of each disease so that patients at highest risk for liver cancer can be targeted for surveillance. Theoretically, they also might be targeted with treatments that prevent the development of liver cancer, when such treatments are developed.


Doctor to Patient

What is alcoholism?

Alcoholism, also known as alcohol dependence, is a disease that includes the following four symptoms:

  • Craving—A strong need, or urge, to drink.
  • Loss of control—Not being able to stop drinking once drinking has begun.
  • Physical dependence—Withdrawal symptoms, such as nausea, sweating, shakiness, and anxiety after stopping drinking.
  • Tolerance—The need to drink greater amounts of alcohol to get "high."

For clinical and research purposes, formal diagnostic criteria for alcoholism also have been developed. Such criteria are included in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, published by the American Psychiatric Association, as well as in the International Classification Diseases, published by the World Health Organization.

Is alcoholism a disease?

Yes, alcoholism is a disease. The craving that an alcoholic feels for alcohol can be as strong as the need for food or water. An alcoholic will continue to drink despite serious family, health, or legal problems.

Like many other diseases, alcoholism is chronic, meaning that it lasts a person's lifetime; it usually follows a predictable course; and it has symptoms. The risk for developing alcoholism is influenced both by a person's genes and by his or her lifestyle.

Is alcoholism inherited?

Research shows that the risk for developing alcoholism does indeed run in families. The genes a person inherits partially explain this pattern, but lifestyle is also a factor. Currently, researchers are working to discover the actual genes that put people at risk for alcoholism. Your friends, the amount of stress in your life, and how readily available alcohol is also are factors that may increase your risk for alcoholism.

But remember: Risk is not destiny. Just because alcoholism tends to run in families doesn't mean that a child of an alcoholic parent will automatically become an alcoholic too. Some people develop alcoholism even though no one in their family has a drinking problem. By the same token, not all children of alcoholic families get into trouble with alcohol. Knowing you are at risk is important, though, because then you can take steps to protect yourself from developing problems with alcohol.

Can alcoholism be cured?

No, alcoholism cannot be cured at this time. Even if an alcoholic hasn't been drinking for a long time, he or she can still suffer a relapse. Not drinking is the safest course for most people with alcoholism.

Can alcoholism be treated?

Yes, alcoholism can be treated. Alcoholism treatment programs use both counseling and medications to help a person stop drinking. Treatment has helped many people stop drinking and rebuild their lives.



Next: Which medications treat alcoholism? »

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Alcohol Abuse and Alcoholism

Introduction

Factitious disorders are conditions in which a person acts as if he or she has a physical or mental illness when he or she is not really sick. Factitious disorder by proxy is when a person acts as if a person in their care has an illness when they do not.

People with factitious disorders deliberately create or exaggerate symptoms of an illness in several ways. They may lie about or fake symptoms, hurt themselves to bring on symptoms, or alter tests (such as contaminating a urine sample) to make it look like they or the person in their care are sick.

People with factitious disorders behave this way because of an inner need to be seen as ill or injured, not to achieve a clear benefit, such as financial gain. People with factitious disorders are even willing to undergo painful or risky tests and operations in order to obtain the sympathy and special attention given to people who are truly ill or have a loved one who is ill. Fact...

Read the Factitious Disorders article »








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