Laryngeal cancer
Mouth cancer
What to look out for, and when to urge people
to seek help
CANCERS
The main symptoms of
alcohol-related cancers are:
Oesophageal
cancer
BOWEL CANCER
Rectal bleeding or blood in
stools; changes in bowel
habits; unexpected weight
loss; abdominal pain.
BREAST CANCER
A lump in the breast;
changes in the size, shape or
feel of the breast; changes
in the skin on the breast.
LARYNGEAL CANCER
Hoarseness that lasts more than three weeks; difficulty swallowing; weight loss.
MOUTH CANCER
Pain in the mouth, or an ulcer that won’t heal; unusual white or red patches in the
mouth; difficulty swallowing.
OESOPHAGEAL CANCER
Persistent indigestion or heartburn; difficulty swallowing; persistent cough; pain in
the throat; weight loss.
ALCOHOL-RELATED BRAIN DAMAGE/
WERNICKE-KORSAKOFF’S SYNDROME
Symptoms include memory loss, erratic behaviour, poor judgement and difficulties
with familiar tasks or processing new information. The symptoms can often be
mistaken for intoxication.
With Wernicke-Korsakoff’s syndrome the symptoms are similar but usually
appear much more quickly and with more severity. Wernicke-Korsakoff’s syndrome
is made up of Wernicke’s Encephalopathy and Korsakoff’s Psychosis – symptoms of
the former include confusion and disorientation, blurred vision, poor balance and
numbness in the hands and feet. Again, people will often appear drunk even if they
haven’t been drinking. Symptoms of Korsakoff’s Psychosis include memory loss,
confusion and apathy.
STOMACH ULCERS
The symptoms of peptic ulcers include persistent indigestion, heartburn,
abdominal pain and bloating.
MALNUTRITION
Symptoms include unintended weight loss, weakness and lethargy, lack of
appetite, depression and wounds taking a long time to heal.
INFECTIOUS DISEASES
Symptoms of tuberculosis (TB) include fever, night sweats, weight loss and fatigue.
If the infection is in the lungs (pulmonary TB) symptoms will include
breathlessness and a persistent cough, which may be bloody.
ALCOHOL POISONING
Signs of alcohol poisoning can include stupor, fits, loss of consciousness and
inability to wake up, confusion, slow or irregular breathing, pale or blue-tinged skin
and hypothermia.
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FOR STAFF IN ALCOHOL SERVICES
WHEN TO REFER YOUR CLIENTS
TO A GP
Generally, any clients in specialist substance misuse treatment should
be strongly encouraged to visit a GP – and dentist – for check-ups. Not
only can this help in the early identification of any health issues but it
can also act as a motivator for behaviour change, although some
clients may need support in attending these appointments.
However, alcohol treatment staff are likely to see many of their
clients far more frequently than these clients see a GP, and there are
questions that staff without formal medical qualifications can ask to
help identify key signs of common problems experienced by heavy
drinkers. They can also help raise awareness of these issues among
clients and encourage them to be on the lookout for potential
symptoms. It is often a good idea to begin with an open-ended
enquiry such as ‘Have you had any health problems recently?’ before
asking specific questions.
Some general questions that might identify potentially serious
health issues include asking if clients ever have sensations of
numbness or pins and needles in their hands and feet, if they ever
have fits or seizures, or if they feel unsteady or experience double
vision, confusion or problems with short-term memory. Staff could
also ask if they have difficulty swallowing solid food, have a mouth
ulcer that won’t heal or if their stools have become looser than
normal or contain blood.
Staff could also enquire if their clients have experienced severe
stomach pains, or hoarseness or voice changes that have lasted more
than three weeks. Finally, clients could be asked if they have irregular
heartbeats or feel their hearts race or skip beats to the extent that it
makes them feel unwell. Anyone answering yes to any of these
questions should be advised to see a GP as a matter of urgency.
More generally, very heavy drinkers should also be encouraged to
have blood pressure checks at least once a year and a fibroscan
(ultrasound) liver test every two years – this can reveal liver damage
that won’t be identified by blood tests alone. Female clients over 50
should also be encouraged to attend breast screening and to
regularly perform self-checks for signs of breast cancer.
There are, however, certain circumstances in which staff should either
call an ambulance or take a client immediately to A&E. These are when
a client collapses, has fits or becomes unconscious, or if they show
signs of agitation, severe confusion, hallucinations or fever consistent
with alcohol withdrawal. The same applies if the whites of their eyes
or skin turn yellow – which may indicate liver failure – or if they
experience potential heart attack symptoms such as painful heaviness
or tightness in the chest or arms, neck, jaw, back or stomach.
Overall, however, the golden rule is that clients should be
encouraged to visit their GP for check-ups as a matter of course so
that they can be seen by a qualified medical professional.
Wider Health Series | DDN | 5