Through blogs and comments, patients and experts explore what it takes to find good health care and make the most of it.
Guest Blog: On Alcohol and Breast Cancer, Guilt, Correlations, Fun, Moderation, Doctors' Habits, Advice and Herbal Tea
| November 11, 2011
Few BC news items irk some women I know more than those linking alcohol consumption to the Disease. Joy-draining results like those reported this week serve up a double-whammy of guilt: first, that you might have developed cancer because you drank a bit, or a lot, or however much defines more than you should have imbibed; and second, now that you've had BC, the results dictate, or suggest at least, it's best not to drink alcohol.
The problem is this: If you've had BC and might enjoy a glass of wine, or a margarita or two at a party, or a glass of whiskey, straight, at a bar, or after work with colleagues, or when you're alone with your cat, for example, you might end up feeling really bad about it - worse than if you had only to worry about the usual stuff like liver disease and brain damage, or if you could simply experience pleasure like others, as they choose.
The newly-published correlative data, in the Nov 2nd issue of JAMA, are clear. The findings, an off shoot of the Nurses' Health Study, involve over 105,000 women monitored from 1980 until 2008. The bottom line is that even low levels of alcohol consumption, the equivalent to 3-6 drinks per week, are associated with a statistically significant but slight increase in breast cancer incidence. And the more a woman drinks, the more likely she is to develop breast cancer.
All things considered, it might be true that alcohol is a breast carcinogen, as Dr. Steven Narod calls it in the editorial accompanying the research study. Still, there's no proof of cause and effect: Other factors, like consuming lots of food or perhaps some yet-unidentified particularity about living in communities with abundant food and alcohol, are potential co-variables in this story. But what if it is true?
From the editorial:
These findings raise an important clinical question: should post-menopausal women stop drinking to reduce their risk of breast cancer? For some women the increase in risk of breast cancer may be considered sub'stantial enough that cessation would seem prudent. However, there are no data to provide assurance that giving up alcohol will reduce breast cancer risk.
How I see it is this: Everything's best in moderation, including enjoyment of one's life. You work, you rest, you have some fun.
This evidence is not like the strong data linking cigarettes to smoking that officials sat on for a few decades under the influence of the tobacco industry. This is a plausible, mild, and at this point well-documented correlation.
I don't deny the sometimes harmful effects of alcohol; no sane physician or educated person could. But if you have a glass of wine, or even a second, so long as you don't drive a car or work while affected, I don't see it as anyone's business but your own. More generally, I worry about how much judging there is by people who behave imperfectly, and how that can make individuals who are good people in most ways feel like they don't deserve to be happy or enjoy their lives.
Women, in my experience, are generally more vulnerable to the put-downs of others. And so my concern about the BC-alcohol link is that this will, somehow, be used, or have the effect of, making survivors or thrivers or women who haven't even had breast cancer feel like they're doing the wrong thing if they go to a party and have a drink. And then they'll feel badly about themselves.
Really I'm not sure what more to say on this loaded topic, except that it points to the deeper and broader ethical dilemma of doctors who are not all perfect examples of moderation, expecting and asking other people to change their personal habits when they themselves like to go out and have fun, and drink, at parties, or have wine in the evenings over dinner in the privacy of their homes.
How shall I resolve this post?
Last night I sipped Sleepytime tea, manufactured by Celestial Seasonings, before reading a book. The stuff is said to be 100% natural, with "a soothing blend of chamomile, spearmint and lemongrass." I tried it first a few weeks ago and, by a placebo effect or through real chemistry, it helps me sleep more soundly.
I've absolutely no idea what are the effects of Sleep'ytime tea on breast cancer. It might help, it might hurt, or it might do nothing at all.
More Blog Posts by Elaine Schattner
Elaine Schattner, M.D., is a trained oncologist, hematologist, educator and journalist who writes about medicine. Her views on health care are informed by her experiences as a patient with scoliosis since childhood and other conditions including breast cancer. She is a Clinical Associate Professor of Medicine at Weill Cornell Medical College, where she teaches part-time. She holds an active New York State medical license and is board-certified in the Internal Medicine subspecialties of Hematology (blood diseases) and Oncology (cancer medicine). She writes regularly on her blog, Medical Lessons. You can follower her on Twitter @ElaineSchattner.
Comments on this post
Please note: CFAH reserves the right to moderate all comments posted to the Prepared Patient Blog. Any inappropriate postings will be removed.
|Jane Dsouza says|
February 23, 2013 at 4:46 PM
Robots to detect breast cancer and cure. http://breastcancerupdates2012.blogspot.com/2013/02/will-robots-detect-and-cure-breast.html
Add Your Comment
|Think Silver Not Pink for Breast Cancer Awareness Month
Amy Berman | November 1, 2011
|Pink Ribbons, Mixed Emotions
Patient Perspectives | October 18, 2011
|Guest Blog: Women with Metastatic Breast Cancer Clamor for a Different Awareness Level
Gary Schwitzer | October 4, 2011
|The Person Responsible for Your Health Is...
CFAH Staff | February 27, 2014
Combining Alcohol With Energy Drinks Can Lead to Heavier Drinking
Alcohol Use Disorders Linked to Death and Disability
Students with Fake IDs at Greater Risk for Alcohol Abuse
First Sips of Alcohol Start in Second Grade