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

|

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

author bio

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.


Tags for this article:
Alcohol/Drug Abuse   Cancer   Elaine Schattner   Promote your Health   Women's Health   Diet and Nutrition  




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


Your name
Your Comment
Characters left:
Check the box to verify you are a human commenter.