Is it safe to consume alcohol with dinner while socializing.

Gingermiss65

Hi, I hope this is the right group to post this. I know it sounds trivial, and lord knows no one needs to ever have alcohol period.

I never drink, but I am single and does anyone have just a small glass of wine, one glass with dinner if you are out socializing. I never do really. Last glass I had was 2 weeks ago at dinner out. I believe my oncologist said a glass here or there is ok, just you cannot drink excessively. Which I wouldn't. I cannot find the do's and don'ts he had written out for me. It is hard to sit there and converse with others at times, if you are the only one that cannot have one glass at least, say once of month if that.

Thank you.

Beesie

There are lots of threads on this site about alcohol consumption. Use the search function in the box on the left side and you'll get lots of information and opinions.

What it comes down to is that some people who've had breast cancer choose to stop completely, but many continue to drink on occasion, usually with the approval of our oncologists.

The effect of alcohol on breast cancer recurrence/mortality is unclear; the studies are all over the map, some showing no impact, some showing a small degree of increased risk, and some actually showing a small degree of benefit. My oncologist is fine with me consuming wine, although he said that from a general health standpoint women should probably consume an alcoholic beverage no more than 2-3 times per week, and for men, 3-4 times per week.

Honestly, the stress from worrying about the occasional glass of wine (or whatever)is probably worse for your health than that occasional glass of wine. If you are out with friends and you want a drink, have it, and enjoy yourself. That's what life is about, isn't it?

sbelizabeth

I had a consultation with a nutritionist while I was in treatment and her recommendation was no more than 2-3 glasses of wine every week.

That being said, I have a nice glass of red wine 3-4 evenings a week. I don't have the sense that it's going to kill me.

Beaverntx

I decided I would not allow BC to take all pleasure from my life. I've managed to lose some weight in spite of being on Tamoxifen, avoid red and processed meat and most of the time limit wine to no more than one glass a day and no more than 3 or 4 days a week. Tonight we had dinner with a group of friends and I did not eat the grilled brats but I did thoroughly enjoy 2 glasses of excellent Grenache! Will wait a few days before having wine again but I refuse, at least for the present and in light of equivocal research findings, to become a tee totaler.

moth

So, I'm one of the naysayers on this. Alcohol is a known carcinogen. I only drank very rarely in the past few years because I begrudged alcohol the calories - I'd rather eat a cookie than waste the calories on alcohol... but now I wouldn't drink even if could afford the calories.
I don't find it awkward at all. I have plain sparkling water or pop or just nothing at all. I know people who are in recovery, people who are teetotal for other reasons and I've never seen any pressure or weirdness about it. If I did, i honestly would be tempted to find a different circle of people to socialize with me as what goes in my body is my business and nobody else's.

AliceBastable

Moth, do you have a link to studies for that "Alcohol is a known carcinogen" statement? Everything is probably a carcinogen in excessive amounts, but I've never heard that minimal amounts of alcohol would be a problem.

moth

yes!
Lancet summary of latest research "No level of alcohol consumption improves health"
"The level of consumption that minimises an individual's risk is 0 g of ethanol per week, largely driven by the fact that the estimated protective effects for ischaemic heart disease and diabetes in women are offset by monotonic associations with cancer." https://www.thelancet.com/article/S0140-6736(18)31571-X/fulltext

The actual original study that the summary above is referring to:

"For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27·1% (95% UI 21·2–33·3) of total alcohol-attributable female deaths and 18·9% (15·3–22·6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0·0–0·8) standard drinks per week.

"We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. "

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(18)31310-2/fulltext

World Health Organization:

"Is alcohol really that bad?

We know alcohol causes cancer"
&
http://www.euro.who.int/en/health-topics/disease-prevention/alcohol-use/data-and-statistics/q-and-a-how-can-i-drink-alcohol-safely &

&
"there is no safe level for drinking alcohol."
http://www.euro.who.int/en/health-topics/noncommunicable-diseases/pages/news/news/2018/09/there-is-no-safe-level-of-alcohol,-new-study-confirms

Sjacobs146

I am pretty sure that one glass of wine with dinner will not cause violence in the street and the family. All things have a relative risk, each individual has to decide whether the risk is acceptable to them or not. Even cancer treatments have certain risks (heart damage, other cancers, etc.). My doc recommended limiting myself to 3 drinks per week. I am trying to lose weight, so I usually only drink in a social situation

MelissaDallas

Heck, you can die from drinking too much water. I’m having a glass of wine or beer a few times a week if I want. I don’t imagine that there isn’t a study somewhere saying pretty much everything in our lives is a potential carcinogen. Ancient peoples without any of the feared things in modern life still got cancer before pesticides, readily available alcohol, plastics, GMOs, petroleum products, pollution, food additives etc.

MountainMia

Regardless of what you decide on whether to drink alcohol or not, remember that a "serving" of alcohol is not necessarily a "glass" of alcohol. A serving in the US is

12 ounces of beer at 5% alcohol content,

5 ounces of wine at 12% alcohol content, or

1.5 ounces distilled spirits (whiskey, tequila, rum, etc.) at about 40% alcohol content.

A typical wine glass in the US is anywhere from about 10 ounce capacity to as much as 20 ounces, or even more. If you have a larger wine glass and only have "one glass," you could be drinking 2 or 3 servings of wine.

If you're having a margarita at a restaurant or a party, you don't have any way to guess how much tequila is in it.

MelissaDallas

I know what a serving is, and personally I don’t think I’ve ever seen a wine glass that would hold 20 ounces (1 1/4 masons jars) of wine

MountainMia

MelissaDallas, my comment was not directed at you. No need to get defensive. Most people probably have no idea how much is a serving, so good for you that you do. Cheers!

santabarbarian

Moth,

Just an aside... pop is as bad for you as wine, or worse!

MelissaDallas

Not being defensive. Just stating facts that most of us know 3/4s of a bottle is not “a glass” of wine. Commenting that some (must be awfully rare) wine glasses hold 20 ounces is kind of taking things to extremes

Scrafgal

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my MO gave the same advice about serving sizes...most people are not aware that restaurants and bars routinely serve more than 5 ounces of wine per glass....patrons would complain if they did so. So, typically, if someone else is pouring, they are pouring Moore than 5 ounces....which I think was Mountainmia's general point. I pour my own when Icam with friends and they all are surprised about how little 5 ounces is!

moth

British Medical journal study on wine glass sizes: "Wine glass capacity increased from 66 mL in the 1700s to 417 mL in the 2000s, with the average wine glass size in 2016-17 being 449 mL."

449 mL is 15 fl oz for the non metric folks... & that's the *average* size of glass according to this research

"Alcohol consumption may feature largely in the festive period but rising levels of drinking may be partly due to the growing size of wine glasses, particularly over the past two decades, suggests an article in the Christmas issue of The BMJ."

https://www.bmj.com/company/newsroom/growing-size-of-wine-glasses-coincides-with-more-drinking/

Scrafgal

---

my MO gave the same advice about serving sizes...most people are not aware that restaurants and bars routinely serve more than 5 ounces of wine per glass....patrons would complain if they did so. So, typically, if someone else is pouring, they are pour more than 5 ounces....which I think was Mountainmia's general point. I pour my own when I am with friends and they all are surprised about how little 5 ounces is!

This glass has 20 ounces of water which most would only fill halfway...so, just ONE half-full glass is 2 five-ounce servings...

moth

Yes, water can kill you in excesss. Yes sweetened beverages are not good for you.

But alcohol has NO safe consumption limit. In fact, the safe consumption limit identified in the Lancet study is zero. And cancer is specifically identified as a result of alcohol consumption.

There is no evidence alcohol is safe but it is ubiquitous in our culture and heavily promoted by industries who profit from it; & indeed for many areas, public service programs, including healthcare, are funded from taxes on alcohol so consumption is lucrative for many.

But it is not a healthy choice. Even with the supposed heart health benefits, I've asked a cardiologist whether someone who doesn't drink should *start* regularly consuming wine and they shrank back in horror. No. And now we know (from that Lancet study) that any benefit to heart health is well offset with increases in cancer rates.

Scrafgal

Btw...my point in showing the picture was to support Mountamia's basic point...2 of this glasses that I showed would actually be 4 five ounce servings. Fundamentally, I agree tha a couple of 5 ounce servings every now and then is a risk that I take...vit shaming anyone for their choices here is really not useful. We are all scared about recurrence at some level and we try to balance that best we can and remain happy. None of us have all the answers.

MelissaDallas

Because a glass holds that much doesn’t mean a restaurant is pouring it to the brim. To the contrary, a small percentage of the capacity is actually poured. Most of the time when I am served a glass of wine in a restaurant it is maybe 1/3 or lessof the capacity of the glass.

Scrafgal

Yea... right

exbrnxgrl

I rarely drink but when I do, I thoroughly enjoy it! I have been stage IV for almost 8 years, with no progression. I am not compulsive by nature and see no reason to stress over everything that goes into my mouth or touches my body. I lead a healthy lifestyle and never deprive myself or worry about indulging. Life is to be enjoyed

Beesie

moth, the study you provided speaks to overall risk from alcohol, and is not specific to breast cancer risk or even to health risk.

The devil is in the detail. Here's what I found from digging into the charts in the appendix.

For high socioeconomic societies (such as North America), the report states that:

- approx. 76% of women aged 35-80 consume alcohol (they have more age groups but I limited my analysis to this group since it represents most of us here)

- average daily alcohol consumption for women in this age group is approx. 2.5 drinks per day

- on average, 3.4% of deaths among women in this age group can be attributed to alcohol, with a higher percent for younger women and a lower percent for older women

- the 3.4% mortality rate attributed to alcohol includes deaths from drinking & driving, deaths from alcohol related violence (murders) and depression (self-harm), and from diseases directly related to alcohol consumption, such as liver disease and some oral cancers.

The report also shows a health benefit from alcohol consumption with regard to heart disease. Overall this benefit is wiped by when looking at all alcohol related deaths (including car accidents, etc.) because of the high prevalence of alcohol related deaths among the young. However as the following chart from the report shows, by the time we are older, the benefits from alcohol (reduction in heart disease and stroke) outweigh the risks (deaths from all alcohol related causes). (Note: DALY is disability-adjusted life-years, so not quite the same as deaths but the only chart available in the report.)

So to the OP's question, asking if there is any harm to "one glass at least, say once of month if that", the answer is NO, THERE IS NO HARM.

And I will return to my MO's suggestion that "for overall health" (not accounting for non-health related alcohol deaths), alcohol consumption should be limited to 2-3 drinks per week for women, and 3-4 drinks per week for men.

TB90

Thank goodness for Beesie's research knowledge. Since learning from you, I never accept simple interpretations of studies, but now read the fine print. Still do not have your ability to analyze. As for serving sizes, there is never any doubt in my world how much wine they are pouring in restaurants as they charge accordingly!! They ask for your choice of serving size. Could not make it more obvious than that. And as for those bar tenders who pour generously, they are then pouring their profits away and will either be fired or go out of business. So they are very rare. Like Melissa stated, wine glasses are about as full (as bags of chips). My interpretation

moth

Bessie, I take your point but an important aspect of that study is that they're looking at the population as a whole, not people who are already at higher risk of cancer due to a previous ca dx.

& as far as I'm concerned their bottom line still stands: " The level of alcohol consumption that minimised harm across health outcomes was zero "

gb2115

What's hard here is no one can see the future, and statistics are all well and good, but so many of us have been on the wrong side of statistics. It comes down to your acceptable risk level. My MO said no more than 3 drinks a week. I tend to drink only 4-5 x a year though I wish it were more.

Beesie

I was trying to bring this discussion back to Gingermiss's question. She wasn't asking about our personal opinions on alcohol, or what we personally choose to do. Here's how she raised her question:

"I believe my oncologist said a glass here or there is ok, just you cannot drink excessively. Which I wouldn't. I cannot find the do's and don'ts he had written out for me."

I answered her question by telling her what my oncologist told me, which is that for overall health, he recommends that women stick to no more than 2-3 drinks per week.

Given the data on alcohol and breast cancer risk, I don't see the point in raising fear or guilt in someone who is asking about "one glass at least, say once of month if that".

.

That said, moth, since you raised the point about "people who are already at higher risk of cancer due to a previous ca dx", here are some studies to ponder:

>> Alcohol Use and Breast Cancer Survival among Participants in the Women's Health Initiative

RESULTS: Women who were consuming alcohol prior to their breast cancer diagnosis had a nonstatistically significant 24% (95% CI, 0.56–1.04) reduced risk of BCS mortality and a 26% (95% CI, 0.61–0.89) reduced risk of all-cause mortality. Some variation was observed by estrogen receptor (ER) status as alcohol consumption was associated with a 49% (95% CI, 0.31–0.83) reduced risk of BCS mortality among ER⁻ patients with no change in risk observed among ER⁺ patients (HR = 0.97; 95% CI, 0.31–1.54), though the difference between these risks was not statistically significant (P for interaction = 0.39). Postdiagnosis alcohol consumption, and change in consumption patterns after diagnosis, did not appear to be associated with all-cause or BCS mortality.

CONCLUSION: In this large study, consumption of alcohol before or after breast cancer diagnosis did not increase risks of overall or cause-specific mortality.

>> Alcohol consumption and breast cancer-specific and all-cause mortality in women diagnosed with breast cancer at the New York site of the Breast Cancer Family Registry

RESULTS: After a mean follow-up of 9.1 years, we observed 211 total deaths and 58 breast cancer deaths. Compared to non-drinkers, we found that both low and moderate to heavy levels of alcohol intake were not associated with greater overall mortality (≤3 drinks/week: HR^O: 0.66, 95% CI: 0.38–1.14); > 3 drinks/week: HR^O: 1.16, 95% CI: 0.85–1.58), breast cancer–specific mortality (≤ 3 drinks/week: HR^BC:0.62, 95% CI: 0.19–2.03; >3 drinks/week: HR ^BC: 0.96, 95% CI: 0.49–1.89), or non-breast cancer-specific mortality (≤3 drinks/week: HR ^NBC: 0.73, 95% CI: 0.32–1.6; >3 drinks/week: HR^NBC: 1.18, 95% CI: 0.75–1.86).

CONCLUSION:

Alcohol intake reported from age 12 to age at baseline was not associated with overall or breast cancer-specific mortality in this cohort of affected women with a family history of breast cancer.

>> Alcohol Consumption and Breast Cancer Survival: A Meta- analysis of Cohort Studies

RESULTS: We included 25 cohort studies. The meta-analysis results showed that alcohol consumption was not associated with increased breast cancer mortality and recurrence after pooling all data from highest versus lowest comparisons. Subgroup analyses showed that pre-diagnostic or post-diagnostic consumption, and ER status did not affect the relationship with breast cancer mortality and recurrence. Although the relationships of different alcohol consumption with breast cancer mortality and recurrence were not significant, there seemed to be a dose-response relationship of alcohol consumption with breast cancer mortality and recurrence. Only alcohol consumption of >20 g/d was associated with increased breast cancer mortality, but not with increased breast cancer recurrence.

CONCLUSION: Although our meta-analysis showed alcohol drinking was not associated with increased breast cancer mortality and recurrence, there seemed to be a dose-response relationship of alcohol consumption with breast cancer mortality and recurrence and alcohol consumption of >20 g/d was associated with increased breast cancer mortality.

.

Are there other studies that do show an increase in mortality? A few, but the overwhelming body of research suggests that there is either no risk or minimal risk at most.

So let's be kind and not scare someone asking a very reasonable question about an extremely low level of occasional alcohol consumption. Will it be harmful? Absolutely not.

Edited for typos/grammar only.

exbrnxgrl

beesie,

👋🏻👋🏻👋🏻👋🏻

santabarbarian

moth, I doubt there's a safe level of white table sugar either...

exbrnxgrl

I know that some of you will think I am gambling with my health and what I am about to say pertains only to me but... When I was first dx’ed (essentially stage IV de novo), I went whole hog on a restrictive diet, juicing, supplements etc. No alcohol, no sugar, very little animal derived foods. My younger dd was living at home at the time and was eager to support all of my efforts. It went well, at first. Eventually we started getting into arguments if I took a bite of chocolate or a sip of wine. It was very stressful having to worry that everything consumed or put on my skin was going to make my cancer progress. For me, life became stressful and somewhat joyless. After all for many of us there is a social component to eating and drinking, and I sorely missed that. In the end (about 10 months in) I decided that since I already live a healthy lifestyle, that eating “forbidden fruit” from time to time was not going to kill me any faster and the pleasures they brought me outweighed the stress that compulsive dietary habits were bringing me.

Again, just me and my story, but something to consider as you go along. At almost 8 years out from my dx, I am content with what I’ve chosen to do. Would I considermy unusual survival (and mostly normal life) a result of my lack of compulsion? No, I’m afraid I have no idea why I’ve done so well. Best to all and bc or not, life is short, so enjoy every minute of it.

TB90

Exbrynxgrl: You summarized my experience also, except I actually ended up crashing with a serious depression. Once I returned to my former, but still healthier self, I regained my quality of life. I think that process was important for me as I tried to regain control back over my life. Well surprise, I never had control and never will.