Alcohol consumption and BC risk (sigh)

Junk science.  Scare tactics by a group whose job it is to dig around and highlight (or perhaps I should say exaggerate) any piece of information they can find about any problems related to alcohol consumption.  That's actually their mission, according to their own website:

"The Alcohol Research Group (ARG) of the Public Health Institute was established in 1959 to conduct and disseminate high-quality research in epidemiology of alcohol consumption and problems including alcohol use disorders, alcohol-related health services research, and analyses of alcohol policy and its impacts. ARG is home to the National Alcohol Research Center, one of 18 such centers funded by the US National Institute on Alcohol Abuse and Alcoholism (NIAAA), and is the only one of its kind specializing in the epidemiology of alcohol use and problems."  http://www.arg.org/about_us/index.php

What they appear to be doing in this case is taking tidbits of information from other research and stretching this information to the greatest degree possible to get to the highest possible mortality numbers.  I've read every research study that I can find on alcohol consumption and breast cancer. There's no question that there is a relationship between alcohol consumption and BC risk/mortality (particularly for women who are overweight - that seems to be the highest risk group) but most studies at best have found the relationship to be a weak one, putting alcohol into the "low risk" category vs. moderate risk factors such as HRT use or high risk factors such as having extremely dense breasts or being female or getting older. 

These studies that have found that alcohol consumption is a low risk factor for breast cancer for the most part have one common fault: They are based on self reporting. We all know that everyone is honest about how much alcohol they consume. So while this may not negate the results, it certainly puts into question the degree to which alcohol consumption affects BC risk, recurrence and/or mortality.

There have also been studies that have shown that moderate alcohol consumption does not lead to an overall increase in mortality from all causes. This is because while moderate alcohol consumption may slightly increase mortality from breast cancer, it reduces mortality from heart disease.  And overall, more women die of heart disease than of breast cancer. Here are articles about a couple of studies that have found this to be the case:

Alcohol May Increase Risk for Breast Cancer Recurrence "Our study increases the limited and mixed evidence base to date regarding the role of alcohol consumption and breast cancer prognosis; namely, that drinking moderate to heavy amounts of alcohol after a breast cancer diagnosis can possibly increase the risk of having a recurrence of breast cancer and dying from breast cancer," Dr. Kwan said.... There was no association between alcohol intake and all-cause death. The authors note, however, that alcohol intake was possibly associated with a decreased risk for nonbreast cancer death, which would be consistent with current literature on "alcohol's likely protective effects on cardiovascular-related outcomes."

Alcohol intake and mortality among women with invasive breast cancer  Women who consumed 10 g per day (corresponding to approximately 0.75 to 1 drinks) or more of alcohol had an adjusted HR (95% CI) of breast cancer-specific death of 1.36 (0.82-2.26;p(trend)=0.47) compared with non-drinkers. A significant inverse association was observed between alcohol and non-breast cancer deaths. Those who consumed 3.4-9.9 g per day of alcohol had a 33% lower risk of death compared with non-drinkers (95% CI 0.50-0.90;p(trend)=0.04).

I'm a wine drinker. I generally keep myself to moderate consumption but in all honesty, there are some days when I have what would be considered to be more than a "moderate" amount of wine. I discovered after my diagnosis of breast cancer that I started to worry about whether or not I should be drinking wine and how much wine I should be drinking. That became a source of stress for me. Stress isn't good for our health in many ways, and there is speculation as to whether it might affect BC development. So I decided to stop worrying about it. I enjoy wine. A glass of wine at the end of the day reduces my stress and I figure that this is a good thing. Since I plan to live to a ripe old age, an age at which heart disease will be a bigger concern for me than breast cancer, I also figure that my moderate wine consumption may be good thing for my health. And I think about my great-aunt, who lived to the age of 92 and had a glass of port every night, both because she liked it and because her doctor told her it was good for her health. She was lively and active and healthy until the last week of her life, so it seems that it was!

We all have to make our own decisions about which risks we are willing to take, and which risks we choose to avoid.  For me, moderate alcohol consumption is a risk that I'm willing to take - although given the other health benefits, I'm not sure that I'm really taking much of a risk at all.  The only thing that frustrates me are all these stupid studies that have holes big enough to drive a tank through, but which are presented as though they are fact based and the whole truth, with their objective being to scare women into stopping all alcohol consumption. 

I don't know...  I guess what jumped out at me from this article was the fact that alcohol is a known carcinogeon, which I don't think I particularly realized or thought of in that context.  So I just did a quick little search and found articles like these that address particular issue:

http://www.dailymail.co.uk/health/article-2192611/How-alcohol-causes-cancer--particularly-lethal-Asian-descent.html

http://www.winespectator.com/webfeature/show/id/46646

As usual, they're contradictory, so we're still left needing to make our own choices based on risk assessment and tolerance.  Personally, as much as I enjoy the social aspect of wine, it's always given me a huge headache, so cutting back to only a very occasional 1/2 glass post-bc-dx was no big deal.       Deanna 

PS ~ There is some other research out there that makes a specific distinction between the risk for those with IDC (okay) and ILC (not safe), and that's something I haven't been able to overlook.

I just love to read things like this, great entertainment. I don't drink at all, I got cancer. It calls alcohol a risk factor. "Alcohol is a big preventable risk factor that has been hiding in plain sight." ~ ~ ~ Well not in my case anyway.

Thanks Beesie.



This topic interests me as I do like wine :-).



Question: How do those researchers know that alcohol 'caused' the patients' cancers? Just because the patients may have been drinkers does not establish cause and effect. I believe it is referred to as an 'association'.



What about all the drinkers (the majority) who didn't get cancer?



I am not a scientist but I have heard that other factors such as excess estrogen and obesity (also associated with estrogen)are risk factors for bc. It is said that alcohol can promote estrogen and sometimes can be associated with obesity.



I choose to think that if you are a healthy weight and take an AI, those risk factors are reduced.



My onc told me that the best action I can take to reduce recurrence is to be as lean as possible.

Racy I have been lean my entire life.  Alcohol is the only possible association factor in my life that (if there was a direct cause for my cancer) could have caused my BC.  I tend to lean towards the crap shoot theory.

As for how some studies are done, I think they are misleading, but I don't really know how most studies are conducted.  

There is so much conflicting stories out there it's hard to sift through what is relative to your particular situation and type of cancer. I've read many of the same articles, although alcohol is not a big issue for me, things like sugar and diet are, and there is tons of conflicting info about diet and brest cancer. 

I guess we are at the mercy of our doctors to help us sift through the info. I think it is good to take an active roll in finding out all you can, but then I take what I find and I ask my doctor what he thinks about the info as it relates to my medical history. 

Is life really worth living if we are forced to live in consist fear of every choice we make? I've been stressing over diet and nutrient as this has been a biggy for me, but I think I've decided that as long as I try to eat healthy then one soda on occassion or one drink in your case, isn't critical in the overall scheme of things.

It is so frustrating.

Bessie,

Great researching and reporting. It is great to be able to get info from so many sources collated together.

I'm thinking for me, it is all things in moderation.

The night before I had my onc appt last week I had 2 glasses of wine. Usually I would have what studies would call 1 glass a week at most. I have enough to worry about without beating myself up over a little indulgence.

What about beer or spirits? I can only drink a little wine, it makes me go red in the face and 1 glass makes me look like a complete drunk. I only drink at home. But I can have a beer or vodka without the same effects. Still I would never have more than 2 drinks out. I dislike the behaviour of drunk people so make sure it isn't me being silly. But I still enjoy a drink ever now and then.

Life is for living but moderation is my answer.

Moira

I personally feel the toxins in the enviornemnt and in our food play a much bigger part in our getting cancer than a glass of wine a day! Just saying!

So glad I found this thread. Alcohol consumption is something I have struggled with since my dx. In my twenties (I'm 33 now) I was a drinker. Who knows, maybe that's why I'm in this mess. Not going out and getting drunk every day, but vacations, weddings and nights out with friends were definitely booze-filled! Then I got married, turned 30 and had a kid. And my nights out partying turned into putting my son to bed on a Friday night and watching a movie, eating some pizza and splitting a 6-pack with my husband. And this has pretty much become our weekend ritual, our way to unwind after a long, hectic week. I also enjoy wine with friends and with dinner from time to time. And it doesn't help that I have an awesome winery about a mile away from my house!

Since my DX I've slowly improved my diet. I've mostly given up meat, dairy and sugar. I've gotten on the organic band-wagon. And I have reduced the amount I drink. But for some reason alcohol is the hardest "vice" to kick. I love what PP said about stress being unhealthy and wine helps stress. So true. I just hate feeling guilty after I have more than 5 oz of wine, which if I'm being honest, is probably about twice a week. 

It's nice to know I'm not the only one out there wth BC that still enjoys a couple drinks from time to time. I feel like every time I'm on here I see someone writing about how they wish they could have a drink. Then I think 'Crap, I just had a drink last night!'

I believe that breast cancer recurrence (and maybe even breast cancer itself) is somehow related to the body's inflammatory processes. All the things that seem to help reduce the risk of recurrence, for example, healthy diet, low-dose aspirin, exercise, and sleep, reduce inflammation in the body. Likewise, those things that increase inflammation, for example, stress and chemicals, seem to increase your risk of inflammation. Wine, in moderation, is known to have a positive impact on inflammatory markers but as consumption increases it has the opposite effect. Of course, breast cancer is not heterogeneous and, in all likelihood, certain types have nothing to do with this.

Related to epigenetics, stress is an interesting (but touchy) topic. I’ve been wondering if psychological hardship is some sort of trigger for disease. There are a lot of quacks out there that believe that cancers appear at the end of a traumatic experience or period of continued stress. I know for me this was true…

You guys are going to love this article. My biggest risk factor was dense breasts. My sister and mom both have dense tissue and don't have breast cancer. Even with that risk my risk at diagnosis was about less than 2%. I'm also 5'6". Being tall is a risk. I'm not a giant but that is considered tall. My sister is 5'1" and my mom was 5'3" (she's shrunk over the years). These are all factors I had no control over.

After 40 Years Of Research, What Do We Know About Preventing Breast Cancer?

Like many of us, I managed to escape the early 80's relatively unscathed. However, it was definitely party time and alcohol was not the only substance that made the scene. Despite those days, I managed to survive and live a pretty healthy life. Gave up drinking for over 10 years, became a competitive athlete, raised (and breastfed) two great kids while dealing with all the stress of modern living and then some.

As I look over the checklist of things that may cause cancer, the only checks I can make are dense breasts and moderate alcohol comsumption. In fact, if I take a breast cancer screening test right now, my chances of having BC are miniscule. But, yet.....here I am with not one, but two types of cancer.

I struggled with my daily glass of wine for a bit after DX and came to the conclusion that my habit of riding a bicycle on the road is much more likely to be a factor in my demise than alcohol. Not to mention the excessive oxidative stress from years of heavy endurance training added to high levels of personal stress which undoubtedly had a much more negative effect than a glass of wine.

When I was racing, I kept myself on a very strict nutrition regime and I gave up a lot of things. Didn't eat a cookie for years. No alcohol. No sugar. You name it, I gave it up. At this point in my life, knowing what I know, even if I knew for a fact that moderate alcohol consumption would shorten my life by XX days or months, I think I would still choose to imbibe. I do not want to spend the last day, week, month or year of my life denying myself anything (in moderation) that gives me pleasure. Be it a cookie, a steak or a nice glass of pinot.......I'll happily trade that satisfaction for a little more time of restriction.

This life is not a dress rehearsal......we only get one......and we have NO way of knowing when it will end. I would hate to spend my final hours knowing I didn't have that chocolate cake that looked so good yesterday.

Just getting to this thread now as have been down and out with the stomach flu....major drag including NO INTEREST IN WINE!  This whole "no wine" thing surfaced about three years ago as I was finishing up chemo, and I did stop and consider not resuming wine drinking post chemo.

But wine is one of my major pleasures in life.  Plus I live in the land of amazing wine (WA State).  As many of you have said, life is for the living, and I am determined to live mine fully.  In many ways, I am, to use the words of the exquisite, beautiful, and wonderfully talented dancer/burlesque performer, Miss Lily Verlaine.....a voluptuary.

So it's wine, and chocolate, and the perfect fruit, and the amazing ski, snow and rain, sunshine and flowers, mountains and sea....and all the other sensory pleasures.  So yes.....cabernet (sauvignon, franc), pinot (gris, noir), malbec, merlot, riesling, nebbiolo, chardonnay....a garden of delights to be savored.

I also work hard and care about what I do.  So a full life, including endurance events to keep the spirit fresh, and the body toned and lithe.

That is what I concentrate on.  Part of my promise to myself was to emerge from the BC experience as "better than ever", and I do believe I am finally there.  Salut! - Claire

Great topic!  I was a teeny weeny bit freaked out by that latest condemnation of alcohol---we live in the Rheingau region of Germany and to become a total teetotaller would be a challenge!!  That being said, I have cut back so much that I'm now the very popular designated driver, haha!

Raising a "pfiffchen" of Riesling to you all!

Cynthie