With warm weather approaching, alcohol will be flowing more freely and frequent social events can make it difficult to limit ones alcohol intake. Much like a pregnant woman is often the unwilling recipient of unwanted advice, so too are women with breast cancer bombarded with suggestions about what to do and what to eat and drink. People in general are becoming increasingly confused by the many conflicting stories in the media about what to do for optimal health. This is even more fraught once you have a cancer diagnosis and want to do everything to minimise the risk of relapse. Some reports state that a glass of wine a day is safe, but some say that women should drink no more than two drinks a week to minimize risk of breast cancer. Some doctors tell women with breast cancer to avoid alcohol altogether. The trouble with the information on alcohol is that it seems to be protective against some health conditions (in small quantities) and for other conditions it appears to raise the risk. With regard to breast cancer, the relationship is certainly unclear. Drinking alcohol does increase estrogen levels in the body, and though this pathway may increase the risk of estrogen sensitive cancers such as ER+ breast cancer. Alcohol is also believed to be carcinogenic independent of the estrogen effects. This applies to wine, beer and hard liquor. Some early studies suggested that for ER+ breast cancer survivors, the risk of recurrence increases even with one or two drinks a week. Remember, as well, that this is a so-called standard drink which is only 5 ounces of wine, 12 ounces of beer or 1.5 ounces of hard liquor. A typical glass of wine usually contains between 8 and 10 ounces which is 2 servings right there. And who stops at just one glass, especially in social settings where attentive hosts keep refilling your glass before it is empty? To add to the confusion, more recent studies have suggested that moderate alcohol consumption improves survival after a breast cancer diagnosis. All of the studies have been observational, which means that none can actually prove cause and effect. People are notoriously bad at remembering intake of food and beverages, and even if they do, are often inclined to embellish or amend the truth a little. The most definite association does seem to be for alcohol and overweight and obese women where it is most likely to increase the risk of recurrence of breast cancer. So if you have a history of breast cancer or are at high risk of breast cancer due to genetic or other reasons, and you are overweight, it may be a good idea to limit alcohol consumption to a weekly treat or on special occasions only. As with everything, don’t focus only on alcohol. Doctors are quick to suggest that women should stop drinking but seldom let the patient know that she is also increasing her risk of recurrence by not exercising daily or by not eating enough fruit and vegetables.
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