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Alcohol and ER+ Breast Cancer

CypressCynthia's picture
CypressCynthia
Posts: 4011
Joined: Oct 2009

The following is from breast surgeon, Dr. Ruddy, Founder and Medical Director of the Breast Service at Clara Maass Medical Center in Belleville, New Jersey. She is reiterating what I heard at MD Anderson. I found it very illuminating.

"Recipe For Disaster: Alcohol and Estrogen-Positive Breast Cancer

As a breast cancer surgeon, my job is to treat breast cancer; but as a healthcare leader, my job is to prevent it. For healthy women, prevention means they never get the disease. For survivors, prevention means it does not come back. The following article meets both objectives.

Alcohol and Estrogen Compete

Alcohol and estrogen are both metabolized in the liver using similar biochemical pathways. So if the liver is busy clearing alcohol from the bloodstream, estrogen levels will rise as they wait their turn through the liver.

Therefore, women who drink regularly, like every day, will have chronically elevated levels of estrogen circulating in their bloodstream. And since estrogen is the equivalent of light, sweet crude for the breast cancer engine, it’s easy to see why regular alcohol consumption is directly linked to an increased risk for breast cancer. In fact, there does not appear to be any “safe” level of alcohol use: even 1/2 glass of wine per day increases the risk for breast cancer. As a red wine and single-malt scotch lover, this was sad news for me when I learned of it several years ago.

Avoid alcohol if you want to avoid breast cancer.

The preponderance of data confirm that drinking alcohol on a regular basis increases the risk for breast cancer by approximately 40%. Therefore, my advice is to drink only occasionally and in moderation. The good news is that by drinking only on special occasions, indulging in expensive wine will be relatively affordable!

Estrogen-positive breast cancer and alcohol are like fire and gasoline.

The link between alcohol and breast cancer is old news, really. But there is more recent news about alcohol and breast cancer, per se, that ought to set off an alarm down every corridor of preventive medicine: alcohol dramatically increases the risk of breast cancer recurrence in women with estrogen-positive tumors.

Here’s the story:

Dr. Li of the Fred Hutchinson Cancer Research Center studied 365 women between 40-79 who were first diagnosed with estrogen-positive breast cancer and who were then diagnosed with a second cancer in the opposite breast. He compared these women to 726 similar patients who had not had tumor recurrence. Li was looking for differences between the two groups that might explain why one group suffered new cancers in the opposite breast, while the other group remained disease-free.

One thing stood out: having one drink per day increased the risk of a second cancer by 90%.

Another unexpected finding: the majority of patients with estrogen-positive tumors did not take or complete anti-estrogen therapy (tamoxifen, anastrozole, femara etc.)

In studying both groups of women, Li made a totally unexpected discovery, not related to alcohol, but that should be viewed as a cautionary revelation nonetheless. Only 39% of patients with tumor recurrence ever used anti-estrogen therapy – although all such women are eligible for this treatment which reduces breast cancer recurrence by 50% – and of the 39% who did use anti-estrogen therapy, only 14.5% completed five years of treatment.

In the 726 women who were used as controls (the patients without tumor recurrence), only 30% ever used anti-estrogen therapy, and of these only 18.5% completed five years of treatment.

Li’s study was not designed to understand why, when 100% of the women enrolled in the study were eligible for anti-estrogen therapy, so few ever used it, and even fewer completed five years of therapy. But for all women in Li’s study, one thing was abundantly clear: drinking alcohol was a very bad idea.

SUMMARY

Alcohol increases the risk for breast cancer, specifically estrogen-positive breast cancer. Furthermore, in women with estrogen-positive breast cancer, drinking alcohol increases the risk of a new cancer in the opposite breast a jaw-dropping 90%.

TAKE HOME LESSON

Avoid alcohol – save it for special occasions.

If you have estrogen-positive breast cancer, avoid it like the plague.

And, please, take and stay the course with your anti-estrogen medication (tamoxigen, anastrozole etc.)

References

C Li, Relationship between potentially modifiable lifestyle factors and risk of second primary contralateral breast cancer among women diagnosed with estrogen receptor positive invasive breast cancer. Journal Clinical Oncology, Nov 10, 2009 (27) 32: 5312-5318"

Alcohol, Postmenopausal Hormone Therapy, and Breast Cancer Ann Intern Med November 19, 2002 137:I-43

http://breastcancerbydrruddy.com/?p=2703

epark's picture
epark
Posts: 338
Joined: Aug 2011

I always hear so many different things about drinking and breast cancer..this is some good information and advice.

Thanks
Eva

LoveBabyJesus's picture
LoveBabyJesus
Posts: 1654
Joined: Jan 2011

Thanks for posting Cynthia. You often have great articles and information.

I hate alcohol. Never drank. Hate smoking too. Never smoked. So avoiding these will be a piece of cake for me. :)

CypressCynthia's picture
CypressCynthia
Posts: 4011
Joined: Oct 2009

I never drank much, but I did enjoy the occasional social drink. These days I don't drink. It is just no longer fun for me because it feels like I am playing Russian roulette when I do drink. I really don't miss it now at all. Good friends, a good book, a quiet meal with my husband and daughter, a nice hike, digging in my garden--these are what make me happiest :-).

I also still really enjoy making the "warm fuzzy" blankets for other cancer fighters. Danny and I just dropped off about 24 blankets at the local cancer center. While we were there, an older whiskered gentleman, who looked like he could be homeless, asked me if I would come and speak to him. Honestly, I thought he was going to ask for money (shame on me). He took my hand and told me how much my blanket meant to him personally. That was a much better high than alcohol could ever be!

I am compliant on my meds and I don't drink--what a boring person...lol!

Double Whammy's picture
Double Whammy
Posts: 2321
Joined: Jun 2010

Just telling us this information and/or quoting it really doesn't have the same impact as having something to read and digest. My onc has never mentioned alcohol to me (that I can remember) and her only reference to AI is that it is every bit as important as chemo, if not more. Never said why - just that it is. She'll answer any questions I ask about anything I've read and has opinions and can quote data intelligently and thoroughly, but for some reason it seems she doesn't see it as her job to educate me in the first place.

I, too, am compliant with the AIs, and luckily I have no side effects. I honestly don't know how I'd do if I had the side effects others have, but I know a little more discussion than a blanket "take this now" would have been nice.

Me and alcohol. Sigh. Before my dx, I loved alcohol and I know I could love it again. When I was diagnosed, I stopped drinking. I don't know why - I just did. Now I have a drink only on very rare occasions - months can go by. I won't say I'll never have a drink again because I will if I want to. I usually don't want to. Went to lunch yesterday with 2 friends who each ordered a cocktail. I had iced tea. I didn't want a cocktail, but if I did, I'd have had one. It's quite interesting when you don't drink to observe how much others do. Never noticed before.

So much thought is now being aimed at things like "managing our terrain" (Dr. Servan-Schriver) and making the cancer neighborhood less hospitable (Dr. Susan Love). Whether the pendulum shifts back again or not, the suggestions are basically a healthy lifestyle and that just makes sense overall.

I don't think we're boring, Eileen. I think we're a hoot. Thanks for the information.

Suzanne

MAJW
Posts: 2515
Joined: May 2009

Interesting that this only applies to estrogen driven bc.... So I guess I could drink my self stupid since I'm triple negative....lol
I've never been a drinker...an occasional bloody Mary....and I do mean occasional....but my last visit this week with my onc PA she asked me if I liked wine....no I don't....she's trying to see what could put weight on me...I said I did like an occasional bloody mary... She said I could have one only not the day before , day of and day after chemo...I'd rather drink V-8 juice which I guzzle it!

So, again, this seems only to apply to estrogen driven bc...and the chance of a cause of it...great article! Thanks CC..

Hugs, Nancy

missrenee's picture
missrenee
Posts: 2137
Joined: Apr 2010

I have to be honest, though, it makes me a little sad to read this. I do, indeed, enjoy my wine and an occasional lemon drop martini. However, I've been seeing more and more of this evidence in the research coming through. Quite frankly, it's making having alcohol a little less fun for me now. I try never to take anti-anxiety meds, but I do admit--a nice glass of wine did help me calm down at times of stress. However, after much thought, reading results from several studies and now after reading your post, I've pretty much decided to give up alcohol. I don't know if it will be completely--I may still have that occasional drink to celebrate whatever if I want it, but what you wrote really hit home to me.

Thank you for enlightening us.

Hugs, Renee

CypressCynthia's picture
CypressCynthia
Posts: 4011
Joined: Oct 2009

I am always shocked by the number of non-compliant warriors here. My attitude has always been that I know my meds will have an adverse effect, but I will manage them. Maybe it is my nursing background, because 1) I have learned there are many ways to manage side effects and 2) I have seen patients in the last stages of cancer. Cancer is the very worst adverse effect.

Unless the adverse effect is catastrophic, I will not whine (well maybe not too much ;-)) about weight gain, fatigue, joint pain, etc. I will persevere and go at least another 25 years with this dreaded disease--that will make me 83 years old :-). Because I am truly blessed in having an ER+ tumor responsive to treatment.

rallendorfer
Posts: 245
Joined: May 2012

The infusion room is so cold. There were a few hand-made afghans on the counter with a note that anyone who wanted one could have it. I finally asked for one the last time (but there weren't any left) not because the hospital didn't have blankets, but because I just wanted to feel like I had a warm hug of love around my shoulders during that terrible ordeal. I just couldn't imagine a more appreciated gift than those blankets that you give away. It comforts the sick that someone cares and they hold onto it like a life saver!

Rebecca

CypressCynthia's picture
CypressCynthia
Posts: 4011
Joined: Oct 2009

Rebecca, I felt the same way. There were times when I was so very cold! One day, an adorable older lady with leukemia came into the infusion center with (I kid you not) a fleece blanket, a pillow, headphones and a DVD player with a chick film ;-). I admired the fleece and thought what a great idea it was.

Then, I came back home and googled no sew fleece and found an instructional video on youtube. One of the kindreds here suggested that I call them "Warm Fuzzies." Now, I make about (not counting but guessing) 20 blankets a month. Finding fleece on sale has become a scavenger hunt--kind of fun.

And I try hard to send good thoughts and love while I am making a blanket, because I want every patient to feel that hug!

Thank you so much for the kind words. It really keeps me going! There are times it all feels a little monotonous and then I hear from a sweet person like you :-).

MsGebby's picture
MsGebby
Posts: 659
Joined: Oct 2011

There goes my summer! Holy hops Batman!!!

I am a social drinker. Summers more so than any other time of the year. (well, the holidays are tempting too) This article is a kick in the teeth.

With all the other mouth watering goods I can't have, I am destined to be a "water only" person. DAYUM.

Big sigh ... but thanks for the 4 1 1

xoxo
Mary

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