Donít Drink Up

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In the past having a glass of wine or a cocktail every evening was a ritual that alleviated stress, provided a bridge from work to home or simply gave you pleasure.

As you recover from breast cancer you may look forward to that nightly drink as part of your return to normal life.
That’s not in your best health interests, say cancer experts who recommend reducing your alcohol intake to lower your risk of breast cancer recurrence.

Instead learn what the experts consider acceptable levels of consumption, develop strategies for getting to that point and otherwise take steps to improve your health.
If it’s hard for you to imagine doing without an alcoholic refresher, you’re not alone.

“Some people have been habitually having a glass of wine every night for a decade or two. It’s difficult to comprehend why they should change their habit,” says Kelly Hogan, registered dietitian, clinical nutrition and wellness manager, Dubin Breast Center, Mount Sinai Hospital, New York City.

Despite the challenge, you can adjust.

An alcoholic drink a day increases breast cancer risk by 5 percent in pre-menopausal women and by 9 percent in post-menopausal women, according to a report from the American Institute for Cancer Research (AICR) and the World Cancer Research Fund.

What about women who are recovering from breast cancer?

The AICR’s 2014 Breast Cancer Survivor Continuous Update report didn’t find enough evidence to link alcohol to recurrence or mortality, but that doesn’t mean there isn’t a link, according to Alice G. Bender, registered dietitian nutritionist, head of nutrition programs, AICR, Washington, D.C.

“It does seem intuitive that if alcohol increases risk for primary breast cancer, it would also increase risk for recurrence, but we just don’t have enough science to say that,” Bender says.

Still, her advice to individuals is to drink less.

“The bottom line is, keeping alcohol intake to less than 1 drink a day for women [if you drink at all], is a good strategy to reduce risk,” Bender says.

Other research has found a connection.

Regularly consuming three to four alcoholic drinks or more a week compared with no drinking was associated with an increased risk of recurrence in post-menopausal and overweight/obese women who were previously diagnosed with early-stage breast cancer, according to a study published in 2010 of close to 2,000 women published in the Journal of Clinical Oncology.

Based on her work Marilyn Kwan, Ph.D. recommends reducing your intake.

“The results of our study support that women previously diagnosed with breast cancer should consider limiting their consumption of alcohol to fewer than three drinks per week,” writes Kwan, researcher on the cancer recurrence study, research scientist with the Division of Research, Kaiser Permanente North California.

Alcohol’s role in cancer recurrence is that it “can possibly influence the risk of primary breast cancer by increasing estrogen metabolism and circulating estrogen levels in pre- and post-menopausal women,” writes Kwan in an email interview.

When it comes to potential risk, Kwan’s research didn’t exempt wine.

However, the link between alcohol and especially wine, and breast cancer recurrence may surprise patients, according to Hogan.

“People can get focused on foods and not what they’re drinking. It’s a balancing act. If you’re having a glass of wine or beer every night it’s something to think about,” she says.

Changing your drinking habits can be a gradual process and one that doesn’t have to lead to total abstinence.

“For many people eliminating alcohol does not fit in with their lifestyle,” writes Dr. Susan K. Boolbol, clinical director, Mount Sinai Health System Cancer Network, Chief, Division of Breast Surgery.

“I prefer to ask patients to decrease their alcohol intake. I find this is a more reasonable approach and works much better,” writes Dr. Boolbol in an email interview.
Dietitians who work with cancer patients can help.

“I generally advise patients to cut back to two glasses a week or less. If it’s a bottle a night, switch to a glass a night,” says Natalie Ledesma, registered dietitian, clinical nutrition specialist, Smith Integrative Oncology and senior dietitian, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, Calif.

You don’t need to pour a standard-size glass of wine to enjoy it.

“If you’re going to drink make the drink smaller. Maybe instead of 5 ounces, cut back to 3 ounces,” Bender says.

Be discriminating in what you drink.

“If you taste something and it’s not fantastic, don’t drink it,” Ledesma says.

At events where everyone is drinking start with a full glass of water or sparkling water before having that first glass of wine, beer or cocktail. Then before a second drink, have another glass of sparkling water, Ledesma says.

You’ll be hydrated and less likely to reach for another drink.

You can also plan ahead for special occasions.
Skip alcohol on six nights and toast the bride with Champagne on the seventh.

Although cancer experts focus on alcohol because it may be easier for patients to manage, you can take other steps as well to enhance your health.

Being obese was associated with breast cancer recurrence in Kwan’s study.

“For some individuals having one glass of wine may not be as big a factor as losing weight if you’re obese,” Ledesma says.

Bender, who advocates for a better diet, recommends you try to avoid weight gain and eat more vegetables and whole grains.

And don’t overlook the value of physical activity.

“Exercise offers all-around health benefits, including cardiovascular benefits as well as stress reduction. Get outside and take a walk or go for a hike. You can’t go wrong,” Kwan writes.

© CTW Features