E is for Equivalency

I remember my NOLA oncologist, Dr. Gurtler, being very opinionated, forceful, and persuasive about a number of things in regards to my diagnosis and treatment:

  1. She thought I should have reconstruction.
  2. She considered exercise as being extremely important and I was truly impressed with her personal exercise regimen–she walked her talk.
  3. Alcohol is really, really bad for you.

Initially, with the timing of my breast cancer diagnosis while working at a charter school with an ‘at will’ work policy (fearing I would lose my job if I took too much time off of work) and then not wanting to spend all of my teacher’s summer break healing from surgery the following summer, I chose not to do reconstruction and so have disregarded Dr. G’s advice in regards to #1–so far. While my exercise routine my first couple of years post-diagnosis was a little haphazard, I think the addition of ROW and rowing and being apart of such an active community for the past 4 years has gotten me close to what she had in mind in regards to my activity level.

But, alcohol…in particular red wine blends and delicious Pimm’s Cups at NOLA’s Atchafalaya and To Go cups of yummy sangria from Katie’s after an exceptional brunch of crabby eggs Benedict and chargrilled oysters or just the general acceptance of drinking in NOLA. Such a cultural norm and so many saying ‘just a glass’…

I’ve tried to give up drinking or at least cut back, trying to follow Dr. Gurtler’s advice, the past 7+ years, but haven’t really followed through in making any significant changes. I’ve been trying this winter to cut back because of my hypothyroidism diagnosis, but have not had much success.

But no one ever gave me an equivalency that could stop me in my tracks.

Until a blog post 2 week’s ago at Uzma Yunas’ Left Boob Gone Rogue written by her husband, Dheeraj Raina, Alcohol and Breast Cancer-a Link Worth a Look, struck a nerve. He writes:

Most of us know about the cancer-risk of cigarettes but are utterly unaware of the cancer-risk of alcohol. Our liver converts all alcohol we drink, whether beer, wine or hard liquor, to acetaldehyde. Acetaldehyde is a chemical that is a known carcinogen (cancer-causing chemical) in humans. There is no controversy about this among scientists.

How much does alcohol contribute to the incidence of cancer in our society? Drinking alcohol increases the risk of cancers of mouth, throat, larynx (voice box), esophagus (food pipe), colon, rectum, liver, and breast.

Narrowing our focus to only breast cancer — what this blog is about — reveals that every year about 15% of breast cancer cases and deaths are attributed to alcohol. That’s about 35,000 new cases of breast cancer and about 6,000 deaths. As a comparison, between 5-10% of breast cancer cases are due to BRCA mutations.

This is why this study — A comparison of gender-linked population cancer risks between alcohol and tobacco: how many cigarettes are there in a bottle of wine? — is a useful one. It quantifies a little-known risk in terms of a well-known risk.

The study concludes that one bottle of wine per week is associated with an increased absolute lifetime risk of alcohol-related cancers in women, driven by breast cancer, equivalent to the increased absolute cancer risk associated with ten cigarettes per week.

One bottle of wine per week is associated with an increased absolute lifetime risk of alcohol-related cancers in women, driven by breast cancer, equivalent to the increased absolute cancer risk associated with ten cigarettes per week.

And this isn’t even focused on recurrence.

Cigarettes have been forbidden in my world since my Grandpa Baldwin died of lung cancer more than 35 years ago when I was 13. I think if I was ever going to smoke, my parents would have disowned me. My family used my asthma as a reason there would be no smoking at the Cottage or in their homes, and they cheered when states such as California started outlawing smoking in bars & restaurants.

There have been plenty, plenty, plenty of anti-smoking PSAs and commercials over the years which have included the dangers of smoking and its impact on others. We all know that smoking can cause cancer and that second hand smoke can also be really bad for non-smokers. Most realize that putting a stop to your smoking can have nearly immediate gains.

But how much of an emphasis has there been on making sure the public understands the link between cancer & alcohol like they they do with cancer & smoking. I wonder why we don’t?

I’ve had a mastectomy to remove 3 cancerous tumors from my right breast. If my Oncotype test had recommended chemo, I would have done chemo. If the margins had not been clear after my mastectomy, I would have done radiation. I’ve been on Tamoxifen for 7 years now and put up with the side effects and I stay on it because I want to increase my chances of avoiding recurrence. I spent a year getting Lupron Depot shots to stunt estrogen being produced by my body which caused my bones to weaken considerably. In the 7+ years since I was diagnosed, I’ve had more than 50 doctors appointments related to my cancer. I’ve had at least 10 mammograms, 3 breast biopsies and 2 uterine biopsies related to my treatment. That’s a lot of time and energy and $. A lot.

And yet I’ve continued to drink, regularly. I’ve continued to drink because of all the stress of the treatments. I’ve continued to drink because I love red wine. I’ve continued to drink even though my tolerance has changed. I’ve continued to drink because it helps calm me when life gets rocky. I’ve continued to drink because I feel like people like me more in certain situations when I’m drinking. I’ve continued to drink because people tell me it’s ok to do so and that it’s not that big of a deal.

Frankly, the way our culture currently views cigarette smoking is similar to the way you are viewed if you don’t drink. The subtle and not so subtle pressure to drink is real, at least in my world.

Hanging out with my parents? Let’s have a drink. Commiserating over drama at work? Let’s have a drink. Bonding after a good row? Let’s have a drink. Having a good time with friends? Let’s drink.

But the equivalency of 1 bottle of wine to 10 cigarettes is truly disturbing to me considering the regularity of my own drinking. I think of all of the PSA’s showing people whose bodies have been damaged because of smoking and I think of my mastectomy scars and how damaged my body is because of cancer treatment. Talk about an equivalency.

That’s the thing. I think I’m ok with taking Cathy Leman at Dam. Mad. about Breast Cancer’s advice in her post, Links Between Alcohol and Breast Cancer Recurrence: Can Beer and Wine Increase your Risk?  about only drinking on really, really special occasions, but frankly my current regular drinking is too much and is most likely negating things like all of my exercising, and while it kind of sucks to give up something I love a lot (and use too much as a crutch), it’s something I really need to work at letting go of. Yes, I might get hit by a bus at any time (and my Grandma Baldwin’s 1st husband did, so I know it can happen) so why give up something that gives my life pleasure, but then why do anything I’ve done to be healthier? Why have any of my treatments, then? Why exercise?

Puh-leeeze.

So, I think I’ve found the equivalency that will get me to cut back on my drinking dramatically. I’ll follow up with a post in 6 months or so with an update. I’m curious to see if this takes hold.

5 thoughts on “E is for Equivalency

  1. Wow. I never smoked for the same reasons as you…and it is smelly and nasty. But I love alcohol, all kinds. I wish you luck, JoAnn, but wish I did not read this before leaving for Peru tomorrow for spring break (the beer! The pisco sours! Did I mention the huge bottles of beer that I drink at every restaurant while the husband eats non-stop??!) ….then my 50th birthday bar crawl in May….argh!

    • Oh, Kel, I am sooooooo sorry!!!!! You need to link to my family history blog, too, so that you can pick and choose a little more! 🙂 Go enjoy yourself, my dear!!!!! Safe travels! Indulge yourself and celebrate your milestone birthday month with abandon!!!!! xoxoxox

  2. Thanks for the link back. I wish you the best in cutting down or quitting drinking. If my blog post leads to even one woman reducing her exposure to alcohol and its associated risk of breast cancer, it will have been worth it.

  3. Pingback: U is for Upbeat Update | Searching for EMWA

  4. We commend you for trying to cut back! It appears you are doing a good job! Your mother is trying a little but we will see!

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