Staying Alive (and a nice glass of red)
I used to be a smoker. Not an occasional, just at parties kind of smoker but a serious, pack-a-day addict. I enjoyed the way it made me feel. I also enjoyed the way it gave me a legitimate break from work and the opportunity to meet people from all over the organisation I worked for. There was a kind of ‘smokers network’ that knew more about what was happening in the organisation than anyone else.
I stopped close to a decade ago. In my own time. When I was ready. Up until then I sang various versions of the dedicated smoker song:
“I need it to relax. It helps me to calm down.”
“Everyone needs a vice and this is mine.”
“I could give up if I wanted to but I don’t want to.”
“I could get in a car today and die in a car accident. Everything has risks attached to it.”
“Oh statistics! You can use them to prove anything.”
“I’m going to die of something. It may as well be cancer.”
Addiction has fascinated me for a long time. You see a lot of the consequences of addiction when you’re a police officer; young people almost dead from heroin that wake up angry when they’re given the antidote, diabetics with a food addiction that die young as a consequence of chronic obesity, gamblers that steal from the people that love them in order to support their habit. It seems to me that a propensity for addiction is part of being human.
It’s also similar to the kind of thinking you see behind a lot of criminal activity. People know the dangers and the risks but do something anyway.
Interesting that when you ask people to define addiction they often use the word ‘compulsion’, or some other description that defines the behaviour as being beyond control. I’m never sure about this. I suspect we like to think of our addictions as beyond our control because it gives us an excuse not to deal with them. For me, a big part of giving up smoking involved recognising an obvious truth; I cannot smoke unless I put a cigarette in my mouth and light it. I may feel a very strong urge to do so but ultimately I must make a decision. To smoke or not to smoke.
Eventually I confronted the horrible truth. Smoking was bad for me. It carried with it a serious risk of developing any of a number of cancers as well as a bucket of other illnesses. If I really did need it to relax then I probably needed to take a long, hard look at why my life was so stressful and what I was going to do, other than smoking, to deal with that stress.
It was true that I might die in a car accident but there was a flaw with this analogy. A car provides all kinds of real benefits. At the time it allowed me to travel to work and earn a living as well as giving me the convenience to shop, travel and enjoy the company of my friends. The risks of an accident were minimal and when weighed against the benefits of car travel I was prepared to accept those risks. The same was not true of cigarettes.
The statistics argument didn’t take long to destroy. It’s true that statistics can be misleading. If you only have a one in a million chance of getting lung cancer and smoking doubles your risk then that’s still only two chances in a million. Had the odds been that long I might have kept smoking. Of course the evidence against smoking is far more damning for so many types of cancer. It’s considered a group one carcinogen. That means it’s been proven to significantly increase your risk of cancers. No question. And as to choosing a way to die, I think just about anything would be better than dying from cancer.
When I stopped smoking I also made a number of other changes. I improved my diet, increased the amount of exercise I was getting and learnt meditation to relax my mind. I read several books on the psychology of happiness and practiced some of the methods they recommended. Life was good. I was fit and healthy and taking better care of myself than most people. Then I got cancer.
I read this recently in a book written to help women with early breast cancer: “..the general medical opinion is that there is no known cause of breast cancer. It’s not one of the ‘lifestyle cancers’ like those that result from smoking of sun exposure…” (One Piece of Advice, Yvonne Hughes)
Wait a minute. What? Not a lifestyle cancer?
I’m pretty sure that there’s no cancer on earth that isn’t influenced, to some extent, by lifestyle. When I asked my oncologist why there was so much breast cancer around these days she didn’t hesitate. “Alcohol. Certainly here, around the north shore. The Central Coast also has issues with obesity, but mostly it’s alcohol related.”
Wait a minute. Alcohol increases the risk of cancer? Since when? That can’t be right. Surely there would be warnings on the bottles just like there are warnings on cigarette packets.
I spent several hours researching alcohol and cancer. It turns out that alcohol IS a group one carcinogen, just like cigarettes. If you google ‘alcohol and cancer’ and ‘alcohol and breast cancer’ you’ll find all of the evidence you need. Here’s a few choice samples:
“The International Agency for Research on Cancer (Centre International de Recherche sur le Cancer) of the World Health Organization has classified alcohol as a Group 1 carcinogen. Its evaluation states, “There is sufficient evidence for the carcinogenicity of alcoholic beverages in humans. …Alcoholic beverages are carcinogenic to humans (Group 1).”[14]“
There’s no ‘may be’ here. This stuff is toxic. Alcohol causes cancer. Then there’s this:
“A woman drinking an average of two units of alcohol per day has 8% higher of developing breast cancer than a woman who drinks an average of one unit of alcohol per day. A study of more than 1,280,000 middle-aged British women concluded that for every additional drink regularly consumed per day, the incidence of breast cancer increases by 1.1%. Approximately 6% (between 3.2% and 8.8%) of breast cancers reported in the UK each year could be prevented if drinking was reduced to a very low level (i.e. less than 1 unit/week).
Among women, breast cancer comprises 60% of alcohol-attributable cancers.“
Okay, two units of alcohol a day is about what most people call one home-poured glass of wine. Some genius in the wine industry managed to get a standard drink classified as 100mls. I don’t know anyone that pours themselves a 100ml serve of wine. 8% might not seem like much of an increase unless you figure in the general risks of getting breast cancer. That’s currently around one chance in ten. Ouch.
If you didn’t like that you’re going to hate this:
“A study of 17,647 nurses found that high drinking levels more than doubled risk of breast cancer with 2% increase risk for each additional drink per week consumed. Binge drinking of 4–5 drinks increases the risk by 55%.“
Wait…..binge drinking is four to five drinks? That’s not even a whole bottle of wine. (A bottle is generally seven and a half standard drinks by the way. Most people think it’s about four.)
But haven’t they proven that red wine is actually good for you? Well, sadly no. In fact the research that’s used to promote red wine involved one compound extracted from the skin of red grapes that was tested in vitro. They didn’t even use wine. Just something from a grape skin. And in vitro proves nothing. It just provides a good starting point for other research. And even if this research pans out it will prove the benefits of red grapes, not red wine. Eat all the grapes you want.
The short version; there is no safe level of alcohol consumption. If you doubt me, do your own research.
Let’s get back to addiction. I think the definition that works for me, when getting my head around addiction, is this one:
Addiction is the continued repetition of a behavior despite adverse consequences. Classic hallmarks of addiction include impaired control over substances or behavior, preoccupation with substance or behavior, continued use despite consequences, and denial. Habits and patterns associated with addiction are typically characterized by immediate gratification (short-term reward), coupled with delayed deleterious effects (long-term costs).
So here’s my problem. Given what I know about alcohol I feel I cannot continue to drink. It’s a group one carcinogen.
Even if I hadn’t already had cancer, this information should be enough to make we want to stop drinking. It was enough to make me stop smoking.
The popular advice is that it’s fine to have a couple of drinks a few times a week but here’s my acid test; if instead of breast cancer I’d had lung cancer would you be okay with me having a couple of cigarettes a few times a week? Or would you consider that to be stupid, self destructive behaviour?
What’s fascinating is the resistance I get when I talk about alcohol and cancer. Guess what people say:
“I need it to relax. It helps me to calm down.”
“Everyone needs a vice and this is mine.”
“I could give up if I wanted to but I don’t want to.”
“I could get in a car today and die in a car accident. Everything has risks attached to it.”
“Oh statistics! You can use them to prove anything.”
“I’m going to die of something. It may as well be cancer.”
In some cases, the people making these statements are the doctors and health professionals that are treating me. They all have their own excuses for why they still drink. It reminds me of the data around health professionals and smoking back when they first tried to ban it in public hospitals.
What interesting animals we are. Knowledge on its own will not change our behaviour, even when that knowledge warns us that something is very dangerous. We have an extraordinary capacity for denial, for redefining our own circumstances as ‘special’ or exceptional or just pretending not to know better. If knowledge were sufficient to change behaviour then nobody would smoke.
And nobody would drink alcohol.
But I’m guessing that if you are already a drinker then nothing I can write here will make you stop. It’s okay. I’m not on a campaign. I’m really just fascinated by how this relates to my recovery and my survival chances.
I gave up drinking a week ago. Unlike smoking, this wasn’t very difficult. I’ve previously given up alcohol when I was pregnant and breast feeding for 18 months. I also gave it up for three years when I was in a relationship with an alcoholic (although his therapist warned me that this was codependent behaviour). I’ve always enjoyed drinking and used to have a reputation for being able to drink fellow police officers under the table. Not my finest achievement.
Having concluded my research on alcohol I showed my husband a page of information that summarised the cancer risks. It’s not just a risk for breast cancer but for several different cancers, including cancers of the mouth, liver, stomach, colon, rectum and lung. It’s not just large quantities of alcohol that increase your risk, but low to moderate amounts. The only reason various cancer organisations have issued drinking guidelines is because they accept that most people will continue to drink, but read their actual position statements and it’s pretty clear that there is no safe level of consumption. When Graham had finished reading the summary I asked him this:
“Do you think I should give up drinking.”
His answer was “Having read this, I don’t think anyone should drink. You should stop. I should stop.”
I didn’t ask Graham to stop drinking. (I understand codependence now)
Still, he’s decided to only drink very occasionally. He’ll probably still have the odd glass with friends over a meal. Or he might just stop. Certainly he hasn’t had anything to drink for the last week.
For me, a big part of the decision was influenced by how I will feel if the cancer comes back. If I haven’t done everything I can reasonably do to prevent recurrence then how will I feel? Surely there will be a part of me wondering if avoiding alcohol could have prevented another bout. It’s not a situation I want to be in.
My first thought when I read about the dangers of alcohol was, “I could stop drinking any time.” My second thought was, “What’s wrong with right now?” It’s possible my drinking has already cause permanent damage to my body. That’s not a reason to compound the problem. Even a couple of drinks a week can increase my cancer risk and I don’t NEED to drink.
I also find it hard to dance around the addiction issue; if I continue with a behaviour that I know to have adverse consequences then, by definition, I am an addict. That’s just the cold, hard truth of it.
Now observe your own reaction to that statement for a minute.
Or just pour yourself a nice glass of red and ignore me.
May as well have a cigarette while you’re at it.
(reblogged from positive3neg.wodpress.com : My blog about staying positive after my diagnosis with triple negative breast cancer)
Comments
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Interesting that we debate all sorts of things from what to eat or not eat, what creams and lotions are best, whether to dye our hair or not but many still choose to drink alcohol when it is an identified risk factor! It is an easy choice for me, definitely no alcohol. Deanne xx0
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Interesting that we debate all sorts of things from what to eat or not eat, what creams and lotions are best, whether to dye our hair or not but many still choose to drink alcohol when it is an identified risk factor! It is an easy choice for me, definitely no alcohol. Deanne xx0
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Your blog is very thought provoking!. I am not a smoker, but do enjoy a glass of wine...(.or 2), three or four times a week.
Can I give that up? I dont know... but this will certainly make me think about it seriously. Thanks
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I think you are absolutely right. I have always been a drinker - a binge drinker in my teens and early twenties then I settled into a life of drinking 4-5 glasses of wine most evenings by my late 20s. Had a break in my early thirties for my 3 pregnancies and breast feeding but went back to it soon after that. I did cut back a bit when I hit 40 (from drinking 6 days a week to 3) but it is only in the last year of so that I've reached pretty much the same conclusion you have.
When I was diagnosed with my cancer two years ago at 46 I had heard about the breast cancer risk (it was my main reason for cutting back when I turned 40) and one of my first thoughts was "I've brought this on myself by drinking so much."
So when I decided to fess up to my oncologist I was expecting a bit of a lecture and a stern warning to cut right back or even stop (I knew I'd still been drinking too much). So I was quite taken aback when she said "Don't beat yourself up about it, the link between breast cancer and alcohol is actually quite weak". Yes, she really did say exactly that!
At the time I thought "Great, I can keep drinking." but since then I have on several occasions trawled the web on this subject myself and almost everything I have read supports the conclusion of a strong link between alcohol and breast cancer and that there are really no "safe" limits particularly for estrogen positive breast cancer like mine. One site described drinking alcohol when you've had estrogen positive breast cancer as like throwing gasoline on a fire! Scary.
I don't know why my oncologist said what she said. Maybe she was trying to be kind and make me feel better or maybe she likes a drink herself and has downplayed the risk in her own mind. Whatever the reason, I have decided that I need to disregard her comment on this issue.
But of coursse it's not an easy thing to give up alcohol after decades of heavy drinking, particularly when we live in a culture that is so focussed on alcohol as part of every occasion and celebration. I admit I have struggled with it and am still struggling with it.
What has helped me enormously - and I would highly recommend it to anyone reading this who might want to cut down or stop drinking - is the website Hello Sunday Morning. I first heard about it when I read Jill Stark's book about heavy drinking called High Sobriety. (Also well worth a read.) The website is a basically an online forum for people trying to cut back or stop drinking. You blog about how you're going (anonymously) and others comment and support you.
Participating on this site helped me reduce my drinking from 3 days a week to about once a fortnight initially. I then tried to cut back to only drinking on special occasions and now I'm about one month into a 3 month HSM as they call it - or period of total abstinance. It is getting easier but I do still struggle with this.
I think given the eveidence I probably should give up completely, for ever. But that is a hard thing for me to get my head around at the moment (yes. I suppose I must be an addict). So I am working towards it in steps. I'll get through this three month period first then see where I go from there. If I do continue to drink I know it needs to be very sparingly and very occasionally. Ideally though, you are right. We shouldn't drink at all.
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What a great post and thank you for being so honest. I only very occassionaly get the urge to drink and I overcome it easily by having lime and soda and remembering why I don't drink. Part of my frustration around this issue is how easy it is for me NOT to drink. I could have stopped years ago.
I have lived with someone that battled a serious alcohol addiction and I saw what he went through. I also went along to AA meetings with him to find out about their program and I can highly recommend it. In particular, the idea of dealing with it 'one day at a time' was hugely beneficial.
Thank you for the advice about the web site. That sounds like a great idea too.
I think that of all the various drugs, alcohol is the most incidious. Good luck with your continuing good health.0 -
Thanks so much for your comments. I'm so glad you enjoy reading my posts.
I know what you mean about all the cosmetics. I also worry about the insecticides and herbicides that so many people spray around and how you can't stop a lot of that from being carried on to your own property. Then you can also add in home cleaning products and all the rubbish in processed foods!
I know everyone makes choices and compromises. We weigh the risks associated with something against the benefits and for a lot of people the very small risk associated with hair dye and cosmetics doesn't worry them. I also know a lot of people will consider the high risks assoicated with alcohol and choose to keep drinking anyway. I do think we need to have much better education about the risks associated with alcohol, particularly for younger women. Most of them will never smoke, thanks to great public education. The same isn't true for alcohol, in spite of the Cancer Council's very clear recommendations.0 -
I agree. Hooray for chocolate!
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But isn't it about reducing the risk by doing what we can to help our bodies? Reducing our exposure to harmful chemicals, pesticides, alcohol, etc is better than not doing this. Keeping our bodies as healthy as possible by eating nutritious food and exercising also adds more to the positive side.
For many of us we just have to hope that the benefits of taking tamoxifen out weigh the negatives. I know statistics are not always helpful but for my situation the Tamoxifen improves my chance of not having a recurrence in the next 10 years from around 50% up to 80%. So I do everything I can to reduce my exposure to other carcinogens and hope for the best! Deanne xxx0 -
I agree, Deanne. The evidence is very clear for Tamoxifen. While it IS classified as a carcinogen the evidence for it reducing the recurrence of breast cancer is overwhelming.
Unfortunately I have triple negative breast cancer so my only treatment options are chemo, radiaton and surgery. If Tamoxifen worked on this type of cancer I'd be taking it.
I think you make a great point about reducing our risks. Every little bit helps. And why not reduce toxins in our lives, and the lives of those we love, anyway?0 -
Hi, Very sobering! Pardon the pun!
I have been drinking wine about once a week since my teens ,but know that it is classed as a binge as my husband and I would have a bottle each- all the usual reasons- stress, fun etc.
I have been thinking about this too. I would be sad to give this time we have up but I guess there are other ways that we need to connect instead.
I have now had a double mastectomy and wonder if that makes drinking safer?- hopefully yes, probably not??
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I wish I could give you good news but alcohol causes all kinds of cancers, not just breast cancer, so the mastectomy won't offer you any protection. My husband and I used to drink wine together too. We've replaced it with lime and soda (we even bought a soda stream!) or really nice tea. We've also found other ways to spend time together including cooking together (home made pasta anyone) and spending more time being intimate. Giving up wine doesn't have to be a loss. I hope that, like me, you find some really great alternatives. X
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Hi
Saw a mock tail recipe you might like. Ginger beer, lemon juice and mint. Tried it and liked it. Like a mojito without the rum.
Cheers
Deb0 -
It sounds good to me! Thanks for the tip. Lime juice and soda in a wine glass is good too! Michelle xx
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I find it's easier and easier to just have iced water at restaurants. My weak point is a friend's BBQ where the other ladies are all sharing bottles of bubbles.
My doctor said the occasional glass of wine is not going to hurt. I figure if there a really nice wine on offer I might have a small glass, really enjoy it and then revert to ginger beer and water.
Though having said that, I find that my tastes have changed and I am thinking less and less about having a glass of wine or spirits. Subconciously looking after my heath or was I just in the habit of having a drink when going out to dinner or with friends?
What do others think?
Deb
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Hi Deb
I used to enjoy a few glasses of wine but had actually abstained for a few months before being diagnosed because I was trying to choose a healthier lifestyle (maybe I should have done this a little earlier!).
I finished my treatment in November last year and had a glass of bubbly on Christmas Day. I did not enjoy it at all and find my taste buds have changed. I eat a very healthy diet and find I do not crave half the unhealthy things (sweet) that I used to. If I eat any rich desserts etc I can actually feel a bit ill. My favourite drink for special occasions is now a glass of soda water with a slice of fresh lime and ice. Everything else is just too sweet!
Habits can definitely be changed and BC has changed a lot of mine for the better.
Take care.
Deanne xxx0
