The Elephant in the Room

During my first visit to the oncologist she commented on the distance we were travelling and asked if it was because of the volume of patients at Gosford Hospital. She’d heard it was getting very crowded there and people were having to wait for treatment.

I told her it was really just about finding a great surgeon and then realising it was best to work with a team of people that knew each other and met regularly to discuss my progress. It was also about getting in as fast as I could, but I hadn’t known Gosford was crowded.

Then I asked her about the reason for the overcrowding. Was this some kind of epidemic? Was Gosford a cancer hot spot? If so, why?

She explained that the whole stretch from the North Shore of Sydney to the Central Coast all had very high rates of breast cancer and the issue for Gosford was about population growth exceeding the capacity of the hospital. Most of Sydney has similar population density but they have numerous hospitals and so the load is spread. Gosford only has one hospital servicing a very large area.

So why was the beast cancer rate so high?

I’m a well educated woman, computer literate and serious about looking after my health. I gave up smoking close to a decade ago because of the cancer risk and  I like to think I’m better informed than a lot of people about the importance of what I put in my body. My oncologist’s rather off hand answer surprised me. What was the reason for the high breast cancer rate?

“Well on the North Shore it’s alcohol. I suppose for the Central Coast some of it’s about obesity as well.”

Sorry. What? Alcohol? I came home and googled “alcohol and breast cancer”.

Read it and prepare to be shocked. Brief summary; alcohol is a group 1 carcinogen. That means it’s been proven to cause cancer. No doubt about it. Other group 1 carcinogens include cigarettes and asbestos. And it gets worse. Just four standard drinks a day can DOUBLE your chances of breast cancer. A bottle of wine contains seven standard drinks (yes, I know that when you share one you’d think it was more like four but you’re not pouring a ‘standard’ drink). This means that if you and your partner like to share a bottle of wine over dinner each night you’re close enough to doubling your risk of breast cancer.

I’m always careful about taking statistics too seriously. A lot of what gets hyped in the media is, upon further inspection, just scare mongering. For example, if your chances of getting something are one in one thousand and something ‘doubles your risk’ then you’re still only looking at two chances in a thousand, but the headline makes it sound shocking.

The trouble is that your chances of getting breast cancer are much higher. Here’s the statistics:

“In 2009 the risk of getting breast cancer in women under 85 was one in eight”

I was shocked. How was it possible that I had, along with most of my friends, had been merrily consuming a group 1 carcinogen with no appreciation of the risks?

Australia has famously had a very successful anti-smoking campaign. We have television ads, help lines, easy access to quit smoking products, the strictest labelling laws on the planet, restrictions on smoking in restaurants, theatres, work places and (ironically) bars. These strategies have had a huge impact on the number of smokers and attitudes towards smoking. It’s possible to go to a party or a restaurant and not see anyone leave to have a cigarette. Most of the remaining smokers are fighting to quit. It’s very rare to meet a smoker prepared to defend their addiction.

But pick up a bottle of wine, or any other type of alcohol, and the most you’ll see is a caution to consume it sensibly. Or in moderation. Where’s the warning that it could kill you? It’s not just a risk for breast cancer. It’s a risk for a whole lot of other cancers as well. Check this out:

Why is it that the manufacturers of cigarettes are vilified as ruthlessly profiting from the misery of others but wine makers are seen as well respected members of the agricultural industry and promoters of all things delightfully decadent? Why is there no campaign to inform people about the risks of alcohol and no policies to limit consumption? It’s as dangerous as smoking. Why are both substances treated so differently?

My oncologist gave me some information sheets about the possible effects of chemo and how to manage them. They’re from a place called eviQ that provides information about cancer treatments online. Under the FAQ section in response to the question “Can I still drink alcohol?” they have this to say:

“It is fine to drink 1-2 standard drinks a day with most chemotherapy drugs. In some cases alcohol can interfere with the way some chemotherapy drugs work. Your doctors and nurses giving the treatment will be able to give you specific advice about whether drinking alcohol is safe with your chemotherapy drugs.” What? I wonder if their sheets for lung cancer patients tell them it’s fine to have a few cigarettes.

When I talk to friends about the risks of alcohol it’s clear that most of them don’t want to hear it. I recognise this response. It’s the same one I used to have to giving up smoking.  “It helps me unwind.” “I don’t think I’d enjoy life without it.” “I don’t care about the risks. I might get hit by a bus tomorrow.”

Fair enough.

Life involves risks. You might get hit by a bus. But the chances are tiny. The chances of alcohol giving you cancer, on the other hand, are well known and well documented. But it’s your choice.

The worst thing about learning this information from my perspective is that I don’t have any difficulty not drinking. I lived for five years with an alcoholic and gave it up easily (there’s a whole other blog about co-dependence right there.). I’ve done Dry July a couple of times and I’m always surprised at how many people comment that they couldn’t give up alcohol for a month. It’s not an issue for me.

My grandmother was in the Salvation Army. They don’t drink. I asked her once if I should be worried about my drinking. She told me to give up for one month every year. If I couldn’t then I definitely had a problem and should stop drinking. If I could then I didn’t need it and should stop drinking. I wish I’d taken her advice.

I don’t know if my drinking caused my cancer but it can’t have helped. I’m not going to turn into the resident wet blanket at every social event but I do plan on letting all my friends know, just once, about the risks. Some people have the same reaction as me. They are thankful. They change their behaviour.

If one less person gets cancer because I shared this information it will be worth it.

Alcohol is the elephant in the cancer ward. It’s killing people.

Here ends my rant.


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