Feminist Philosophers

News feminist philosophers can use

Having a cocktail is such fun; let’s blame breast cancer deaths on it. April 12, 2013

Filed under: ageing,aging,breast cancer — annejjacobson @ 12:37 am

Goodness knows why alcohol got the blame, but it certainly did. A large study based on nurses’ self-reports was a very significant factor in this story.

Alcohol and Risk of Breast Cancer
Steven A. Narod, MD
JAMA. 2011;306(17):1920-1921. doi:10.1001/jama.2011.1589.

In this issue of JAMA, Chen and colleagues1 report findings from the Nurses’ Health Study exploring the relationship between alcohol consumption and breast cancer risk. The authors’ principal findings were that the cumulative amount of alcohol a woman consumes during adulthood is the best predictor of her breast cancer risk and that low levels of alcohol consumption (as few as 3 drinks a week) are associated with an increased risk of breast cancer.

Everyone (it seems) at the large, famous and amazingly effective cancer center, MD Anderson, is extremely anti-alcohol.

But that may not be the whole story. From today’s NY Times:

Alcohol consumption is known to increase the risk for breast cancer. But a new study suggests that moderate drinking has little effect on survival after diagnosis, and may reduce deaths from cardiovascular disease.

Researchers, writing online in The Journal of Clinical Oncology, studied 22,890 women with breast cancer, recording information on alcohol intake before diagnosis and, for a subset of 4,881 of them, after diagnosis as well.

After controlling for age, education, stage of cancer, body mass index, smoking and other factors, they found that breast cancer survival was similar in women who drank alcohol after diagnosis and those who did not. But women who drank moderately before diagnosis — three to six drinks a week — were significantly less likely to die of breast cancer and of cardiovascular disease. Cardiovascular disease, the authors write, is increasingly being recognized as a mortality cause among breast cancer survivors.

There are a lot of questions left unanswered. One is about the difference between risk and death for people not yet diagnosed at age 50.

 

7 Responses to “Having a cocktail is such fun; let’s blame breast cancer deaths on it.”

  1. Phenomenonymous Says:

    I am pretty sure that I am just muddled, but is this a parody of sloppy reasoning? Between “Goodness knows why alcohol got the blame” and the bolded part of the first quote which answers the question and the assertion that MD Anderson is “extremely anti-alcohol,” this has all the markers of parody, but it really does looks serious.

  2. annejjacobson Says:

    Reality can come close to a joke. What I’m describing has actually happened.

    I decided to argue against some MD Anderson doctors about the nurses study. Why are they putting such pressure on cancer victims? The nurses’ study involves self reports. That is surely far from definitive; lots of people underestimate stuff like alcohol consumption. The results of my argument were unpleasant, and I had to put some effort into getting one doctor’s interpretation off my medical record.

  3. Merry Says:

    “…low levels of alcohol consumption (as few as 3 drinks a week) are associated with an increased risk of breast cancer. ”

    “But women who drank moderately before diagnosis — three to six drinks a week — were significantly less likely to die of breast cancer and of cardiovascular disease. Cardiovascular disease, the authors write, is increasingly being recognized as a mortality cause among breast cancer survivors.”

    So, if I’m a moderate drinker, I’m more likely to be diagnosed with breast cancer, but I’m more likely to survive it, because I’m less likely to have a heart attack. Is that the right takeaway from this? It’s confusing.

    Eh, I’m going to drink my wine and have my chocolate, because eventually, I’m still going to die of something.

  4. annejjacobson Says:

    Merry, that’s how I’m reading. BUT we can add that the increase risk from alcohol is, I think, pretty small.

  5. iimnotmrabut Says:

    “Woozles are usually not a simply a matter of authentic misreporting. They also reveal a desire to read into the data an a priori position that is really not there, what Bacon calls “idols of the theatre”. … All the data reporting mistakes I have found in the literature, without exception, were made in the direction of supporting feminist preconceptions.”

    Domestic Violence – Donald G Dutton – Page28 – 2.3 Woozle Effect http://goo.gl/s8zDh

  6. survivor Says:

    I think it’s rather implausible that Chen’s research team studied over 100,000 women and published their results because they wanted to “blame breast cancer deaths” on alcohol consumption, or that they were inspired by the fact that “having a cocktail is such fun.” Nor is everyone at the MD Anderson Center “extremely anti-alcohol,” as this advice page, among many others, attests.

    Wendy Chen is devoting her life to the prevention of cancer, especially breast cancer. Snarky posts that impugn her motives or the motives of the Anderson Center seem highly inappropriate to me.

  7. annejjacobson Says:

    Survivor, thank you for your comment. You have, I fear, made a mistake in taking a familiar and standard jokey approach as somehow making assertions that should be taken literally.

    There are a number of very important ways in which breast cancer treatment in the US tends to be very responsive to cultural factors, and not purely medical ones. I could list several ways in which this shows up at even MD Anderson, which in general I admire a great deal. For example, one psychiatric social worker started a session by telling her client that she was to blame for her cancer, since she had 1-2 glasses of wine a day.

    A radiation oncologist said that any one would find it difficult to stop haviing her wine should go to AA. After an argument about this, she wrote on the client’s chart that the client believed herself to be an alcoholic.

    The standard advice from an array of doctors was that one should never drink alcohol again.

    There is a very big downside to the advice that one avoid alcohol, and that’s what the references to cardiac problems is important.

    In addition, one could worry a lot about the claim in the abstract that alcohol is the best predictor of breast cancer. There seems almost a tradition of leaving out environmental toxins.


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