Why I have quit drinking

In My Humble Opinion
41

My understanding is no, at least for the marker of family history of ovarian cancer.

One source puts our op with Ashkenazi heritage and a mother with ovarian cancer at “moderate risk” - meaning a one in ten lifetime chance. They’d advise genetic counseling to check for the the BRCA, BRCA2, MLH1, MSH2 or MSH6 genes. Mind you ovarian cancer risk is NOT increased with alcohol intake (pancreatic cancer risk is).

She can also take a pancreatic cancer risk assessment test. Answering as her and assuming no risk factors other than specified I got her at elevated risk there. But per this guideline not high enough to warrant being in a screening program (would need two relatives with pancreatic cancer, one of whom was first degree) unless genetic counseling uncovered a gene of risk significance.

If it was me I’d get a referral to a genetic counselor.

42

Humans, (including me!) are really bad at assessing risk for things, especially ones that have a degree of randomness.

Case in point. Shortly after the Fukushima nuclear incident, we decided to take our very young kids down to Taiwan from Tokyo, where we were living at the time.

My wife and I returned to Japan first. On the way to the airport we were discussing the possible risks and my wife was adamant that we should take absolutely no risk, no matter how small, from radiation for our children. During this discussion, the kids (age two and age 5 months) were in the backseat being held on laps because grandpa’s tiny car was too small for child seats.

I completely agree with the first statement, and another way of saying the second one is that “it’s as correct to drink moderately as to not drink.”

43

That’s why we are so lucky modern science and medical research gives us tools and knowledge to make informed decisions.

There is no correct and incorrect when it comes to drinking alcohol. You either accept the risk of consuming a known carcinogen, or not.

44

Well, and also because we tried prohibition and it was a complete and utter failure.

The part where the government tried to inflict drug prohibition on the masses, only to see a repeat of the societal messm, is the part where the government is tacitly supporting supporting public risk.

45

They weren’t trying based on healthcare or scientific reasons, either.

46

Also equally phrased that you either accept a behavior associated with living longer with less risk of disabilty, or not. Not a big impact either way though really.
TokyoBayer is of course correct, as BeenJammin’s lack of understanding what the science tells us about the risks (and benefits) illustrates.

We see it all the time. The most attention is paid to trying to control the risks that are relatively small but pretty much not in our control, while more significant risks that are fairly easily within our power to do something meaningful about are not paid much attention to. Part of the human condition I guess. When we have little to no control we desire even the illusion of it all the more.
Again, RivkahChaya, with your family history it might not be a bad idea for you to see a genetic counselor. The biggest reason that those two cancers (ovarian and pancreatic) are such bad news is that usually they are not detected until pretty late in the game. No symptoms. Screening everyone is not advisable, it is a reasonably big deal. But IF you have one of the genetic high risk markers, which is reasonable to suspect in your case, then screening regularly to detect something early would be worth it, and detecting those cancers early is all the difference in the world. Usually that early detection is just by chance (see Ruth Bader Ginsberg) but one at high risk can stack the deck in their favor.

47

I had fibroids removed recently, and I tried for over a year to get my doctor to do a hysterectomy instead of just removing the fibroids. I said my mother died of ovarian cancer, and my mother and maternal grandmother both had hysterectomies for fibroids. It isn’t the standard treatment anymore, though, and I don’t have the BRCA gene, which is the one that allows for prophylactic mastectomies. They might have done a prophylactic hysterectomy/oophorectomy with my mother’s history IF I had had the BRCA gene. But no such luck. Fibroids apparently have no association with cancer. If I had had polyps, they would have done it, but they didn’t see a single polyp when they did the fibroid removal. They did a thorough visual inspection, is what I was told, and didn’t see any pre-cancerous signs.

I’m kind of pissed about it, because I still have periods (even after the surgery-- they said it might jump-start menopause, but no luck). I’m 51, and my periods are as regular as a Swiss watch. No menopausal symptoms whatsoever. I thought maybe I had a hot flash at work last winter, then one of the young women started complaining that the heat was turned up too high.

June made it officially 40 years of periods. Not that I’m counting, or anything.

48

They might not have made the connection with cancer but the temperance movement was aware that reducing alcoholism was highly desirable component of healthcare. The prohibitionists were also part of the recognition that alcoholism is a disease, not simply a moral failure.

They didn’t understand all the mechanisms - neither do we, after all - but they certainly believed that it was healthier not to drink. Chalking it all up to religion is a gross simplification.

49

I doubt “they” were all of exactly one mind. There probably were religious moralists who thought the deity didn’t want you to drink; there were probably also people who had had an alcoholic parent, and saw what that could do to families, as well as recovering alcoholics who were either trying to make their own lives easier, or hoping to remove temptation from future generations. There were probably health fanatics who thought that anything slightly indulgent had to be very bad for you (yes, they have been with us for a long time), and probably naive people who didn’t like to drink themselves, and really believed that once it was illegal, people would forget about it in time.

FWIW, I would never think of trying to make alcohol illegal, and I’m also in favor of pot being legal (but I wouldn’t use it), and decriminalizing other kinds of drug use (albeit, with restrictions, exactly like we have for alcohol: employers can tell you you can’t come to work high, you can’t drive under the influence, etc.)

BTW: I expect to be appointed the designated driver regularly in the future, once word gets around. If my social circle won’t be rotating the responsibility, and it will mostly be falling to me, am I out of line to either ask for gas money, or to use someone else’s car? FWIW, DH has a car that has five seatbelts; mine has only 4 (and one is sticking-- I need to take it in). I have a few friends with SUVs or vans that have 7 seatbelts. I’m actually thinking more of rotating cars than asking for gas money, not just to keep things even, but because of the seatbelt issue. Indiana has a “primary stop” law for seatbelts, which means you can be stopped merely because a cop suspects someone isn’t wearing a seatbelt. Some states don’t have “primary stops,” and issue seatbelt tickets only when you are stopped for something else, and the cop notices someone not wearing a seatbelt.

They will even ticket you here for “improper” seatbelt use (and it’s like, $250), which means if you have the shoulder belt under your arm, or behind you (which big-busted women used to do all the time), you can be ticketed.

Also, FWIW, I supported the mandatory seatbelt law when it was proposed; my father witnessed an accident once (he had to give a deposition) where everyone in one car was belted, and walked away, and everyone in the other car wasn’t: the two in the front seat were killed, and the back seat passenger was taken to the hospital with critical injuries. My father was right behind one of the cars, and not belted, but he became fanatical about seatbelts after that. So I was brought up with “always belt.”

I will not start the car until my passengers are buckled in. I don’t care if that makes me seem either nerdy or fanatical.

50

It seems to me that saying she doesn’t know if she’s at higher risk or not misunderstands the concept of risk. If we had perfect information, it wouldn’t be about risk, but about certainty. Risk is based on that lack of knowledge. Risk is about taking the knowledge that is available and calculating the possibilities. That which you don’t know is just the uncertainty level of the risk assessment.

If you can provide ideas to reduce that uncertainty, great. But that doesn’t mean she doesn’t know her current risk based on the information she does have.

51

Really I think she gets it.

Here’s what is known.

Overall, the average person who drinks moderately is at a bit lower risk of premature death or disability. Not completely clear that there is causation of course. The average person who drinks moderately is at lower risk than the average person who is a teetotaller. There is in fact no reason to believe that the average person who currently drinks moderately will lower their risk of premature death or disability by switching to completely abstaining, and some reason to suspect the opposite might be true even if to a very small degree.

But our op is not so worried about death and disability per se but specifically about cancer and like most of us is not “the average person”. She has specific family history and ethnicity that may reflect an increased predisposition to certain cancers - specifically ovarian and pancreatic, and possibly stomach and colorectal cancers. She is also concerned about breast cancer. There is no association between alcohol intake and ovarian cancer, but there is to some of the others of interest to her. In particular there is an association with breast cancer, to the degree that one drink a day may increase breast cancer risk by 7 to 12% (depending on the study). Of course our op was drinking much less than that.

Mind you moderate alcohol intake is associated with decreased risk for a couple of other cancers (renal cell and non-Hodgkin lymphoma).

The impact up or down of her stopping her minimal alcohol intake on specifically her cancer risk? Not enough data to say if going from a drink several times a year to zero does anything. The data for that is not just uncertain, it does not exist. But it is something she can do and doing something about things outside our control helps us feel better. As long as it does not reduce the chances of her doing those behaviors that have greater impact (the nutrition items, the exercise, the avoidance of obesity, the social connectedness, getting appropriate screening, so on …) more power to her.
Please also note, regular drinking in more than moderate amounts, even occasional binge drinking, let alone alcoholism, are without question of major net health harms. Switching from complete abstinence to moderate intake runs some non-zero (albeit uncertain) risk of moving into the heavier drinking group and is not encouraged.

52

I would suggest you reread the part you quoted. I didn’t say what you seem to think I said. I was talking about someone else saying she didn’t know her risk.

53

One thing to consider in general is whether the behavior (in this case, drinking) is linked to the types of cancer the parents had. Breast cancer: definitely (as you noted). Pancreatic: dunno, never read about it. Both my parents died of cancer, though neither is a type I’m prone to: as far as I know there’s no link between father having prostate cancer and daughter having any other sort, and mom’s lung cancer was from 50+ years of smoking (which I don’t do).

So I personally am not inclined to give up the rare drink I have due to a cancer connection - but if I were an occasional smoker (I’m not - never even tempted to try a cigarette) that would be a good incentive to me to do as you have, and quit the mildly risky behavior.

The other behaviors you mention doing (exercise, eating better) will certainly have a more definite effect, and I need to follow your example!