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ALCOHOL AND CANCER
When you’re used to kicking back with a drink to unwind, choosing to abstain from alcohol isn’t easy. But for some warriors, it’s worth the sacrifice if it means lessening the risk of recurrence.

The commencement of patio season is one of my favorite times of the year. It’s a time where I can reunite with friends and colleagues under a sidewalk awning, sipping on a perfectly prepared margarita or delicious glass of sangria. An awful day at work with an annoying coworker is easily forgotten over wine at a two-for-one happy hour. Sure, every once in a while, you might imbibe a bit too ambitiously, waking up the next morning staring at the open dishwasher you accidentally mistook for the bathroom toilet the night before (reinforcing the adage that beer and wine should never be mixed). And while these mishaps are not frequent, your friends never let you forget any cocktail-induced catastrophes.   

So as I rushed to my doctor’s office for a last-minute appointment on an unseasonably warm February afternoon in 2018, I was pleased to see a few eager patrons already sitting outside and enjoying some frosty brews. Perhaps I would text my friend to meet after my appointment and we could toast to an early spring. But sitting in the doctor’s office, her hands on my right breast feeling what I assumed was a blocked milk duct from breastfeeding, there was no escaping the scared look on her face.  

Three hours after a very expensive cab ride uptown for an emergency mammogram and ultrasound, I was diagnosed with breast cancer. Within weeks, I scheduled a double mastectomy and lymph node biopsy. After surgery, my sister flew to Toronto, where I was living with my husband and one year old son. As she held my hand in the surgeon’s office, we received the results of the final pathology: stage I invasive ductal carcinoma, HER2 and 100 percent estrogen receptor positive. 

The good news was that they caught the cancer before it had spread. 

My sister and I went back to my apartment to celebrate life with some pinot grigio and episodes of “The Golden Girls.” It’d been less than two months since finding the initial lump and this was the first time I felt like I wasn’t holding my breath. I thought more about the appointment, and while I was pleased with the outcome, I wasn’t exactly bursting with relief. According to Breastcancer.org, 30 percent of early stage breast cancer patients are later diagnosed with metastatic breast cancer. The reality was my breast cancer could come back. 

My fears were further compounded a few weeks later when I received the results of my oncotype test. This test analyzes 21 different genes of your tumor sample and gives patients who have had node negative HER2 estrogen receptor positive breast cancer a score out of 100 of how likely the cancer is to recur, assigning a low, intermediate or high score of recurrence. 

Drinking even small amounts of alcohol can increase the risk of developing breast cancer as alcohol raises the level of estrogen in the body.

I began hyperventilating when I learned my number fell well within the intermediate category. I never wanted to get a lower score on anything more in my life. My oncologist was confident that implementing the strongest hormonal protocol for treatment—eliminating as much estrogen from my body as possible—could reduce that risk considerably.

“But Sarah, no patient is ever at a 0 percent risk of recurrence,” my oncologist said. “There is always a chance it could return.” 

Maybe it would, but regardless, I needed to make sure I was doing everything on my end to curb my estrogen production. Our first child was about to turn one and my husband and I were discussing having another via surrogacy. These kiddos were going to need their mama. 

At 115 pounds and 5 feet 5 inches, I was not overweight and exercised daily. I knew I was doing everything I could to limit the growth of estrogen-producing fat cells. My diet was pretty clean and I made sure to be mindful of those French fry trips. 

But the biggest change I made was eliminating all alcohol from my diet. According to Cancer.org, drinking even small amounts of alcohol can increase the risk of developing breast cancer as alcohol raises the level of estrogen in the body. In fact, according to the site, drinking even one alcoholic beverage a day can directly increase your risk of recurrence. 

It was a risk fellow breast cancer survivor Shauna Krajacich was also not interested in taking. In fact, her sobriety was one of the first things we bonded over when meeting at Rethink Breast Cancer, an organization offering support to younger women with breast cancer. “Like many people, alcohol played a big role in how I socialized,” Krajacich says. “I feel like the one thing that health experts seem to universally agree on is the role alcohol plays in cancer and recurrence.”

To my delight, it’s not the cocktails but rather the company around me that I actually enjoy.

Giving up alcohol also forced me to pay more attention to my mental health. I was by no means an alcoholic, but like many 40 year olds, I turned to alcohol as an easy way to unwind with friends and escape stress. Now, I’ve embraced journaling and meditation as coping mechanisms and I am grateful for a good barre workout to decompress during these insane times. 

And what about patio season? Does it have the same allure without the pinot grigio? To my delight, it’s not the cocktails but rather the company around me that I actually enjoy. It’s still fun when sipping a Diet Coke instead of a daiquiri on warm evenings. 

Krajacich also says the joy still remains in alcohol-free outings. “I would have never thought I could have fun at parties sober but I was wrong,” she says. And she too has turned to healthier options for processing life’s laments. “I’ve incorporated meditation, mindfulness, gratitude and Qi Gong practices into my daily routine and I feel like it really helps!” Krajacich adds.

Of course, not everyone agrees with my libation-limiting lifestyle. My mother-in-law still offers me a glass of wine. “Everything in moderation, my dear. One glass won’t kill you,” she’ll say to me. 

Maybe she’s right and maybe I’m overreacting. But while I will always miss that nice little ‘rita buzz on a humid summer day, I’m happy being a teetotaler.  Sitting on a patio with friends, sipping a lemon lime seltzer in a chilled wine glass, is just as good as a midday mimosa. Well, almost.

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