December 2009


Science giveth and science taketh away. Just when I was starting to feel downright giddy about my diet, another study comes along and rains on my parade. I’d be a hypocrite if I only raved about the good news, so here’s my bad news for the week.

Researchers at Kaiser Permanente in California found that drinking alcohol may increase the risk of cancer recurrence in breast cancer survivors. More specifically, women who drank 3 to 4 servings of alcohol a week—roughly 3 to 4 glasses of wine—were 34 percent more likely to have another bout of breast cancer than women who drank little to no alcohol. My personal silver-lining is that the greatest risk was among post-menopausal, overweight women; neither one of which describes me (yet). But I feel as though I’d be tempting fate not to take this news seriously.

To be honest, this finding is less than shocking. Drinking has long been known to increase a woman’s risk of breast cancer because alcohol is estrogenic, meaning it increases the circulating levels of estrogen in the body, and estrogen—as we’ve discussed—is to breast cancer cells what Miracle Gro is to anemic backyard tomatoes. But the gap between knowing this information and its practical application is Grand Canyon-esque.

I’ve known about the link between breast cancer and alcohol for years but, at least before my diagnosis, I chose to look the other way. Like any self-respecting health writer I focused on research that supported my favorite indulgences, such as the stack of studies showing that wine is good for the heart. Since my family history is riddled with heart disease but has (had) nary a wisp of breast cancer, I easily rationalized a few glasses of wine a week. Heck, wine was practically a health food in my book.

That said, I was hardly a heavy drinker. I’d sip a glass of wine while I cooked, which was a couple of nights a week, plus drink a glass or two with friends on weekends. Although my weekly wine tally didn’t seem like much, it easily added up to 3 or 4 glasses a week—the same amount that showed negative consequences in the study above.

I swore off wine after being diagnosed with breast cancer. But, after six months of depriving myself of all of my favorite foods and food rituals (like drinking a little wine while cooking), I realized that living in fear of my favorite foods and beverages is downright depressing. So, in the past month or two, I’ve eased up a bit. Part of that has meant a return to wine, albeit less than I drank before. Although I’m not one to shift dietary course on the winds of a single study, this news does make me rethink my relationship with alcohol. While I don’t want to be a teetotaler, I might need to make wine more of a special-occasion treat. Sigh.

Soy Reprieve?

In the wake of my breast cancer diagnosis, I took a long, hard look at my diet. I stared down the contents of my refrigerator the way a crime victim glares at a line-up of possible perps. I wanted justice. I wanted revenge. I wanted to guarantee this wouldn’t happen to me again. (All the time knowing there are no guarantees.) Still, out went cheese, yogurt, and wheat (mostly). In came raw nuts, rice milk, and a staggering amount of fruits and vegetables. But one of the hardest transitions was saying goodbye to soy. I hung on with desperation, like a child hanging on to the last threads of her favorite blankie.

Eating soy meant I could still order a latte at Starbucks and—somehow—feel like I still had a toehold in the land of “foods normal people eat.” Saying yes to soy meant I could still indulge in things like eggless-egg salad and stir-fried tofu. But, after looking at the scientific research, I wasn’t convinced the natural phytoestrogens in soy wouldn’t ratchet up my body’s estrogen load. And, since I was going to the trouble of taking Tamoxifen to block the estrogen in my body, why possibly add to it?

My oncologist was no help, but, at least, he was honest. “We really don’t know if soy is helpful or harmful for breast cancer patients,” he said. Then he followed up with the mantra “in moderation it’s probably fine.” But “probably” was a far cry from the certainty I craved and when another health care professional questioned my continued intake of soy (saying something along the lines of “why play with fire?”) I decided he had a point. Maybe it was fine but what if it wasn’t? So, I said sayonara to soy foods.

But today I saw some news that made my shriveled taste buds perk up in hopes they may once again know the joys of soy. A study published in this week’s issue of the Journal of the American Medical Association found a higher intake of soy foods was associated with a lower risk of death and breast cancer recurrence among breast cancer patients in China. Researchers enrolled more than 5,000 breast cancer survivors (a nice big number) and followed them for nearly four years (not a decade or more, which would have been nice, but a solid length of time). Interviewers asked them detailed questions about their diet and closely tracked the amount of tofu, soy milk, and other soy foods the women ate. In the end, they found that soy intake was inversely associated with mortality and recurrences in the group. Meaning, the more soy the women ate (up to 11 grams a day), the lower their odds of dying or having a breast cancer relapse.

So, what about those plant estrogens? The scientists are placing their bets on the anti-estrogenic theory of soy. In other words, that plant estrogens directly compete with the body’s own estrogens for cellular parking spaces. When a plant estrogen glides into a parking space, other estrogens are forced to keep circling. Eventually, the game of musical chairs ends and the estrogen (now dizzy from driving in circles) is booted from the body. As far as we know, beyond being parking-space hogs, plant estrogens don’t continue to impersonate “real” estrogen and, therefore, they subtract rather than add to the body’s estrogen load. At least, that’s the theory this group is espousing. While this notion isn’t new to me, it’s nice to see some new scientific oomph behind it.

Of course I would be remiss in my duties as a medical writer if I ever suggested one should make a dietary change based on a single study. And, no, you won’t find me bingeing on tofu and washing it down with great gulps of soy milk. But I may just indulge in the occasional soy latte. (After all, who can afford them more than occasionally?) So, thank you to scientists who keep exploring the hinderlands of breast cancer research, and Starbucks here I come…

Finally…Connecting the Dots

Well, my stint as a professional blogger for Time Magazine is ancient history. Ironically, instead of giving me a burning desire to blog,  it turned me off of blogging for awhile. Not in any theoretical sense, I was just bone tired of cranking out words. Even last month’s mammogram mayhem wasn’t enough to draw me out of my anti-blogging funk. (Maybe because I had so much to say…I just couldn’t begin to distill it down.)

But today is different. Today I want to shout from the rooftops about a recently published article in the New York Times. An article that made me want to jump up and say “Hallelujah!” The op-ed, titled “Cancer from the Kitchen” and written by Nicholas Kristof, is about the connection between chemicals in the environment and breast cancer. Long before I was diagnosed with breast cancer I was frustrated by the lack of attention given to environmental toxins and their role in cancer. Since my diagnosis, my low-grade irritation transformed into a red-hot annoyance. So I was thrilled to see someone at the NYT discussing the subject.

In a nutshell: it’s the estrogen stupid. Scientists have long known that a woman’s lifetime exposure to estrogen is directly linked to her risk of breast cancer. The more estrogen percolating through her bloodstream, the higher her risk of breast cancer creeps. That’s because estrogen fuels rapid cell division in breast tissue and cancer is a disease of rapid cell production.

But what scientists are only now beginning to understand (insert sound of forehead smacking here) is just how much environmental estrogen is contributing to breast cancer rates. More than 80,000 new chemicals have been developed since World War II, states Kristof, but “even of the major chemicals, fewer than 20 percent have been tested for toxicity.” And, since 1975, a woman’s risk of breast cancer has gone from 1 in 100 to 12 in 100.

Many of these chemicals act like estrogen in the human body, meaning they are estrogenic. These substances aren’t esoteric agents handled by people in biohazard gear, these chemicals are in our homes, more specifically they are in our pantries and in our medicine cabinets. They hide in plain sight in our detergents, our perfumes, our make-up, and our plastics. Estrogen swims in the food we eat and the lotion we slather onto our skin. Over the years I’ve written about this topic at length for Health Magazine, Yoga Journal, and others. In doing so, I’ve interviewed some of the top endocrinologists in the country. They’ve been sounding the alarm bells but no one seems to be listening.

Earlier this year a 10-year-old girl in California was diagnosed with breast cancer. (Here’s a link to her blog.) Makes you wonder how bad things will need to get before more people get red hot and insist on a change.