The Australian study suggests that talking about physical appearance and mental health may be a more effective strategy than focusing on long-term consequences.
“Interestingly enough, we have seen this in other areas,” said Bevers. “Sun exposure, for example. We are more likely to be successful talking about how the sun makes your skin leathery and wrinkly than talking about the far-off risk of skin cancer.”
Bevers doesn’t tell her patients who carry genetic mutations not to drink alcohol.
“But I do make it a point that it increases their risk a little more. They’re already at higher risk, so if they can, they should limit it,” she said.
Bevers said primary care physicians are talking about weight, physical activity, smoking, and excessive alcohol use. But they may not think to counsel a patient who drinks three to five glasses of wine a week.
“I think health organizations should be talking not only about breast cancer risk, but alcohol’s relationship to other diseases, like diabetes. It’s a good educational point,” she said.
As far as his patients go, Sardesai said that timing of these conversations is important. Patients are most receptive to changes at the time of a new diagnosis and immediately following active treatment.
“At OSU, we have incorporated these discussions as a part of our cancer survivorship program, as well as the high-risk breast clinic, to address the impact of alcohol, weight, and physical activity in our patient population,” he explained.
“This is a complex issue and it needs a comprehensive approach with investment from the community, patient advocates, health providers — including nutritionists and exercise physiologists — health centers, and political initiatives to address these issues,” said Sardesai.
“Anybody at higher risk who can do things to reduce or limit risk would be good,” said Bevers.