F.D. Flam: Drinking’s cancer link is underrated — especially by women

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Now that the vast majority of Americans don’t smoke, it’s hard to know what we’re supposed to do about the recent news that 40% of cancer cases are preventable. Drinking alcohol is one of the top risk factors — and yet doctors aren’t talking to patients about its connection to cancer.

Alcohol was third behind obesity and smoking among the “modifiable” risk factors according to this new study. You can’t walk into a doctor’s office without being put on a scale, and everyone knows smoking causes cancer, but drinking a glass of wine or two every night? Not long ago, that was considered healthy — due, researchers now say, to a systematic error in several widely publicized earlier studies.

And drinking is a bigger cancer risk factor for women than it is for men. About 300,000 women are diagnosed with breast cancer in the US each year. It’s by far the most common potentially lethal cancer among nonsmoking women.

Alcohol consumption accounts for about 16% of breast cancers, said the lead author of the study, Farhad Islami of the American Cancer Society. Most of the increased risk is attributable to people who exceed the current health guidelines of no more than one drink a day for women. But even a drink a day raises risk — especially if you’re filling up a big wine glass.

Drinkers of both sexes have an increased risk of liver cancer, esophageal cancer and other malignancies of the digestive tract, but these are not nearly as common as breast cancer.

There are still many critical questions that experts can’t answer until there’s more research: How much is a woman’s lifetime breast cancer risk elevated by heavy or binge drinking in college and early adulthood? How much can a woman reduce her risk by going from moderate drinking to abstaining? Are there women with certain risk factors that make them more prone to cancer induced by alcohol use? How and why does alcohol raise breast cancer risk?

There are a few studies suggesting that alcohol can cause breast cancer by increasing the amount of estrogen circulating in the bloodstream. Should women taking hormone replacement therapy skip the daily glass of wine? It might make sense, but it remains in the realm of things that need more study.

Instead, doctors usually recommend diligent annual screening mammograms if you want to try HRT, but of course, screening doesn’t prevent cancer. In the most optimistic estimates, programs of regular screening mammograms reduce cancer death by 20%, but more recent studies show less benefit along with a serious risk of unnecessary treatment.

In one of the many articles on the limitations of mammography, professor of medicine Russell Harris of the University of North Carolina suggests it’s more important for doctors to council women to stop smoking, maintain a healthy weight and cut back on drinking.

In June, the New York Times tried to quantify the risk of moderate drinking. One researcher said drinking seven drinks a week only costs you about two and a half months of life. The researcher, Tim Stockwell of the Canadian Institute for Substance Use Research, emphasized that was an average — most people may lose nothing, but a few will lose a lot.

It’s hard to isolate the effects of drinking because it’s tied up with other behaviors and conditions, he told me. Take the “sick quitter effect,” he said. People who get serious warnings from their doctors often quit drinking, and so studies can show a correlation between quitting drinking and getting sick — because getting sick caused people to quit. And some people don’t ever drink because they have health problems or are on medications. Missing that link is one reason earlier studies showed — wrongly — that moderate drinking was beneficial.

Some people who don’t drink any alcohol might compensate with other unhealthy behaviors. For example, consumption of sugary soda might explain a high incidence of heart disease and diabetes in Middle Eastern countries where many people never drink alcohol for religious reasons.

With alcohol, risk is associated with lifetime consumption, Stockwell said, and some studies show that a long-term pattern of youthful excess puts you at higher risk of heart disease when you’re older. We need more research to know how lifetime patterns of drinking affect cancer risk — all we know is that if you want to minimize your risk, it’s better not to drink.

But of course, minimizing risk isn’t everything. Drinking is an important part of celebrations and socializing, and we have to weigh those benefits against the health risks. Some people have a highly tuned palate and get enormous pleasure from fine wine, while some of us are just as happy with a fake beer as long as the company is genuine.

It’s also a major quality of life issue to be cancer-free, rather than facing surgery, radiation or chemotherapy. To estimate the trade-offs, we deserve better information — both from researchers and from our doctors.

F.D. Flam is a Bloomberg Opinion columnist covering science. She is host of the “Follow the Science” podcast.

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Movie review: ‘It Ends With Us’ a bungled adaptation of romance novel

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To understand the new Blake Lively-starring romantic melodrama “It Ends With Us” is to understand that it exists in context: in the context of the long tradition of the “women’s picture,” and the current landscape of the publishing industry, which is dominated by female authors and consumers. This understanding explains the film’s existence, as it serves an audience that is often overlooked in today’s film market, and sports extensive name recognition.

Adapted for the screen by Christy Hall, the source text of “It Ends With Us,” is the massively successful 2016 novel by Colleen Hoover, an author who started out self-publishing her own books. They became so popular on Kindle Unlimited that she made it to the New York Times bestseller list on her own before she was picked up by Atria Books, a division of Simon & Schuster. “It Ends With Us” is a cathartic personal story for Hoover, based on family experience, about a woman, Lily (played in the film by Lively) overcoming a cycle of domestic abuse, which she witnessed in her parents’ marriage and later experiences herself in a toxic relationship.

The story follows Lily (last name Bloom, yes it is acknowledged), a young woman living in Boston, who has dreams of opening up her own flower shop (yes, it is called “Lily Bloom’s”). The film opens at the funeral of her father (Kevin McKidd) at which Lily struggles to name even a few things she loved and respected about him. While processing her complex feelings on a rooftop patio at night, she encounters a hunky neurosurgeon with a temper, Ryle Kincaid (Justin Baldoni).

Running into him months later, his sister Allysa (Jenny Slate) now working at Lily Bloom’s, they fall into a relationship, which is complicated by yet another coincidental run-in, with Lily’s first love Atlas Corrigan (Brandon Sklenar), the hunky chef and owner at their favorite restaurant, whom Lily has not seen since high school. Ryle’s jealousy toward Atlas escalates the increasing volatility of their relationship, which has started to result in violence and injury toward Lily, whether accidental or not.

For all the limitations of Hoover’s novel, with its juvenile writing style and cringe-worthy prose, it is at least clear-eyed about the realities of intimate partner violence. Lily in the book is young (early 20s) and an often irritatingly immature character, but her eyes are at least open to what’s happening in her relationship. The Lily of the movie reads older, and cooler; the dialogue by Hall is much sharper and funnier. But in the film, Lily is delusional about her relationship, and the film blurs the lines of the abuse for too long to a frustrating degree that essentially robs our heroine of her agency, and elides some of Ryle’s obvious manipulation.

Of note here is that Baldoni, playing the abusive Ryle, is also the film’s director. Perhaps it was in the screenwriting, or a top-down decision based on test screenings and audience reaction, but there is a clear story choice to conceal Ryle’s true nature, and reveal his intentions late in the film, in montage, that does not square with how the events proceed in Hoover’s telling. Perhaps this decision was made so that the audience (who may not have read the book) might not turn on his character too soon.

Other small storytelling changes alleviate Ryle of some of his darker actions as well. Choices to condense, omit and change texts in the process of adaptation are necessary, but the choices made for this film adaptation result in our heroine, though seemingly much more mature and intelligent, becoming a character who is helpless, complicit and confused, which is troubling for this topic of intimate partner violence.

Baldoni’s approach to crafting the stylistic world of “It Ends With Us” is to offer the romantic escapist fantasy inherent to the literary and cinematic genre: elaborate costume and production design, luxe interiors, a Boston where it mysteriously never snows, extensive courtship and seduction montages set to contemporary indie ballads. It never feels like it’s set in the real world, but given that this is romantic melodrama, it doesn’t have to. But there are also harsh realities that the story must face, and gilding Lily’s experience by softening the blow, so to speak, doesn’t get at the harsh truths that Hoover unearthed in her book, which clearly connected with a large female readership craving stories like this.

“It Ends With Us” continues the tradition of “women’s pictures” that were an essential part of Hollywood film production in the 1940s — Bette Davis could have starred in a version of this some 80 years ago. But women’s pictures also have to express stark truths, which feel unfortunately muddled here, in a bungled adaptation that is at once too close and too far from its source.

‘It Ends With Us’

2 stars (out of 4)

MPA rating: PG-13 (for domestic violence, sexual content and some strong language)

Running time: 2:10

How to watch: In theaters Aug. 9

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Report: Timberwolves will play Mavericks on Christmas Day in Dallas

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Even as the NFL begins to take over the day that once belonged to basketball, Christmas Day games are still a status symbol for NBA teams.

Only the brightest stars and most intriguing watches are featured on the five-game, 10-team slate.

And, for many, many years, the Timberwolves weren’t invited to the party.

They now have a seat at the table. For the first time since 2017 — Jimmy Butler’s one full season with the Timberwolves — and only the third time in franchise history, Minnesota will play on Dec. 25.

According to The Athletic, the Wolves will meet the Mavericks in Dallas for a rematch of the Western Conference Finals. Minnesota’s game appears to be the second of the day, which would be expected to tip around 1:30 p.m. Central.

That would put the Wolves up on the sports schedule against the NFL’s doubleheader that day, which features Kansas City playing Pittsburgh and Baltimore taking on Houston.

The Wolves’ first Christmas Day game was in 2016, when they lost 112-100 to the Thunder in Oklahoma City. In 2017, Minnesota played at the Los Angeles Lakers and won 121-104.

Minnesota’s success from a year ago makes it a more attractive team to put in spotlight games, but the real attraction for the NBA likely comes in the form of Anthony Edwards, a now 23-year-old superstar who’s captivated a number of basketball fans across the globe.

The Christmas Day schedule is reportedly as follows:

San Antonio at New York

Minnesota at Dallas

Philadelphia at Boston

L.A. Lakers at Golden State

Denver at Phoenix

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Tim Walz depicted as rural champion at Farmfest by Heidi Heitkamp and Peggy Flanagan

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MORGAN, Minn. — Minnesota Gov. Tim Walz, announced this week as Vice President Kamala Harris’ running mate for the 2024 presidential election, wasn’t at Farmfest this year. But he had a former U.S. senator and his lieutenant governor stumping for him and defending his record in farm country.

In southwest Minnesota, which is far from blue territory in the state, Walz got support from former U.S. Sen. Heidi Heitkamp, a Democrat from North Dakota, who was at Farmfest on Wednesday, Aug. 7, on behalf of the Harris-Walz ticket.

Former U.S. Sen. Heidi Heitkamp of North Dakota stands with Minnesota Sen. Aric Putnam at Farmfest on Aug. 7, 2024, in Morgan, Minn. (Noah Fish / Agweek)

Heitkamp said she met Walz during her first couple of weeks in Congress.

“I got to meet him traveling back and forth on the plane from D.C. to the Twin Cities, and I tell people my first impression was that I’ve known him all my life,” Heitkamp said. “He’s like everybody else that I grew up with. Every social studies teacher, every person who makes communities work.”

Walz, a U.S. House member for 12 years before becoming Minnesota’s governor, has a history of supporting farmers, Heitkamp said. She called him “instrumental” in passing “one of the most successful farm bills.”

During his last term in Congress, Walz sponsored legislation to expand veterans’ access to farm programs.

“We’ve been building on that ever since,” Heitkamp said of the current farm bill which includes extended provisions from Walz’s veterans bill.

Heitkamp said she believes that Walz, who grew up on his family’s farm in Nebraska, will give rural America “a seat at the table” if elected as vice president.

“Where we are headed in agriculture going into the future, we can’t just rest on our laurels and assume that we can keep doing the same thing that we’ve always done. I think we need dynamic leadership that understands that you just don’t throw money at a problem,” Heitkamp said.

Minnesota Lt. Gov. Peggy Flanagan filled in for Walz during his slotted speech time at Farmfest on Wednesday as he attended a campaign rally in Eau Claire, Wis.

“I think during our last five years, we’ve been incredible partners with agriculture,” Flanagan said.

She pointed to hiring farmer and former Minnesota Farmers Union lobbyist Thom Petersen as Minnesota’s ag commissioner as “one of the most powerful things” done by Walz’s administration.

“The investments that we have made in ensuring that we have low-interest loans for farmers, our work around emerging farmers has been important, and the investments in AGRI (value-added grants) and dairy,” she said of some of the accomplishments led by Walz.

She said the Walz administration has been able to respond and partner with farmers as the state has navigated through multiple droughts and now flooding.

“The best thing, I think, that we can point to is how we listen to the agriculture community, and then we see that translated into policy. That’s how we’ve been leading,” Flanagan said. “I think people can expect that from him in the future.”

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