I would be very grateful for your advice about two problems relating to diet and cancer. I have had ovarian (ten years ago) and breast cancer (two years ago) and my husband has prostate cancer, although he is still in the watching and waiting stage. As you can appreciate, we have been trying to find ways to reduce our problems and have been thoroughly confused by conflicting advice on the best ways to do this. One recommendation which we have followed is to reduce our dairy intake, as one scientist, Jane Plant, has suggested. We now have soya milk in tea, although as I am on tamoxifen to block oestrogen this may not be very good for me. She feels that dairy should be completely eliminated, basing the premise on the fact that women in the Far East do not eat much, if any, dairy and have a much lower incidence of hormone-driven cancers. Do you think this is true, and that we should have a diet which is completely dairy-free?

My other question is about alcohol. I have seen it recommended that anyone who is trying to avoid breast cancer should drink very little, if any, alcohol. One doctor suggested one drink a year, at Christmas. Although we do not drink very much in total, we do enjoy wine regularly, although if it is likely to be doing harm we will give it up completely (difficult, but not impossible!).

We would be most grateful to hear your opinion on both these tricky problems. We have been reading your column for years and are always impressed by your sensible advice. Name withheld

I admire Professor Jane Plant greatly but I don’t find myself always in total agreement with all the conclusions she draws from her research. I however do agree that anything that is likely to increase weight, especially abnominal weight and girth, may influence the hormonal balance in women and that obesity is a risk factor for developing breast cancer. There is some evidence that a high fat diet, which includes cream, does predispose to prostate cancer but this is low in my risk of possible risk factors for this disease.

So far as your husband’s prostate cancer is concerned, managed surveillance with very frequent examinations and PSA estimates (every three or six months in all probability) is a possible line of treatment for patients who are known to have a low Gleason score of two, three or four.

There is not much evidence if any that alcohol is harmful in prostatic cancer but there is some evidence that alcohol is a risk factor for breast cancer. Fortunately although moderate doses of alcohol are a minor risk factor for breast cancer they improve lifespan in other ways. Men, if they want to achieve maximum longevity, should have two or three glasses of red wine a day, women one or two.

Incidentally the term watchful waiting as a way of dealing with prostatic cancer has now been abandoned as a term because it was found to discourage adequate surveillance.

As you have two well established risk factors, ovarian cancer and breast cancer, you should have very regular mammography and could even consider the possibility of simple bilateral mastectomies. See my answer to a later question.

My paternal grandmother died from breast cancer in her forties. If this was genetic, could the genes responsible have been passed to me through my father? Should I regard myself as being at increased risk of breast cancer? Susannah, Gloucestershire

This is an increased risk, but only a very small one for a grandmother is not a first degree relative. If other relatives had had breast cancer as well it would increase the risk rating we would accord to a grandmother. You would not be considered at an appreciable risk of developing breast cancer but even so you should make certain that you have regular mammographies preferably, if you can afford it, every year over the age of 50 and every 18 months after the age of 40. In younger women the benefits of more frequent mammographies have to be balanced against the risk of developing it according to their genetic background and the feel of the breast.

I had a "mother and son" (in situ) removed from the breast last summer. I was 66 and learnt that my cancer was not hormone driven. What drove it then? Also, rather than having mammographs every six months for the next five years, I am anxiously waiting for developments in tomography to replace the former. Is there any likelihood for this and, if so, when? Yvonne Burgess, Italy

Stick to regular mammography not less than once a year. Other systems of diagnosing breast cancer are still in the developmental stage and I wouldn’t yet trust my life to them. You ought to consider simple bilateral mastectomies. You are 10 years younger than I am and as you are a woman your breasts are obviously more important to you. I however have cancer of the prostate and one of the side effects of this treatment is the development of breasts but not only enlarged but have become very tender and painful. Like many men I am considering having a bilateral mastectomy. I realise that it has less emotional implications but it is an easy, quick and safe piece of surgery.