Clash of the titans

Pierre Boulez conducts Daniel Barenboim and the Berlin Staatskapelle.

With Daniel Barenboim and Pierre Boulez - titans of the classical world - sharing a stage, the question of musical dominance was always going to arise. While a programme of Liszt piano concertos promised the traditional rivalry between soloist and orchestra, it was the altogether quieter rivalry of soloist and conductor that proved more compelling in performance, as Boulez's restraint and precision faced off with Barenboim's expressive showmanship.

Conducting Barenboim's own orchestra, the Berlin Staatskapelle, Boulez was always going to be at a disadvantage. Often directed by Barenboim from the piano, you could hardly blame the players for responding to their director's gestures and barely-concealed cues, yielding two concertos that while solid enough, lacked the energy that comes from absolute clarity and specificity of interpretation.

The contrast between the two musicians was encoded into the programme itself, with the bravura of Liszt's concertos framed in each half by one of Wagner's orchestral works. With Barenboim absent the hall lost much of its rather manic electricity, but while even Boulez's control couldn't lend substance to the youthful indiscretion that is the Faust Overture, his clean textures made something unusual of the Siegfried Idyll.

The Staatskapelle's smooth-edged sound is a miracle of many years' making, and the tenderness of Wagner's birthday gift to his wife offered a sympathetic vehicle for this peculiar sweetness. Originally (and pragmatically) scored for just 15 musicians, Wagner's Idyll here enjoyed slightly expanded orchestration, allowing for the scope and rather awkward acoustic of the Royal Festival Hall auditorium. Its spirit however remained resolutely that of a chamber performance, balancing intimacy (the most vulnerable of string pianissimos) with Boulez' habitual emotional coolness. The result was oddly exhilarating, its passions (and there were plenty) keener for being hard-won.

Hearing Boulez conduct such repertoire is only more fascinating than it is bizarre. While his musical boundaries have broadened considerably in recent years, encompassing Wagner and Mahler, such Romantic extremes as the Liszt concertos represent new territory, encountered for the very first time in the current concert tour. It was only natural then that Barenboim should take the lead here, his personality pounded hard into the keyboard and flung out at the eager audience.

The impact of the Piano Concerto No. 2 may have been enough to reduce Matthew Arnold to the "sweetest, bitterest tears", but I'd imagine few were tempted to that condition last night. While the woodwind offered a suitably moody opening, and instrumental solos (exquisite cello in particular) tugged plaintively at the heartstrings, there was a thrust and force to Barenboim's playing that spoke briskly of action rather than contemplation. At his bravura finest in the dramatic authority of the Marziale, it was his textural contributions - the delicate moments of arpeggiation and motivic dialogue - that reminded me of his musical intelligence and maturity.

There was no ignoring however the intrusive smudge of the sustaining pedal, blurring much of the passagework and clouding the tone of the RFH's Steinway. It was an issue that persisted in the E flat concerto, where it was again balanced by the Mozartian lyricism of the Allegretto, hands unfolding themselves into flurries of filmy ornamentation.

Yet rather like the infamous solo triangle, placed rather intrusively centre-stage at Barenboim's left elbow, something still jarred about this performance. While the finale was an Olympian parade of muscular will, its scope and volume seemed alienated from the earlier movements, a trumpet-call of victory without the validation of a battle. Barenboim is surely unequalled among pianists for visual drama and musical personality, impressing them upon score and audience with equal authority, yet where he lacks is surely in narrative. His colourful episodes each emerge distinct and complete, but the connecting conceptual thread - the guide rope with which Boulez never loses contact - is often lost.

Royal Festival Hall, London, 13 June

Davide Restivo at Wikimedia Commons
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Scientists have finally said it: alcohol causes cancer

Enough of "linked" and "attributable": a new paper concludes that alcohol directly causes seven types of cancer.

I don't blame you if you switch off completely at the words "causes cancer". If you pay attention to certain publications, everything from sunbeds, to fish, to not getting enough sun, can all cause cancer. But this time, it's worth listening.

The journal Addiction has published a paper that makes a simple, yet startling, claim: 

"Evidence can support the judgement that alcohol causes cancer of the oropharynx [part of the throat], larynx, oesophagus, liver, colon, rectum and [female] breast"

So what's especially significant about this? 

First, scientists, unlike journalists, are very wary of the word "causes". It's hard to ever prove that one action directly led to another, rather than that both happened to occur within the same scenario. And yet Jennie Connor, author of the paper and professor in the Preventive and Social Medicine department at the University of Otago, New Zealand, has taken the leap.

Second, alcohol not only causes cancer of one kind – the evidence supports the claim that it causes cancer at seven different sites in our bodies. There was weaker evidence that it may also cause skin, prostate and pancreatic cancer, while the link between mouth cancers and alcohol consumption was the strongest. 

What did we know about alcohol and cancer before?

Many, many studies have "linked" cancer to alcohol, or argued that some cases may be "attributable" to alcohol consumption. 

This paper loooks back over a decade's worth of research into alcohol and cancer, and Connor concludes that all this evidence, taken together, proves that alcohol "increases the incidence of [cancer] in the population".

However, as Connor notes in her paper, "alcohol’s causal role is perceived to be more complex than tobacco's", partly because we still don't know exactly how alcohol causes cancer at these sites. Yet she argues that the evidence alone is enough to prove the cause, even if we don't know exactly how the "biologial mechanisms" work. 

Does this mean that drinking = cancer, then?

No. A causal link doesn't mean one thing always leads to the other. Also, cancer in these seven sites was shown to have what's called a "dose-response" relationship, which means the more you drink, the more you increase your chances of cancer.

On the bright side, scientists have also found that if you stop drinking altogether, you can reduce your chances back down again.

Are moderate drinkers off the hook?

Nope. Rather devastatingly, Connor notes that moderate drinkers bear a "considerable" portion of the cancer risk, and that targeting only heavy drinkers with alcohol risk reduction campaigns would have "limited" impact. 

What does this mean for public health? 

This is the tricky bit. In the paper, Connor points out that, given what we know about lung cancer and tobacco, the general advice is simply not to smoke. Now, a strong link proven over years of research may suggest the same about drinking, an activity society views as a bit risky but generally harmless.

Yet in 2012, it's estimated that alcohol-attributable cancers killed half a million people, which made up 5.8 per cent of cancer deaths worldwide. As we better understand the links between the two, it's possible that this proportion may turn out to be a lot higher. 

As she was doing the research, Connor commented:

"We've grown up with thinking cancer is very mysterious, we don't know what causes it and it's frightening, so to think that something as ordinary as drinking is associated with cancer I think is quite difficult."

What do we do now?

Drink less. The one semi-silver lining in the study is that the quantity of alcohol you consume has a real bearing on your risk of developing these cancers. 

On a wider scale, it looks like we need to recalibrate society's perspective on drinking. Drug campaigners have long pointed out that alcohol, while legal, is one of the most toxic and harmful drugs available  an argument that this study will bolster.

In January, England's chief medical officer Sally Davies introduced some of the strictest guidelines on alcohol consumption in the world, and later shocked a parliamentary hearing by saying that drinking could cause breast cancer.

"I would like people to take their choice knowing the issues," she told the hearing, "And do as I do when I reach for my glass of wine and think... do I want to raise my risk of breast cancer?"

Now, it's beginning to look like she was ahead of the curve. 

Barbara Speed is a technology and digital culture writer at the New Statesman and a staff writer at CityMetric.