En español | Last spring, when Americans rushed to stockpile essentials, toilet paper and hand sanitizer weren't the only items being tossed into virtual and real-life shopping carts with abandon: Sales of packaged cookies and crackers shot up substantially, as did online purchases of alcoholic beverages — while baking supplies such as yeast all but vanished from shelves. So perhaps it's not surprising that now, more than six months into the pandemic, many people are admitting to having gained the “quarantine 15” (or more).
"I've had so many patients coming in and saying, ‘I haven't been behaving; I've definitely been drinking more,'” says Radhika Acharya-Leon, D.O., medical director of the UCHealth Cancer Center in Highlands Ranch, Colorado. “Everyone is gaining weight, too. I call it the COVID 19 because everyone is gaining [around] 20 pounds.”
Seeing the scale tick upward can be alarming for a host of reasons, but oncologists including Acharya-Leon are concerned that weight gain — plus other troublesome lifestyle shifts — could predispose more women to breast cancer, a disease that already hits 1 in 8 of them.
"There are some things in life you can't control, such as your genetics, but some aspects of breast cancer risk we can control,” says Deborah Lindner, M.D., chief medical officer of Bright Pink, a breast and ovarian cancer education and advocacy group.
Though lifestyle alone rarely determines whether someone gets breast cancer — genetics and simply getting older tend to be more influential factors — 85 percent of breast cancers occur in women with no family history of the disease. You should also know that not everyone who carries a genetic predisposition will develop cancer: “Something has to trigger it,” Acharya-Leon says. “We know that lifestyle plays a big role."
Ask a cancer expert about which pandemic-related lifestyle changes are most worrisome and you'll learn that delaying routine health screenings, including mammograms, tops the list. (Staying on top of screenings doesn't prevent cancer, but it helps catch it in the earliest, most treatable stages.) Next in line? Gaining weight, being sedentary and consuming too much alcohol.
The cancer-weight connection
An estimated 22 percent of adults have gained weight during the pandemic, according to a recent survey. Increased stress and boredom, decreased physical activity, and lack of sleep (which affects hunger hormones) may all be contributing to this trend.
Once COVID-19 became a threat, Becky Hellwig was among those who were eating and drinking “a little too much.” By August, however, Hellwig, a San Jose, California, native who recently relocated to Germany, resolved to turn things around, so she pulled back on both food and alcohol. “I feel better, lost weight and have more control,” she says. That's a good thing, as numerous studies have found a connection between excess weight and an increased risk of breast cancer.
Becoming overweight or obese seems to be most problematic after menopause, says Acharya-Leon. “You store estrogen in fatty tissue,” she says. And estrogen in turns drives the growth of some breast cancers.
Why exercise matters … a lot
Though obesity and physical activity are often closely connected, they're actually independent risk factors for breast cancer. And lack of exercise seems to be the bigger offender of the two, Lindner says.
"Overweight people who exercise have a lower risk than thin ones who don't exercise,” she says. Becoming more sedentary contributes to an increased risk of breast cancer because it is believed that activity may help regulate hormone levels in your body. For these reasons, Lindner calls it “super important” to get the recommended minimum of 150 minutes of moderate physical activity weekly.
Older adults aren't exempt from that recommendation, yet it's easy to fall short — especially now that many are hunkering down at home. While this isn't the best time to hit the gym or go mall-walking, fear of the coronavirus should not prevent you from taking walks in your neighborhood, Lindner says. (Remember to wear a mask and/or keep a safe distance from others.)
When drinking gets risky
Whether it's due to stress, boredom or a desire to feel connected (virtual happy hour, anyone?), adults of all ages have been drinking more during the pandemic. Women in particular seem to be drinking more often and more heavily, according to recent data.
And plenty of older adults were drinking too much even before COVID hit: Nearly 11 percent of adults age 65 and older reported consuming four or more drinks in a day, according to research gathered between 2015 and 2017.
"People are bored, stressed and self-medicating,” Lindner says. “But studies have found that up to a third of breast cancers in the average-risk group could be attributable to alcohol intake.” (An average-risk group is defined as those with no genetic predisposition to the disease.)
How much is too much? When it comes to breast cancer, less really is best: Women who have just three drinks per week are 15 percent more likely to develop breast cancer compared to those who abstain. Alcohol is a likely carcinogen and also plays a role in hormone regulation.
"If you've noticed that you've started significantly increasing your alcohol intake during this time, take time to reassess,” says Jennifer Litton, M.D., a breast medical oncologist at MD Anderson Cancer Center in Houston.
Giving bad habits an expiration date
Overdoing alcohol, being sedentary and gaining weight are damaging for many reasons, Lindner says. For one thing, the same lifestyle choices that raise breast cancer risk also raise the risk for heart disease, an even bigger killer. “These are shared risk factors,” she says.
However you're getting off track, Litton emphasizes that it's never too late to change course — but that you shouldn't tell yourself you're waiting until the pandemic ends to do so. “Even if a vaccine gets released, it will take time to distribute it,” she warns. “This will not magically be fixed.”
Lindner agrees that people who are hoping to ignore their bad habits — including putting off crucial health screenings — until the pandemic is “over” are out of luck. COVID-19 isn't going away anytime soon, she says, and “we need to figure out a safe way to continue to live our lives and not die from breast cancer in the meantime.”