It's breast cancer awareness month again: Rite-Aid is selling pink TicTacs, rosé is on sale at Whole Foods, and Sephora is hawking a "Breast Cancer Awareness Makeup Palette."
If you're suffering from awareness overload, you're not alone.
When it comes to breast cancer, we're inundated with what health studies professor Samantha King calls a "tyranny of cheerfulness." Rather than addressing the more complex issues of inadequate health insurance, environmental pollution, and stalled research, the public face of breast cancer advocacy veers toward to what Barbara Ehrenreich calls "the breast cancer cult," an ultra-feminine, consumer-driven approach drenched in sentimentality and good cheer.
The ubiquitous pink ribbon often overshadows the actual achievements of breast cancer organizations.
Far from being pawns of a corporate fundraising campaign requiring them to share the color of their bra or accumulate a house-full of pink tchotchkes, many breast cancer activists are politically savvy women who have helped change the way medical research is funded, agitated for tighter environmental restrictions, and made significant improvements to the US healthcare delivery system.
"When you mention breast cancer, people think of Race for the Cure and support groups," says Sue Wittewer, an active member of Iowa Breast Cancer Edu-Action. "When I tell people that I'm learning to lobby for better healthcare coverage, they're surprised. You have to explain it to them, since they don't know anything about it."
Angela Wall, the communications manager at Breast Cancer Action, an advocacy organization based in San Francisco, agrees. "You can't get the real issues out there for all the pink noise," she says. "Juggernaut pink organizations like Komen and Avon have the pink mouthpiece and and that makes it hard to get a word in edgewise to talk about the real issues that will actually address and end this epidemic."
National Breast Cancer Awareness Month was started in 1985, the brainchild of the American Cancer Society and AstraZeneca, a multi-national pharmaceutical companyas an initiative to promote mammograms. But the first woman to come up with a ribbon for breast cancer awareness was 68-year-old Charlotte Haley, who made peach ribbons in her living room. She distributed them with a card that read: "The National Cancer Institute annual budget is $1.8 billion, only 5 percent goes for cancer prevention. Help us wake up our legislators and America by wearing this ribbon."
In 1992, Self magazine and cosmetics giant Estee Lauder had the idea to create a breast cancer awareness ribbon. Haley wanted nothing to do with this campaign, seeing it as too commercial. Estee Lauder chose to pursue the ribbon idea anyway, and decided to use a different color.
They chose pink.
At the time, this was almost revolutionary: research about the disease was underfunded, and women were often ashamed of having had mastectomies. Tens of thousands of women died of breast cancer every year, but nobody talked about it in public.
Eventually, other companies jumped on board and soon the pink ribbon was plastered on everything from cologne to corn chips.
This Komen Foundation Perfume was discontinued because it contained a chemical classified as toxic. You can still buy the chips though.
At the same time corporations were discovering they could improve their image with women by slapping a pink ribbon on their merchandise, thousands of breast cancer survivors were coming together to create political change.
The National Breast Cancer Coalition (NBCC) lobbied to increase federal funding for breast cancer research which resulted, improbably, in the Department of Defense Breast Cancer Research Program. The program, administered by the Department of the Army, funds innovative research proposals which consumer advocates help select. "It was important to us that women have a seat at the table," says Visco. "It wasn't enough to just be raising the money."
To make sure that advocates were prepared, the NBCC started an intensive science immersion course for survivors called Project LEAD. Since its inauguration, over 2,000 women have been trained in the program. "The project really stands out as a model for developing activists who ask relevant and important questions, and acknowledge their power when working with the scientific community," says Dr. Kay Dickersin, a longtime faculty member with Project LEAD.
Healthcare coverage is another major issue for women with breast cancer, which is rarely addressed by the pink ribbon contingent.
Until 2000, free breast cancer screening was available for uninsured women, but treatment was often out of reach. Activists affiliated with the NBCC lobbied to make treatment more accessible, resulting in the The Breast and Cervical Cancer Treatment Act. The legislation gave states the option to offer Medicaid assistance to women who were screened through the program.
While it's all good and well to fund research for a cure and help women with cancer get treated, even better would be to stop the disease before it starts. "We need to reduce the number of women who are diagnosed with breast cancer, not celebrate the number who are getting mammograms," says Wall.
To that end, BCA has lobbied Eli Lilly to stop producing rBGH, the growth hormone that is present in dairy products and which may increase the risk of breast cancer. The organization was successful in its campaign to have methyl iodide, the pesticide that scientists called "one of the most toxic chemicals on earth," pulled from the U.S. market by its manufacturer, Arysta LifeScience Corporation. And they've been a party in a lawsuit against Myriad Genetics that challenges the company's patents on breast cancer genes BRCA1 and BRCA2, patents that were ruled invalid in 2010.
Every year, Christine Norton helps organize the Race for the Cure in her hometown of Minneapolis. She wears a pink ribbon, but she's also a longtime board member of the NBCC and she's acutely aware of the problems with the symbol. "Pink ribbons can be counterproductive to the larger issue," she says. "Some people think it's enough to just put the pink ribbon on, but really, at this point in time, that's doing jack squat."
Angela Wall believes that more and more women are coming to the same conclusion. "Women are not stupid. We're incredibly savvy. Our bullshit detectors ring loud and clear. We know when something isn't working."
Jill Moffett, PhD, MPH is a freelance writer based in Durham, North Carolina. She blogs at Women's Wellness Watch.