Is Breast Cancer Awareness a Marketing Sham?

[An earlier version of this piece appeared in In These Times]

After 24 years of shocking pink ribbons, it has become impossible not to be aware of breast cancer. But does all that thinking pink really contribute to "The Cure," or is it actually designed to keep us from seeing red?

Breast cancer is clearly the poster child disease for cause marketing. It doesn't kill as many women as lung cancer or heart disease, but breast cancer attacks the most visible symbol of female sexuality, and as the porn industry has amply proven, sex sells.

There is no other disease that we try to eradicate by going shopping. We are bombarded with all manner of wonderful pink things we can buy to raise money to help fight breast cancer. Everything from makeup to a line of clothing from the Ford Motor Company. Never mind that the makeup contains ingredients linked to cancer and auto exhaust contains known carcinogens, it's all for a good cause.

But in the opinion of Jaynse Ashley, who has undergone three surgeries for breast cancer, "We don't see little penis trinkets being sold to 'support prostrate cancer awareness,' now do we? I cannot adequately articulate how disgusting I find the marketing of trinkets, appliances, etc. on the backs of those of us in this battle. The contribution percentage is negligible compared to mark-up on the product. How dare they use women in this battle to line their pockets? There will be a reckoning and I hope I live to see it."

Much of the information that is spewed out in the name of awareness focuses on personal risk factors that we can't change, such as genetics and family history. The American Cancer Society (ACS) devotes its entire explanation about what causes breast cancer to genetic factors, despite the fact that by their own admission, only 5-10 percent of breast cancer is hereditary.

Only one paragraph in their discussion of risk factors is devoted to environmental pollutants, which it terms an unproven connection. Yet according to Breast Cancer Action (BCA), there are over 100,000 synthetic chemicals in use in the U.S., more than 90 percent of which have never been tested for their impact on people.

A new study by the World Wildlife Fund links pollutants to breast cancer because of what researcher Andreas Kortenkamp calls a "cocktail effect" of exposure to multiple chemicals that mimic estrogenic effects. In light of recent research that suggests a link between the recent dramatic drop in breast cancer rates and the decreased use of hormone therapy, it is urgently important to continue research into these effects.

As BCA points out in State of the Evidence 2006, "Considerable resources continue to be spent to encourage women to make changes in their personal lives that might reduce their risk of breast cancer. But many factors that contribute to the disease lied far beyond an individual's personal control and can only be addressed by government policy and private sector changes."

BCA urges the use of the precautionary principle in addressing the dangers of pollutants where an "indication of harm, rather than definitive proof of harm, triggers policy actions."

Yet despite all the ribbons and races, instead of a cure, we are left with many unanswered questions, not just about what causes cancer but also how we detect and treat it. Almost 10 percent of breast cancer deaths worldwide are in the U.S. despite our aggressive detection and treatment protocols. Women are advised by organizations such as the American Cancer Society and the Komen Foundation to get annual mammograms starting at the age of 40.

By contrast England, Canada and Australia only recommend routine mammograms every few years after the age of 50 and not at all for younger women unless there is a specific cause for concern. According to Breast Cancer Australia, the national organization that administers mammograms in Australia, "At this point in time, available scientific evidence does not justify a national mammographic screening program which would actively recruit women ages 40-49 years."

Recent research by the Nordic Cochrane Centre in Denmark also raises questions about the effectiveness of mammography. In a study of 2000 women, they found that one woman would have her life prolonged but 10 would undergo unnecessary treatment and 200 women would experience unnecessary anxiety because of false positive results. According to the authors of the study, it is "not clear whether screening does more good than harm."

Why then are American women still being advised to get so many mammograms? While we would like to believe that the medical advice we get is based solely on good medical practice, it is important to note that companies such as General Electric and DuPont, both of which manufacture mammography equipment, are also large donors to organizations such as Komen and ACS and also make products that have been linked to cancer. In addition, General Electric owns NBC, which leaves the potential of a conflict of interest in news reporting about breast cancer by NBC News.

The standards for treatment of breast cancer also raise many questions. Until recently, virtually all women with breast cancer underwent chemotherapy despite the fact that of those who receive chemo, 15 percent will benefit, 25 percent will get worse and 60 percent didn't need it in the first place.

Recent research has also found that the side effects of chemo are much greater than previously known. And for all the hoopla about drugs such as Reloxifene and Tamoxifen, we still don't know whether either drug actually prevents cancer or just delays its occurrence.

AstraZeneca, which makes Tamoxifen, is the the primary corporate sponsor of National Breast Cancer Awareness Month. Like many other pharmaceutical companies, they are supporters of the American Cancer Society and the Komen Foundation. Clearly from the point of view of these companies, it is much more beneficial to fund 'cures' than to eradicate the disease in the first place or to support non-medical treatments such as exercise which has been shown in numerous studies to lower hormone levels and can reduce the chance of getting or dying from breast cancer by as much as 60 percent.

There is an inherent conflict of interest when organizations that provide guidelines for treating a disease also receive funding from corporations that benefit financially from the recommended treatment.

Breast cancer patients deserve a national policy where further research into the causes of breast cancer is paramount, and where standards of treatment and diagnosis are based on the health of patients, not corporations. This many years later, we need to move beyond awareness and start demanding answers.

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