The first time pink ribbons made me see red was a couple of years back, when I was stopped short by a sign at a gas station. Cunningly placed next to a pump, it sported the ubiquitous pink bow and read: "Be a driving force against breast cancer."
For me, who had finished treatment for the disease three years earlier at the age of 35, that tore it. Corporations know that those pink ribbons translate into green cash: According to a 2000 Opinion Research International poll, more than two-thirds of women said they would purchase a product linked to the fight against breast cancer.
But how many of them will ask how their money is actually spent or how corporate donors may themselves "drive" the breast cancer agenda?
Consider Breast Cancer Awareness month, which is every October. Its founder, the drug maker AstraZeneca, manufactures the breast cancer drug tamoxifen and other chemotherapies, but until recently it made agrochemicals as well.
It's a perfect profit circle.
DuPont, another sponsor of awareness programs, continues to manufacture pesticides that contain known carcinogens. So this month, we are likely to hear a great deal about "prevention" in the form of behavior modification and diet but will not hear that as many as half of all cancers are not associated with known risk factors. The "e word"--environment--if it comes up at all, will be quickly dismissed.
We will also hear that early detection is the best protection. We will not hear that mammograms miss 25% of cancers in women under 50. Nor will we hear that, in many cases, early detection makes no difference in outcome, either because the woman's disease is too aggressive or because it is sufficiently nonaggressive that she'd be just as likely to survive or die if she waited until she or her doctor discovered a lump.
Meanwhile, a 10-year study published this month in the Journal of the National Cancer Institute, covering more than 250,000 women, showed virtually no difference in death rates from breast cancer between those who did monthly breast self-examinations and those who did not. We also will not hear that too little has changed in the treatment of breast cancer since President Nixon raised the battle cry in 1971. Our choices are still slash, burn and poison.
Women without health insurance don't even have those options.
Here's what we need to be thinking about: Mammography, while the best screening currently available, is simply not good enough. We need to focus, urgently, on developing more effective, safer screening technologies that will better predict which tumors need aggressive treatment.
And more attention needs to be paid to possible environmental links to the disease. Establishing those relationships is notoriously complex, as a recent 10-year study of breast cancer in Long Island, N.Y., showed. But that's no reason to abandon the effort. There are thousands of pesticides, solvents and fuels lingering in our environment and in our bodies that may be affecting our breast tissue.
Of course, research that could result in pulling products off the shelves may not be a popular idea with corporate sponsors. They'd rather have women passively shopping for a cure than angrily demanding a search for a cause.
Finally, we need better treatment options for the 40,000 women who die each year of this disease, whose cancers were too aggressive to be helped by mammography detection or current therapies. Their deaths were not a failure of will but a failure of medicine.
The pink ribbon once represented the effort to transform breast cancer from a source of silent shame into a public health crisis. To make good on its promise, we need to do more than patronize companies that support complacency in the name of "awareness." Before we put our money down--whether for a gallon of gasoline, a handbag (in partnership with an automobile company!) or to sponsor a friend on a fun run--we need to ensure that the pink-ribbon profits will make a real difference in prevention, detection and treatment of breast cancer.