Every year, when Pink October, aka Breast Cancer Awareness Month, rolls around, dozens of women with breast cancer begin posting online to express one single sentiment: Make it stop.
It's not the gifts from well-meaning friends that they mind so much, though they could do without the toasters and blenders in the color of Pepto-Bismol and the pink-iced pastries (never mind the warnings that sugar may be a culprit in cancer growth). "Today is just one of those days when I could scream if I am attacked by one more piece of pink," one woman writes on a breast cancer site called Breast Cancer Insight. Then there are the pink chin straps on NFL helmets, plus other football accessories. Also, the big-ticket splurge: the "Warriors in Pink" Ford Mustang, with pink side stripes, leather seats with pink stitching, gray floor mats embroidered with pink ribbons. All of which adds up to the bold statement … that … what? "Cancer, I crush you with my Mustang?"
It's more than bad taste that's disturbing to breast cancer survivors. It's also the whiff of impotence and manipulation. Breast Cancer Awareness Month has become a distracting sideshow, a situation that sociologist Gayle A. Sulik explores in compelling depth in her new book, Pink Ribbon Blues. Sulik argues that despite the $1 billion raised over the years by pink-clad volunteers on hikes, despite the greater billions the U.S. plows into related research each year, science has failed to make any real progress in the fight against breast cancer. All the hoopla and boosterism of Breast Cancer Awareness Month leaves the impression that important work is being done, but in fact, in the time since the war on cancer was declared 40 years ago, things have gotten worse. The stats are dismal. *
Sulik's evidence is strong and disturbing. A woman now has a 1-in-8 chance of getting breast cancer in her lifetime. In 1975, the figure was 1-in 11. The risk of dying from the disease, upon diagnosis, decreased just 0.05 percent from 1990 to 2005. A woman with invasive breast cancer today will be bombarded with many more treatments and spend a lot more than her grandmother might have on care, but she'll have about the same chance of dying from the illness as women did 50 years ago. *
But the pink ribboned are unfazed by these statistics. Or more likely, unaware of them. "Survivors and supporters walk, run, and purchase for a cure as incidence rates rise, and the cancer industry thrives," Sulik writes. She points out that "cancer drugs are the fastest growing and best selling class of drugs" in the prescription drug market, which totals more than $200 billion and is ever growing. Given the profits, Sulik questions whether any amount of pink-ribbon volunteering can alter the medical establishment's investment in the current treatments. Who needs a cure if you can make so much money without one?
If that sounds shady, National Breast Cancer Awareness Month itself has a dubious provenance. It was established by the American Cancer Society with funding from the pharmaceutical giant Zeneca. The company continues to underwrite and direct publicity for this month's breast cancer early detection campaign while also manufacturing the pesticides and insecticides that cause breast cancer.
Early detection is the cornerstone of Breast Cancer Awareness Month. Pink-October fundraising groups like the Susan G. Komen Foundation promote the importance of early mammograms. * (Komen is the Pink Behemoth; it claims to have raised more than $1 billion since its founding in 1982.) But the faith that mammogram screening protects women is largely outdated, Sulik writes. In 2006, researchers concluded that "for every 2,000 women invited for screening throughout 10 years, one will have her life prolonged and 10 healthy women, who would not have been diagnosed if there had not been screening, will be treated unnecessarily." Though you'd never know it from reading the Komen Foundation's materials, the consensus in medicine now is that early mammograms are of questionable benefit.
For its takedown of the breast cancer industry, Pink Ribbon Blues is an important book, though not a perfect one. The writing can be as stiff-limbed as a thesis candidate's and the cultural analysis is sometimes woeful. Sulik also ascribes more cultural power to what she calls "pink ribbon culture" than it has. "Women who don't live up to the expectations of pink culture face an ongoing stigma," she claims. Meaning what? They come over and rip off your ribbon?
Still, Sulik's hard hitting points more than make up for the missteps. She's especially sharp in decrying the shining face that the pink world puts on breast cancer. The women featured in stories and ads embody the triumph of the human spirit, they fight fight fight, they're always transformed by the experience and they rarely have recurrences, even though, in the real world, some 30 percent of women do. Pink campaigns largely steer clear of incurable Stage 4, with its average life span of two and a half years. "We are the dirty little (and not so little) secret that Pink October doesn't want to advertise," one woman in this category posted on Breast Cancer Insight. "Why would anyone contribute money if they thought Stage 4 could happen to them?" Yet it is the sizeable number of women with advanced cancer who most desperately need the treatment advances October dollars are supposed to help develop.
So what can be done about Big Pink? I'd like to make a proposal. Given that 20 years or more of toaster sales and fundraising hikes haven't produced much in the way of scientific breakthroughs, for one year, let's pool the millions raised during October for a neediest cases fund. The CEO of the Komen Foundation, who earns $459,406 a year (more than 5,000 race entry fees), could try living on the wages of your average oncologist—$250,000 a year—and top up the fund with that extra $200,000 or so.
This way, we'd have ample resources to help directly. We could provide cab service for the woman with brain metastasis forced to drive 40 minutes each way for a scan. We could pay for a counselor—couples' or otherwise—for the women whose husbands turn mean after their diagnoses. "He tells me he's waiting for me to die," one posts on Breast Cancer Insight. Women could get housekeeping services during the molasses days of chemotherapy, child care for scan days, money for a lawyer if their jobs are suddenly declared "redundant" upon diagnosis. If we can't yet abolish breast cancer, then let's at least tackle the social ills that come with the disease. We wouldn't even be diverting the majority of Komen funds from science. Only 23.5 percent goes to research, anyway.
Corrections, Nov. 12, 2010: The statement "The stats are dismal" was originally cited as a verbatim quote from the book. It does not appear there. ( Return to the corrected sentence.) This sentence originally failed to note that this chance of survival applies only to women with invasive breast cancer. ( Return to the corrected sentence.)