In North America, October is associated with pumpkins, fall foliage, and the color pink. While the last item is not a part of nature’s season, it has become associated with the cause for the month designated as National Breast Cancer Awareness Month (NBCAM).
It’s become such an institution that many of us are unaware of the origins. Some research was necessary to dig it up.
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The rise of awareness and pink Octobers
On October 4, 2017, the Breast Cancer Consortium published A Brief History of Breast Cancer Awareness Month. It reports the institution was born in 1985, and its parents were the American Cancer Society and the pharmaceutical division of Imperial Chemical Industries, which is currently owned by AstraZeneca, a major producer of drugs used in cancer treatments.
The raison d'être for NBCAM was, according to A Brief History of Breast Cancer Awareness Month, “to educate and empower women to “take charge of their breast health.” Awareness was seen as key to achieving that end, and, in association with the signature pink adopted by the best-known cancer organization in the United States, Susan G. Komen, the month that follows September has become known as "Pinktober”
Similar to mainstream pink ribbon culture, Pinktober is upbeat, disseminates simple awareness messages, stresses the urgency and aggressive action inherent in any war metaphor (i.e., Join the Fight), and encourages people to participate in pink ribbon culture especially through the purchase and display of pink paraphernalia vis-a-vis the breast cancer brand.
Understanding pink ribbon culture and its effects
There’s an entire book on pink ribbon culture called Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health. The author is Gayle A Sulike, PhD, a medical sociologist and 2008 Fellow of the National Endowment for the Humanities for her work on breast cancer culture.
Each chapter is followed by pages of footnotes that point out the dark side behind the pink ribbon. She points out very little true progress has been made in the battle against breast cancer, for all the fanfare of pink products, awareness, and the popularity of donning pink or coloring products pink all in the name of supporting “the cause.”
The myth of salvation through mammograms
The repeated mantra, “Early detection saves lives” in making yearly mammograms the key to breast cancer survival has been an integral part of the positive spin on ending breast cancer in pink ribbon culture, but it is far from a cure or even of benefit for all women.
As Sulike explains in the book: "Screening mammography is largely responsible for the ever-increasing diagnoses of stage 0 breast cancers, the types that are not technically breast cancers at all.”
Such results stack the deck for the claim that early detection saves lives when the lives "saved" were never in danger in the first place. In addition to false positives, mammograms can yield false negatives, meaning that the cancer that is there will not be detected.
In the book, she quotes an article that appeared in 2009, "Chief medical officer of the American Cancer Society Dr. Otis Brawley said: 'I'm admitting that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated."
The more research done into the impact of mammograms, the more they are revealed to be a mixed-bag at best with the benefits possibly outweighed by the risks involved.
In 2014, the British Medical Journal published a twenty-five-year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study that challenged the conventional wisdom still in practice by many gynecologists today of pushing for annual mammograms in all women over 40.
“In conclusion, our data show that annual mammography does not result in a reduction in breast cancer specific mortality for women aged 40-59 beyond that of physical examination alone or usual care in the community. The data suggest that the value of mammography screening should be reassessed. “
But there’s more to pink culture than the perpetuation of the myth of early detection, and that also gets people miffed by the Komen-dominated branding of this form of cancer.
In October 2012, Madhulika Sikka published “What Color Is Your Breast Cancer?” in The Atlantic. The answer she offers to the title question is “It's probably not pink.”
She then goes on to suggest that it’s time to move beyond the pink ribboned awareness stage:
I think we've outgrown breast cancer awareness month. Having gone through it I can tell you that what helped me wasn't the NFL clad in pink, the grocery items adorned with pink packaging or any other made-to-order-assuage-your-guilt-pink-something.
New names that define and redefine the cause
It took a full six years, but it seems that Komen finally got the message that women are tired of being forced to look at breast cancer through monochromatic pink-colored glasses. That’s why the Run for the Cure, its major fundraising event held in key locations all around the country has now rebranded to the “More than Pink Walk.”
Komen put out some press releases about the shift in branding for such a high-profile event, in which it speaks in glowing terms of the shift in the name of the event in referencing greater inclusion and an association with additional colors to represent what it calls its “four pillars: research, care, community, and action.”
In all the positive spin, what it does not come right out and say is how this shift in name is reflecting what is actually a much less ambitious goal than it had originally associated with its brand and the name of the fundraiser. It’s worth looking at its own shifts in name and what they signify.
The Komen organization’s own name tells more than one story
Of course, the base name, Susan G. Komen, comes from the woman it memorializes. As the organization’s site explains:
In 1980, Nancy G. Brinker promised her dying sister, Susan, that she would do everything in her power to end breast cancer forever. In 1982, that promise became the Susan G. Komen® organization and the beginning of a global movement.
But the name also got an additional descriptive term, the same one that was tacked on to its major fundraiser: namely “for the cure.” For years, the Komen organization branded itself as Susan G. Komen for the Cure. In fact, it considered that “for the cure” part as integral to its name and brand identity.
In fact, one of the reasons (and there are quite a few) the Komen organization came under fire over the last decade is that it went so far to protect its exclusive rights to using “for the cure” in its name that it demanded that no other group use it, no matter what the cause.
As reported in “Lawsuits for the cure?” a Komen representative admitted that the organization “Komen monitors U.S. Patent and Trademark Office filings to protect its brand.”
But now that part of the name is completely absent from the newly branded “Beyond Pink Walk” that replaces the “Run for the Cure.” The official word from Komen representatives evades any direct address about the missing word “cure.”
Perhaps that’s because the claim to be in pursuit of a cure is what draws the most fire from critics of the Komen organization because the lion’s share of the money it raises does not go for research that is intended to find a cure.
Where’s that cure?
For all of its possessiveness over the word as its own trademarked property, the fact is that Komen’s activities on the breast cancer front have largely been linked to awareness and possibly education but not very much to the kind of research required to find a real cure. In fact, that is one of the major critiques people have of an organization that literally named itself for something it has failed to deliver.
Despite all the years of collecting millions of dollars, we are no closer to a cure for breast cancer than in 1982. That is the central thesis of the critique of organizations that question blindly supporting Komen as a feel-good no-brainer gesture of supporting a worthy cause.
Think Before You Pink is one of those organizations that wish to bring a different level of education to the public about breast cancer than the wrapped in a pink bow variety it has been getting from Komen. It focuses a lot of attention on "pinkwashing," which gets in the way of true progress, another issue that Sukile addressed in her book.
In directing well-meaning people with four questions they should ask before blindly participating in Komen fundraising events, Think Before You Pink, it points out the fact that the stated goal is clearly not being achieved just by throwing more and more money at the cause as defined by the Komen organization:
Some of these walks have become huge affairs that are hosted by multi-million dollar charities and sponsored by multi-billion dollar corporations that raise millions to “end breast cancer.” And yet each year, 250,000 women still get diagnosed with breast cancer and 40,000 women still die of this disease.
This concern finally erupted into a public demonstration calling Komen to account for failing to deliver on a cure in 2018. Their slogan and hashtag is "Cure Komen,” which they have emblazoned on their black - - not pink -- T-shirts.
As you can see in the video above, they point out that Komen has raised over a billion dollars just over the past five years and still has failed to make a real difference in terms it had originally defined for itself: that of finding a cure.
The report on the demonstration quoted one of the demonstrators who also serves asacting president of MET UP, the activist group that helped to organize the protest.
"It's research that's going to save lives…not awareness, not public health education."
A social scientist, Noah Goldstein, Ph.D., whose wife died from breast cancer in 2018, said his goal was to bring pressure on Komen to change. Well, they did end up doing so but not in the way he envisioned.
Obscuring the real issue with the rainbow addition to pink
Instead of reallocating its assets to direct more to research, Komen decided to make a virtue of its division of funds by spinning the story of four pillars to replace “for the cure” in its tagline. That way it makes it's messaging align with its spending, which is not really all about ending cancer as it has claimed but about offering a variety of resources, including what it has become known for in defining its own standards for community for women who embrace pink ribbon culture.
In her book, Sulike also examines the mythology of the "she-ro" who must rise above her suffering according to the script tied with a pink ribbon. This approach has excluded many women, as Lara Huffman, a breast cancer survivor wrote in “Why I Am Anti-Komen”
Would people like Huffman and Sikka become supporters of Komen with the makeover? Not very likely.
Certainly, Karuna Jaggar, Executive Director of Think Before You Pink is not. As she noted in a blog entitled “Before You Walk for Breast Cancer,” the problem with the way the organization operates is not its color choice itself:
Komen’s new rainbow of color solves nothing if their walk expenses exceed their program spending, if they continue to promote misleading statistics that falsely reassure people, and if they continue to include simple narratives that exclude anyone who isn’t a cheerful “survivor.” These events have long been multi-million dollar marketing bonanzas that too often benefit corporate reputations more than women living with and dying from breast cancer.
That's something to think about when we feel we've done our part in contributing to a cure by just choosing the pink-labeled product over the standard one without really thinking about what that does and does not accomplish in the battle against cancer.