It’s October—the leaves are turning yellow, porch ornaments are coming up pumpkin orange, the first frost is sparkling silver, and everywhere I turn the sight of pink ribbons affronts my sensibilities. The annual pink ribbon extravaganza, surely one of the most successful marketing campaigns in history, has millions of Americans walking, running, racing and selling merchandise “for the cure.” Having spent the first half of my career studying religious rituals, I can’t help but think that many of the ribbon bearers see their little scraps of pink as an amulet or a charm, a means of warding off an enemy that makes us all feel impotent. If we just wear or sell enough pink ribbons during the month of October, we bargain with the cancer gods that maybe we’ll be safe from breast cancer for the coming year.
Maybe I’m a cynic or an agnostic, but as a means of averting breast cancer I’d rather put my money on cleaning up toxic chemicals from the environment than on adding a bunch of pink ribbons to our November trash piles. When my mother became ill with and eventually died of breast cancer in 1971, no one talked about it—not even her close friends were present to offer aid or comfort. Yet today, as we paint the town pink, I am concerned that we have come to see breast cancer as a relatively normal part of the female life course: puberty, pregnancy and childbirth, followed by menopause and breast cancer. Pushing against this cultural tide, I feel a need to yell: Breast cancer is not normal. Nor is it pinkly feminine or cute. The rise in rates of breast cancer over the past century is a palpable sign that something is wrong with our world.
America loves winners, and we have come to regard women who are diagnosed with but do not die from breast cancer as heroic fighters. Those women who die are hidden, lying somewhere outside of the victory circle—“victims” in a culture that at best pities and at worst blames victims for their own misfortunes. It feels absurd to have to say this, but it needs to be said: Breast cancer can’t be cured by the optimism or will power or athleticism or fighting spirits or strength of character. Breast cancer should not be treated as a challenge or as a measure of one’s moral fiber. And it should never, ever be treated as a commodity.
In her Psychology Today column about how breast cancer culture undermines women’s health, Gayle A. Sulik draws attention to some disturbing implications of the ubiquitous pink ribbon. First, pink ribbon marketing, like all “cause marketing,” primarily benefits the company. Second, as a result of cause marketing, people actually give less to charities. And third, pink ribbon and other cause marketing can mask conflicts of interest, like when companies promote the idea of cancer research but also manufacture, disseminate, or sell products that contain toxic or carcinogenic ingredients. Over the past few years, the failure of the pink ribbon movement was brought home to many of us when the Susan G. Komen for the Cure foundation, the most visible promoter of pink racing for the cure, announced that it would no longer fund breast cancer screenings at Planned Parenthood, the healthcare home for millions of young and low-wage women. This decision, believed to reflect the Komen’s Foundations’ capitulation to anti-choice advocates, was reversed when donations to the organization plummeted in response.
Victory laps in races for the cure, together with the ubiquitous pink ribbons, may lead people to believe that far greater strides have been made in preventing and treating breast cancer than have actually been made. The reality is that promoting “awareness” may not be helping end breast cancer at all. A 2014 article published in the New England Journal of Medicine reports that data shows no evidence that routine mammography screening of women at average risk saves lives. A high-quality study made public by the Swiss Medical Board, “acknowledged that systematic mammography screening might prevent about one death attributed to breast cancer for every 1000 women screened, even though there was no evidence to suggest that overall mortality was affected.”
“While corporations [such as manufacturers of mammography equipment] have made billions off the disease, progress in breast cancer treatment, prevention, survival, and inequities has not been forthcoming. Three million women in the U.S. are living with breast cancer. Up to one-third of all breast cancers will metastasize, even when found in the early stages. Black women are still 40% more likely to die of breast cancer than white women. And each year, 40,000 women die of breast cancer.”
We can do better.
While spending on breast cancer detection and treatment continues to increase, funding for prevention and for learning about the causes of breast cancer is far less marketable. This year, the legislature in my home state of Massachusetts failed to fund research on potential carcinogenic impacts of chemical exposure despite clear findings that there are specific communities in Massachusetts with particularly high rates of breast cancer. According to reports, the Massachusetts Senate budget did not include a $500,000 request to fund water quality and public health research specifically requested by the Massachusetts Breast Cancer Coalition to study exposure to toxic chemicals in drinking water and homes in Central Massachusetts and on Cape Cod.
Today, when I walked past the Massachusetts State House on my way to work and saw pink ribbons everywhere, women’s health pioneer Barbara Ehrenreich’s words came to mind. Writing about her own experiences with breast cancer, Ehrenreich wrote, “What sustained me through the ‘treatments’ is a purifying rage, a resolve, framed in the sleepless nights of chemotherapy, to see the last polluter, along with say, the last smug health insurance operator, strangled with the last pink ribbon.” Forty years after my mother’s death, there are days when I can comfort myself with the thought that she never had to put up with pink teddy bears, pink running shoes, or pink drill bits used for fracking in the name of “finishing the fight against breast cancer.” There are many more days when I share Ehrenreich’s rage at the billion dollar American cancer industry for using its power and money to draw more women into the breast cancer fold through mammography and breast cancer “awareness” rather than to study and address the causes of breast cancer. But during the month that has come to be known as “Pinktober,” I mostly mourn the years my mother missed and the cruel triumphalism surrounding the cult of brave survivors.
In honor and memory of my mother, Bernice C. Starr.
Related Reading: Enough With the Boobs, What About Saving Women’s Lives?