Deborah Ostrovsky

I belong to the generation whose understanding of breast cancer has been shaped almost entirely by pink ribbon campaigns. I’ve shopped for pink tote bags, votive candles, and other trinkets – all to support the respectable cause of breast cancer research and awareness.

Throughout university in the mid- to late-90s, I spent October weekends with friends running for the cure. At that time, feminist activists like Barbara Ehrenreich were just starting to lament the demise of the women’s health movement and the sabotage of the breast cancer sisterhood by pink teddy bears, runs, and rhinestone bracelets. Meanwhile, a tidal wave of well-meaning but naïve consumers, ready to buy and jog for the cure, was just coming of age.

And then there was Samantha King. As a young graduate student in 1997, she picked up a copy of BCAM co-founder Sharon Batt’s, Patient No More (1994) and started asking some very important questions. Despite being a young person deep in the thick of a growing consumer culture, King began analyzing prior moments in the social and political history of breast cancer while observing the rapid rise of pink ribbon campaigns from a critical distance – a distance she’s maintained ever since.

As King explained in her lecture, “Public Health/Private Interests: Breast Cancer Profiteering and the Struggle for a Prevention-First Approach,” the 1990s was an era when pink ribbon culture and fundraising awareness products proliferated at an alarming rate. While others welcomed the trend, King became suspicious.

She had good reason to be. Just two decades earlier, breast cancer had been so stigmatized it was essentially a nameless “private tragedy.” This was followed by a period of struggle when feminist activists challenged their doctors and the patriarchal medical establishment, finally sharing their experiences of the disease publicly.

And then, King explains, breast cancer won the hearts of industry and was transformed from the unnamed illness to the darling of all disease-related causes. Everyone from cosmetics CEOs to car company execs vied to sponsor pink ribbon fundraising campaigns, despite the disease’s former pariah status.

How, she asks, did breast cancer evolve from taboo to a cheery, pink fundraising colossus, coveted by the likes of Estée Lauder, Kentucky Fried Chicken, Avon, Smith and Wesson (with 9mm pistols engraved

with awareness ribbons, sporting pink handles), KitchenAid, and Scotties tissues, to name only a few?

King, a health and gender studies professor at Queen’s University and author of the highly-praised Pink Ribbons Inc.: Breast Cancer and the Politics of Philanthropy (2006), has dedicated over a decade of scholarly research to mapping out the complex social forces shaping our perceptions of the disease. Her work draws attention to the pivotal era when a groundswell of corporate interest changed the way breast cancer would be portrayed in the public sphere. No one, she explains, could have ever predicted that “the vaguely commercial nature of fundraising for the disease would become an industrial juggernaut by the end of the decade.”

Pink ribbon culture has become a cash cow and a cause that fares well with a corporate model. Other illnesses – and some more prevalent than breast cancer like heart disease and stroke – are strongly associated with bad lifestyle habits such as smoking and poor diet. The fight against breast cancer, however, involves the preservation of all the things about women that society holds sacred: the intact female body, the nurturing breast, and the precious tropes associated with maternity and motherhood.

Who could possibly criticize an industry wanting to be associated with such an admirable cause? And who would be against running and shopping to support it?

Sure, shopping and running can boost morale and raise some money for creative, useful purposes. But these are deceptively simple, anodyne distractions from the reality facing patients who find themselves alone in the oncology ward. Their medical choices, King notes, have arguably not improved all that substantially over the past decade.

King explains that most awareness campaigns do not include investigating environmental and occupational links to breast cancer – areas of research that have been fatefully stalled. She also reminds us that, despite all the money being pumped into research, the illness kills an estimated 460,000 men and women annually, worldwide. And while treatment may be more accessible for some patients as a result of fundraising, prevention is still an abstract concept outside the modus operandi of many nonprofits.

To exert any effective change, she explains, we need a public health approach in which governments commit to building policies that protect consumers from known and suspected carcinogens. Such a strategy would also initiate the long-overdue regulation of toxins, pesticides and other noxious substances increasingly linked to cancer.

Rather than fundraising to understand disease causation, awareness-raising has become an industry in and of itself.

But until then, the public face of the disease has been hijacked by plucky, healthful women modeling pink for-the-cure t-shirts, pink lights on the Parliament building, pink perfumes and pink no-stick frying pans.

King’s lecture outlined some of the dubious ethics involved in awareness campaigns devised by companies like AstraZeneca (manufacturer of the cancer therapy drug tamoxifen and former producer of acetochlor, a pesticide and possible human carcinogen), or General Electric, the largest mammography equipment producer in the world. Both companies have huge stakes in making profits from treatment and screening protocols, rather than in the prevention of the disease.

Along with the issue of pinkwashing, and industry’s simultaneous production of  hazardous chemicals while claiming a place in the leadership of breast cancer awareness campaigns, King also described how some aspects of pink ribbon culture have been shipped overseas, morphing into a new form of imperialism under the guise of spreading awareness. For instance, Avon and the Susan G. Komen Foundation have entered partnerships with the U.S. government to bring breast cancer screening campaigns overseas to places like Dubai.

Dubai already had free, existing screening programs and a lower breast cancer rate than most Western nations. And the Komen Foundation’s Race for the Cure events in Egypt and Ghana have transported the pink ribbon to the Global South where breast cancer rates are generally lower. Such international strategies suggest more cynical attempts at business ventures in parts of the world where the West desires an extension of its economic influence.

King also discussed what she has coined the “tyranny of cheerfulness,” describing how alienating it is for many women she has interviewed whose experience of the disease doesn’t conform to the pink and perky narrative.  It is unclear what sort of psychological dissonance such an implacable, upbeat narrative creates in the life of a patient at such a vulnerable time, when anger and confusion might seem like more normal emotions.

Meanwhile, the Susan G. Komen Foundation and the Canadian Weekend to End Breast Cancer have started fundraising for other cancers requiring ever more elaborate events with costly overheads. Rather than fundraising to understand disease causation, awareness-raising has become an industry in and of itself.

Amidst the comments shared in the Q&A after King’s lecture, one poignant question stood out: how do we share our concerns about the troubling politics behind the pink ribbon culture with people who are enthused by the breast cancer fundraising cause? And if we do share our opinions, how to do so with tact?

King shared a few reflections that demonstrated equanimity and thoughtfulness, suggesting that it is possible to remain sensitive to others, even if we need to think critically about the pink ribbon culture that surrounds us.

I would venture a step further and suggest that tact is no longer what we need. Industries that manipulate the sick are tactless. Companies that latch onto a disease because it suits their marketing strategies are tactless, too. And the more we talk honestly about corporate interests in disease-related causes – even if we do step on toes and hurt feelings – the better chance we have of seeing meaningful change happen in our lifetime.

Confronting The Pink Ribbon And Corporate Profiteering first appeared in Volume 19, No.1 Spring 2011 of the BCAM Bulletin