Background Note: I have long been skeptical of the ties between profit-making corporations and non-profit pink ribbon projects for breast cancer detection, research, and treatments. When my friend, Barb Jarmoska of Freshlife Foods (www.freshlife.com) biked across the U.S. a few years ago with several other older women to raise awareness about breast cancer, she introduced me to Breast Cancer Action. BCA is a grassroots, non-profit organization based in San Francisco that investigates the link between environmental carcinogens and the large companies who make products that pollute the environment. Some of these same companies give money to pink ribbon campaigns. I knew something wasn’t kosher here and the book I review below helped me put all the pieces together.
Pink Ribbon Blues is a hard-hitting treatise on what author Gayle Sulik calls Pink Ribbon Culture. The subtitle to her new book is called “How Breast Cancer Culture Undermines Women’s Health.” From Gayle Sulik’s first sentence in the Introduction, ˜Pink culture is ubiquitous to the last chapter in which the author asks us about “taking a road less pink,” we’re in for a roller coaster ride about breast cancer and how cause-marketing formulates our thoughts and actions about the disease and how to support it.
With almost ten years of research and writing by Sulik, a medical sociologist, the book covers the full range of topics on breast cancer and its pink culture, from What is Pink Ribbon Culture? (Chapter One) to Consuming Pink: Mass Media and the Conscientious Consumer (Chapter Four) to Rethinking Pink Culture (Chapter Nine). Each of the nine chapters is filled with well researched facts, ideas, concepts, and links between cancer and the culture that has risen around it and now surrounds it, shaping our thoughts, pricking our guilt, and selling us all kinds of pink paraphernalia in the name of saving lives.
The main question I think the author poses is: Does all this hype, from Racing for the Cure to the War on Cancer to buying products from corporations that send money to cancer organizations really do the job of helping women with cancer? Her evidence would say otherwise, or at least gives us cause to pause and rethink pink.
Sulik discusses how some late stage cancers are undetectable through mammograms, the most widely touted tool for detecting breast cancer. Yet, mammograms also contribute to over-diagnosis and over-treatment of conditions that are not life threatening. The research also shows that even when some women are diagnosed early, for many of them, especially those who have limited resources, early detection does not make a big difference in their survival, since they do not necessarily have the insurance or resources to follow up with the medical recommendations. For Hispanic and African American women, these and other factors contribute to poorer survival rates compared to those of white women.
Pink Ribbon Blues explodes with stories, statistics, and the subversion of some of the facts surrounding all the hype on The War on Cancer. Sulik writes:
The economic incentives of the cancer industry help to create a consumer-oriented environment that shapes the medical and scientific enterprise. The social and clinical investment in diseases with large markets (e.g., women at risk for, or diagnosed with, breast cancer) supplies a huge number of customers for a broad range of cancer-related products and services (pp. 160-161).
For example, GE, who makes mammography machines that are very costly, overstates the cancer survival facts when they advertise that early detection saves lives. Their 5-year survival rate, not really a cure anyway, was actually based on statistics for only early-stage breast cancer.
National Breast Cancer Awareness Month (NBCAM) and its sponsors are also called to task:
Still the sponsor* of NBCAM, along with the American Cancer Society, the conflict of interest between sponsoring breast cancer awareness programs, while profiting from breast cancer diagnosis and treatment and/or contributing to a carcinogenic environment, is one of the many competing interests that undermine pink ribbon cultureâ€ (p. 19).
*Here Sulik is referring to Zeneca Group plc of Imperial Chemical Industries (which later merged with AstraAB to become the pharmaceutical giant AstraZeneca). On page 205, Sulik notes in a quote from an article by M. Klawiter (Racing for the Cure, Walking Women, and Toxic Touring) that Zeneca Pharmaceuticals was a key player in NBCAM’s breast cancer early detections campaigns, and at the same time, through ICI (their parent company), the company actually manufactured insecticides and pesticides that contribute to causing cancer. AstraZeneca continues to sponsor the campaign and profit from the sale of oncology drugs.
Even the concept of the war on cancer is called into question by Sulik, because some women are too sick to fight the war, race for the cure, or be all smiley and upbeat in the face of a drastic diagnosis. On this topic, Sulik writes:
No model in pink ribbon culture captures the ethos of American cancer culture and pink femininity better than the she-ro. With feminine style, optimism, courage, humor, and resolve, this woman hero in pink fights breast cancer and winsâ€ (p. 101).
In the chapters on women’s stories, the author explains that some women do not feel like she-roes: What Barbara and others reject is the overemphasis on transcendence, which encourages optimism to the point of encouraging women to conceal their distress based on the misguided belief that it will afford survival benefits (p. 244).Â And later in this section, Sulik states that, “Embodied social stigma is also visible in women’s feelings of personal responsibility for getting breast cancer in the first place” (p. 263).
(My note: The prominent view of the triumphant survivor ignores the woman whose diagnosis is so harsh that optimism, courage, and humor do not play a part in her mind-set. (There are many women in this category.) She does not feel like she-ro. She feels tired, angry, guilty, and doesn’t necessarily survive, despite early detection. Gayle’s note: She feels like Barbara, mentioned above.
Be clear that the author does not deny or exclude the importance of early detection or even wearing a pink ribbon. Rather, the book questions the ubiquitous nature of the pink ribbon culture masking too many other vital issues surrounding breast cancer. No longer are women silent about their illness. But is disclosure via the pink ribbon culture the best or only way to help women cope with this life-threatening illness?
For me, after reading this book, clearly the answer is NO. My now-informed response is to take the road less pink. If there is a war to fight (for me through Breast Cancer Action), it is the big companies like General Electric and AstraZeneca. They sponsor cancer pink programs while profiting from the disease or pollute the environment with chemicals that may be contributing to the very cause they sponsor, because their so-called support makes them look good and detracts from their polluting practices.
If you have a Books to Read list, as I do, please put this one at the top of your list. It is a must read for anyone concerned about breast cancer, which is just about every woman and also many men. Pink Ribbon Blues will open your minds, test your beliefs about the facts and fiction surrounding breast cancer, and hopefully open your hearts to embrace a different viewpoint about pink ribbon culture that will help many women (and men) with breast cancer and their families find other realistic choices to deal with their illness.
Gayle Sulik’s Pink Ribbon Blues, published by Oxford University Press (www.us.oup.com), is available at bookstores and also online at www.Amazon.com. You may also obtain more information via www.pinkribbonblues.org. Click on the icon below to go directly to Amazon to purchase this eye-opening book.
P.S. Gayle Sulik recently posted a very interesting essay on pink ribbon culture regarding the Komen trademark feud, posted on the Oxford University Press blog. Here is the link to the essay: http://blog.oup.com/2010/12/breast-cancer/.