How Corporations, Charities Can Curb Cancer

Ten years ago, when I began conducting research on the intense public interest in raising money to fight breast cancer, I was convinced that this was a fad that would soon fade away. Like the brightly colored silicone wristbands that swept so rapidly in, and then out, of our lives last year, the pink ribbon, I predicted, would quickly lose its luster.

It probably goes without saying that I could not have been more wrong. As National Breast Cancer Awareness Month wraps up, American consumers have been barraged with advertisements promoting merchandise produced to raise breast-cancer awareness.

Alongside the ubiquitous cosmetics and perfumes, flip-flops, vacuum cleaners, cell phones, sleepwear, boxing gloves, toothpaste, frozen dinners, and snowshoes are just some of the products on offer this year. For each purchase made, sponsoring corporations promise that a small donation will be made to charities that fight against the disease.

What’s more, members of the public who wish to open their lungs, as well as their wallets, to support the battle against breast cancer can participate in any of the more than 125 breast-cancer fund-raising runs and walks taking place in October alone.

Public concern about a disease that kills more than 40,000 American women and men each year is not in itself surprising. But the fact that breast cancer remains at the pinnacle of philanthropic causes a decade after a New York Times magazine cover article declared it “this year’s hot charity” is not quite so easily explained.

Approximately 10 times more women will die of heart disease than breast cancer in 2006, and more than 73,000 women are expected to die of lung cancer. Why, then, does breast cancer provoke such an unprecedented charitable response?

The standard answer to this question is that the disease affects a prominent cultural icon that is associated with motherhood, nurturance, and sex.

Moreover, unlike lung cancer or heart disease, breast cancer is not commonly understood to result from “bad” behavior and thus does not carry with it the kind of victim-blaming that tends to accompany other diagnoses.

Such observations make sense, but they also overlook the fact that the positive image of breast cancer is a very recent invention: That marketers would be clamoring to associate their products with the disease, or that women with breast cancer now proudly declare their identity as survivors, would have been unimaginable for much of the 20th century. What has actually changed, then, is how we think about the disease.

Over the past three decades, breast cancer has been transformed from a stigmatized affliction best dealt with privately and in isolation, to a neglected epidemic worthy of public debate and political organizing, to an enriching and affirming experience.

In the latter of these three phases, the figure of the breast-cancer survivor has helped elicit an outpouring of generosity — a continued supply of which, we are led to believe, will ensure that the fight against the disease remains an unqualified success.

As the disease has shed its stigma, breast-cancer activists have learned from their allies in the AIDS movement about the importance of labels that suggest active and empowered individuals. No longer “victims” or “patients,” women with breast cancer began to describe themselves as “survivors,” and the disease itself came to be more commonly understood as almost a positive experience.

In some respects, this clearly marks a change for the better: Women who are in a position to take advantage of the optimism and camaraderie of survivor culture are likely to find that it aids in their recovery.

The new image of breast cancer has also brought with it a slew of other problems, however.

The cheerfulness and consumer-oriented character of breast- cancer survivor culture can be enormously alienating to women who do not have the financial means or networks of social support to participate in it.

It also has the effect, as the critic Barbara Ehrenreich argues, of transforming the disease into a rite of passage, rather than an injustice to struggle against.

This particular problem has been magnified considerably by the interest business has shown in the disease.

Businesses looking to sell more products to female consumers have been quick to latch onto changing attitudes toward breast cancer, and the pink-ribbon industry that has emerged as a result is deeply dependent upon a positive image of the disease.

Sickness and death do not sell, but images of survivors who are uniformly youthful, ultrafeminine, immaculately groomed, and radiant with health do.

The effect of breast-cancer marketing campaigns is to erase from public consciousness the fact that incidence rates remain stubbornly high and newly diagnosed women face essentially the same options — surgery, radiation, chemotherapy — that they did 40 years ago.

Although mortality rates have declined very slightly among all women since the early 1990s, a shift that is attributed in part to developments in chemotherapy, women of color have benefited less from these advances than white women.

Corporations are not alone in promoting an overly optimistic account of the struggle against breast cancer, however.

It is quite possible to attend, as I have done, numerous splashy charity fund-raising events and to come away with the impression that breast cancer is a disease from which people no longer die.

The large breast-cancer charities have also discovered, in other words, that upbeat messages improve the dedication of volunteers and increase the amount corporate sponsors are willing to give.

When people learn of these concerns, their response is often to point to the good work that breast-cancer campaigns perform in raising “awareness” and to argue that, regardless of the messages that accompany them, pink-ribbon products and 5k runs raise large amounts of money for a good cause.

But this position raises its own set of questions: What exactly are we being asked to gain awareness of? And how is the money raised being spent?

For those campaigns and events that venture into specifics, awareness usually means preaching the benefits of early detection through mammograms.

Although this approach might prompt people to discover if they already have breast cancer, this selective brand of awareness asks individuals to take personal responsibility for fending off the disease, while ignoring tougher questions related to what might be done to prevent it in the first place.

As for the money raised, contrary to claims commonly made about the great difference a minor purchase can make, breast-cancer marketing often produces relatively small sums of money.

Take, for example, the prominent New Balance athletic-gear promotion currently under way. For every $25 a consumer spends on products from the Lace Up for the Cure Collection, they will receive a donation postcard to send in to New Balance as proof of purchase. For each form received, New Balance will donate $5 to the Susan G. Komen Breast Cancer Foundation.

Five dollars is no small amount of money — I’ve seen much smaller percentages donated — and we can assume given the price of the products in question that many customers have the potential to raise more than just $5 apiece.

It could also be argued that as long as lots of people were diligently buying their running apparel, filling out their postcards, and mailing the proofs of purchase in before the deadline, it wouldn’t matter if each individual only raised the minimum. But a close reading of the promotional small print reveals that the campaign runs for just six months and the company won’t give more than $175,000.

This means that if and when the maximum donation is reached, unsuspecting consumers will be lining the coffers of New Balance as opposed to contributing to the struggle against the disease. Although companies are surely well intentioned in their support of the fight against breast cancer, by tying these good intentions to their marketing strategies and bottom lines, they inadvertently exploit people’s inclination to be generous and civic-minded citizens.

To be sure, breast-cancer- related marketing campaigns have collectively raised millions of dollars over the years. But can we expect to win the fight against breast cancer based on the assumption that large sums of money allocated to such research must eventually, by the “logic of tidal waves,” in the words of the historian Ellen Leopold, simply overwhelm the disease?

A well-financed research agenda is clearly what is needed to reduce mortality rates. In particular, more research is needed to find effective, less-toxic treatments and to learn how to stop tumors from spreading. After all, people don’t die from the tumors in their breasts, they die when the tumors metastasize.

Most important, however, we must find ways to stop this disease at its source.

One option is for consumers to push companies to direct the money from marketing promotions into scientific research on ways to prevent breast cancer.

Another option is to avoid buying products linked to the diseases, such as yogurts that are made with bovine growth hormone, cars that produce polycyclic aromatic hydrocarbons, and cosmetics that contain parabens.

The best approach is to circumvent what activists at Breast Cancer Action San Francisco call “pinkwashing” and give money directly to those organizations working to end the disease. That way we might find ourselves on the path to a cure, or better still, a world without breast cancer.

Samantha King is an associate professor of physical education at Queen’s University, in Kingston, Ontario. She is the author of Pink Ribbons, Inc.: Breast Cancer and the Politics of Philanthropy (University of Minnesota Press).