5:18pm

Sun October 16, 2011
Health

Breast Cancer: When Awareness Simply Isn't Enough

Originally published on Sun October 16, 2011 8:01 pm

It's October and one color dominates the landscape: pink, the color of National Breast Cancer Awareness Month.

Breast cancer fundraising events dominate the month, from the massive Avon walks that take place in nine U.S. cities to the international Susan G. Komen Races for the Cure. Even the White House gets bathed in pink floodlights in recognition of the campaign.

But what if your breast cancer diagnosis doesn't make you want to wear pink socks, walk for the cure or be a "warrior in pink?"

Barbara Ehrenreich's backlash against the pink-ribbon breast cancer culture began when she was in the mammogram room, waiting for her results.

"There was an ad for a pink breast cancer teddy bear," Ehrenreich, the author of 13 books, including Nickel and Dimed, and most recently, Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America. "That was kind of an existential turning point for me because I realized I'm not afraid of dying, but I am terrified of dying with a pink teddy bear tucked under my arm."

The women's movement Ehrenreich came out of was concerned with health issues and giving patients the power, she tells weekends on All Things Considered guest host Rebecca Roberts. The message she was seeing now seemed to say that somehow breast cancer made you "less of a person." She prefers to say she was treated for the disease rather than calling herself a survivor.

"The fact that I am alive and another woman is now dead doesn't mean I'm a better person," she says. "I didn't battle the disease more bravely — I'm lucky."

Ehrenreich says while she is pleased breast cancer is in the public eye, she expected a more questioning attitude toward treatment of the disease.

"The treatments are terribly debilitating and toxic," she says. "I can't get behind the idea of awareness, awareness, awareness when we don't have really effective and safe treatments."

Ehrenreich expresses solidarity with those who undergo breast cancer treatments, but she says the disease is not something we should ever decide we can live with as a society and turn into a growth experience.

"This is ugly, this is nasty," she says. "I want to know why it happens and stop it."

Too Much Pink?

Nancy Brinker, the woman responsible for breast cancer awareness being dressed in pink, founded the Susan G. Komen Foundation in honor of her sister – whose favorite color was pink. As ubiquitous as the color might be during the month, Brinker says it's never enough.

"We have a lot of complacency in the world ... and it really isn't too much attention," Brinker says. "[Breast cancer] is the second leading cancer killer of women in this country. As long as a woman, or even a man, dies every 74 seconds from this disease, there's not enough pink."

Brinker says colors have been great for disease movements — red is the color of HIV/AIDS awareness — and she is grateful that the breast cancer movement has a color.

"I think my sister would have just loved it," she says. "She really liked pink."

Perhaps pink isn't your favorite color, but what's the harm?

"The harms are partly that the awareness itself has been redefined as visibility for the sake of visibility [and] fundraising," says Gayle Sulik. "A deep awareness of the realities of breast cancer and where we really are in that war on breast cancer has gotten lost in that."

Sulik, author of Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health, says there's often a misconception that anything with a pink ribbon on it is supporting and funding research for a cure. But in reality, she says, that isn't the case.

Sulik says people need to read the fine print, look at the organizations that receive those funds and examine what those allocations are going toward. She believes that people definitely associate pink with breast cancer, but says the branding has probably oversimplified the disease, its detection and treatment in people's minds.

"People need to know that it is more complicated and messier than that," she says.

Sulik's tagline for breast cancer awareness: "Go deeper."

Copyright 2013 NPR. To see more, visit http://www.npr.org/.

Transcript

REBECCA ROBERTS, host: This is WEEKENDS on ALL THINGS CONSIDERED from NPR News. I'm Rebecca Roberts in for Guy Raz. Today, Dr. Martin Luther King Jr. physically joins the ranks of American leaders Thomas Jefferson and Abraham Lincoln with a permanent spot in our nation's capital.

President BARACK OBAMA: That is why we honor this man because he had faith in us. And that is why he belongs on this mall.

ROBERTS: President Barack Obama was one of several dignitaries paying homage to the icon of America's civil rights movement in front of a crowd of thousands here in Washington earlier today. We'll have more on the Martin Luther King Memorial dedication later in our show.

But first, it's October when one color dominates the landscape. No, not fall gold or Halloween orange. It's breast cancer awareness pink.

(SOUNDBITE OF VARIOUS ADVERTISEMENTS)

UNIDENTIFIED WOMAN #1: I'm a warrior in pink.

UNIDENTIFIED WOMAN #2: What?

UNIDENTIFIED WOMAN #1: Well, it's all about breast cancer awareness. That's...

JENNIFER ANISTON: When you buy this T-shirt, you help researchers take a giant leap towards finding a cure for breast cancer.

UNIDENTIFIED MAN: We'll help raise money for breast cancer too. Look what they got. T-shirts, lip balm, these little (unintelligible) things that are so cool. And my favorite, the pink bandanas to wipe the sweat from your brow as you're walking.

ROBERTS: You can work up that sweat at any number of breast cancer fundraising events, from the massive nine-city Avon walks and international Komen Races for the Cure, to small community events like last week's Making Strides Against Breast Cancer in Mt. Airy, Maryland.

UNIDENTIFIED WOMAN #3: This is so exciting. It's my pleasure that we had over 660 walkers today.

(SOUNDBITE OF CHEERS)

UNIDENTIFIED WOMAN #4: Pink. Pink and more pink.

UNIDENTIFIED WOMAN #5: Pink. Of course, I have pink everywhere.

(SOUNDBITE OF LAUGHTER)

UNIDENTIFIED WOMAN #6: I've got on my pink shirt, my pink running shirt, my boa as a belt, so I have a little tail, and then I have my pink tutu.

UNIDENTIFIED WOMAN #7: My mother-in-law had breast cancer, and so did my mother. And I'm here to support any fundraising we can do to get this taken care of.

UNIDENTIFIED WOMAN #8: So we are giving birthday cookies for the survivors because the American Cancer Society is helping people celebrate more birthdays. So all of these survivors are celebrating more birthdays today, and we're so excited to have them here.

(SOUNDBITE OF CHEERS AND APPLAUSE)

ROBERTS: But what if your breast cancer diagnosis doesn't make you want to wear pink socks and be a warrior? Our cover story today, pink fatigue. It's hard to picture Barbara Ehrenreich in a pink tutu. She's the author of 13 books, including "Nickel and Dimed" and most recently, "Bright-Sided: How the Relentless Promotion of Positive Thinking Has Undermined America." Her backlash against the pink-ribbon breast cancer culture began when she was in the mammogram room waiting for her results.

BARBARA EHRENREICH: And there was an ad for a pink breast-cancer teddy bear. Now, I can't tell you how much that freaked me out at that moment. That was kind of an existential turning point for me because I realized I'm not afraid of dying, but I am terrified of dying with a teddy bear tucked under my arm. You know, I'm a grownup. This is the most serious health issue I've ever had.

You know, it was this expectation that having breast cancer made you not a full person anymore, not a full adult anymore. And part of the women's movement I came out of was always very concerned with health issues, and what we wanted was to give power to patients. And so that was sort of my theme. And I thought, hey, what happened to that?

ROBERTS: Awareness, to you, it's not getting at the real problem. In some ways, it's pinkwashing the problem...

EHRENREICH: Yeah.

ROBERTS: ...in terms of it's just become acceptable when it really is not okay.

EHRENREICH: It's not okay. No. I don't believe that there are treatments that are very effective. In fact, the treatments are terribly debilitating and toxic. And I cannot get behind the idea of awareness, awareness, awareness when we don't have really effective treatments and safe treatments.

ROBERTS: Is the breast cancer culture and using the word survivor instead of victim and the races and all this sort of togetherness, is that the logical extension of the health activism, that it's not about being ashamed, it's about empowerment?

EHRENREICH: No. I think that's - it's very good that breast cancer came out of the closet. But the kind of questioning attitude toward treatments and toward the approach to it, I mean, asking that question, why is it happening? What's causing it? That's what I expected to encounter. The survivor stuff, I will tell you, I will not use that word.

ROBERTS: What do you prefer?

EHRENREICH: Mostly - you know, I can say I was treated for breast cancer. The fact that I am alive and another woman is now dead doesn't mean I'm a better person. I didn't battle the disease more bravely. I'm lucky. And I do not like the implicit putdown of the many victims who succumbed to the disease.

ROBERTS: It seems like a natural human instinct to sort of want a ritual or some totem to hold onto that gives you some anchoring in what could be a very scary situation. And whether it's a pink bear or a race you're training for, has that become the way people handle the disease? And if it's not a great way to handle it, what's a better one?

EHRENREICH: Well, first of all, you know, I want to express some - a lot of solidarity and support to other women who are going through this kind of thing. I know it's hard, and we have to reach out to each other, but this is not something we should ever decide we need to live with as a society and make it actually a good part, a growth experience. You're like, no. This is ugly. This is nasty. I want to know why it happens and stop it.

ROBERTS: Writer Barbara Ehrenreich.

One woman is responsible for breast cancer awareness being dressed in pink. It's Nancy Brinker, who founded the Susan G. Komen Foundation in honor of her sister.

NANCY BRINKER: Well, I think it's really very simple. It was her favorite color. She was a very, very wonderful person who loved, actually, a lot of color. She was an amateur artist on top of all the other things that she did. So she loved to paint and draw, and she just loved the color pink.

ROBERTS: It's Breast Cancer Awareness Month. The color pink is everywhere.

BRINKER: Yeah.

ROBERTS: I mean, pink eyelash curlers.

(SOUNDBITE OF LAUGHTER)

ROBERTS: The - you know, the...

BRINKER: Yeah.

ROBERTS: ...football players wearing pink cleats. There's even pink pistol grips. Is there a point where the pink has become so ubiquitous that it's lost its meaning, that people forget the underlying cause behind it?

BRINKER: You know, you often hear people say there's enough awareness. Well, enough awareness for who? But still, we have a lot of complacency in the world, and yet, people say, oh, that's too much attention. Well, it really isn't too much attention. It is the second leading cancer killer of women in this country. The truth of the matter is as long as a woman or even a man dies every 74 seconds of this disease somewhere in the world, there's not enough pink.

ROBERTS: Do you worry that companies can slap a pink ribbon on something and pretend they're doing something for cancer when it's just a cover?

BRINKER: At Susan G. Komen, we have a very strong code with our cause-related marketing partners in a very strong agreement that these programs must be upheld. There's a strict guideline for what a partner must do to be able to use our pink ribbon, but there of course are people who are going to abuse anything that seems to be working well.

ROBERTS: Do you ever have a moment when you look out on the sea of pink and think, gosh, I really wish my sister had liked green?

(SOUNDBITE OF LAUGHTER)

ROBERTS: I mean, is there a moment when you think enough with the pink?

BRINKER: No. Actually, it doesn't phase me as much because I'm very, very intensely involved in the underlying part of what we do and the mission. And I am so grateful we have a color. You know, after all, if you think about a time when we wouldn't have had red to identify the AIDS movement, we possibly wouldn't have had anti-retroviral drugs. Think about that. Colors have been great for disease movements.

I will tell you. I think actually, my sister would've loved it. She really liked pink.

(SOUNDBITE OF LAUGHTER)

ROBERTS: That's Nancy Brinker, founder of the Susan G. Komen Foundation. She's been speaking to me from Atlanta, Georgia. Ambassador Brinker, thank you so much.

BRINKER: Thank you for having me. Always a pleasure.

ROBERTS: So maybe pink isn't your favorite color, and maybe some of the pink products out there aren't for you. But what is the harm? That's a question for Gayle Sulik, author of "Pink Ribbon Blues: How Breast Cancer Culture Undermines Women's Health."

GAYLE SULIK: The pink ribbon and the pink products and everything that has come up around the cause of breast cancer, the harms are partly that the awareness itself has been redefined as visibility: visibility for the sake of visibility, visibility for the sake of fundraising, and so a deep awareness of the realities of breast cancer and where we really are in that war on breast cancer has gotten lost in that.

In addition, the industry that's been created around breast cancer, which is upwards of $6 billion a year being raised in the name of the cause, that's also created a situation where any money for the sake of money, any product for the sake of any product has become the norm. And many of those products, you know, they don't go anywhere at all. At the same time, some of the products are actually contributing to ill health, and in some cases, cancer itself.

ROBERTS: Let's follow the money for a second. If each, you know, tub of pink-ribboned yogurt, or whatever the product is, sends some money to breast cancer research, how much money are we talking about?

SULIK: Well, it's hard to answer that question, because not all of that money is actually going to breast cancer research. There's an idea that anything with the ribbon on it that's going to support the cause is actually supporting research toward a cure, but in reality, that's not the case. So you really have to read the fine print. You have to look at the organizations that are the recipients of those funds and look at specifically what those allocations are.

ROBERTS: At this time of year, Breast Cancer Awareness Month, when the pink is everywhere, you know, you can't turn on a football game without seeing pink, do you think it still means breast cancer? And if so, what message do you think people should be getting from that? What would you like the tagline under the breast cancer awareness to be?

SULIK: It's a good question. I think when people see pink at this point, they definitely do think breast cancer. And I think one of the issues around the branding of breast cancer is that it has made breast cancer very simple. There's a ribbon, there's pink, there are simple messages such as: Join the fight, get your mammogram, detection saves lives. And people need to know that it's more complicated, and it's messier than that. So the tagline, I guess, would have to be something like, Go deeper.

ROBERTS: Gayle Sulik. Her book is called "Pink Ribbon Blues." She joined us from her home in Texas. Thank you so much.

SULIK: Thank you. Transcript provided by NPR, Copyright NPR.