'The pink ribbon culture that has grown up around breast cancer promotes a tyranny of cheerfulness’


October 9 2006

'The pink ribbon culture that has grown up around breast cancer promotes a tyranny of cheerfulness’


October 9 2006

'The pink ribbon culture that has grown up around breast cancer promotes a tyranny of cheerfulness’



Q Heart disease kills so many more women than breast cancer does. But there’s a seemingly endless supply of pink ribbon products. Why is that?

A: Well, heart disease and lung disease have come to be associated, rightly or wrongly, with bad lifestyle choices. And that’s not what we think when we think of breast cancer. The marketing savvy of the large breast cancer foundations and corporations that link themselves with the disease has made breast cancer a hot cause.

Q: You write that cause-related marketing is a way of branding and increasing profits. But why did so many corporations seize on breast cancer?

A: Until the 1990s, breast cancer was thoroughly stigmatized and viewed as a private tragedy, and women with the disease were “victims,” which suggests passivity and perhaps inevitable death. One lesson of the AIDS movement was that disease identity categories can profoundly shape the course of an epidemic. People with AIDS refused to be known as victims, they wanted to be seen as people living with AIDS, active in fighting the disease and fighting for changes in how it was approached. Activists in the breast cancer movement saw the potential for shifting how people think about breast cancer, and it’s a dream cause for corporations, at least in part because of the cultural symbolism of the breast, and its association with mother-

hood and nurturing, which makes it safe, unthreatening and familiar. And subsequently, marketers have really transformed how we think about breast cancer, by disassociating it from death and associating it with survivorship and the idea of a cure.

Q: All of which sounds positive.

A: Certainly we can see the relationship between the public, empowered identity of the survivor and women feeling good about themselves and proud. The survivor identity is also connected to women winning involvement in the research process. What’s been lost is the more negative but very real component of breast cancer: it’s a really horrible disease and people still die from it.

Q: Which may be why people like the pink ribbon. It’s a symbol of hope.

A: I would ask, what do we mean by hope? Hope for a cure? Which is kind of a limited way of thinking about breast cancer. Or hope for prevention? Which I think is where we need to be putting our dollars. The problem is not so much with the ribbon itself as how it’s used, and the fact that it’s come to be associated primarily with splashy fundraising events that have costly overheads, and with selling products.

Q: But commercialization has also helped de-stigmatize breast cancer, as you point out, so women are no longer ashamed of having the disease. I think a lot of people would say, well, if that’s the price, it’s a fair one.

A: I think it is hard to overestimate how significant that shift has been. But only for

certain women.

Q: Who’s been left out?

A: The pink ribbon culture that’s grown up around the disease promotes a tyranny of cheerfulness. What my research and the research of others shows is that the experience of breast cancer is profoundly different for different women. Not all women experience breast cancer positively. They might feel anger, hopelessness, fear. And profoundly alienated by pink ribbon culture.

Q: How much of the money raised by pink ribbon products actually goes toward research?

A: It’s hard to say on average because there’s so much variation in the campaigns. Here’s a Canadian example: in 2005, Yoplait ran a 69-day campaign where consumers could purchase specially produced yogourt cartons, and for every lid mailed back to Yoplait, the corporation would donate 10 cents to the Canadian Breast Cancer Foundation. The consumer would have to buy and eat three cartons ofyogourt a day just to raise $20.70! Even if consumers were diligently doing that, and cleaning the lids and mailing them in, H the fine print said that the amount Yoplait m would give was capped at $80,000. And that’s ï one of the major criticisms I have of these 2 campaigns: a lot of them have caps, and once g the maximum is reached, any more money consumers spend on the special products ^ stays with the corporations. Which means that potentially people are purchasing someg thing with the idea that their money is going ¡5 to help research, when in fact it isn’t. With S

so many of these promotions, very small amounts of money actually go to the cause.

Q: But isn’t that better than nothing?

A: Breast cancer research is extremely wellfunded relative to other diseases. And I think we have to move beyond the idea that any money is good money. We’ve been pumping large amounts of money into breast cancer research without asking hard questions about whether we’re spending it in the right way. And incidence rates have remained stubbornly high in spite of all this money. A woman’s lifetime risk of breast cancer was one in 22 in the 1940s, but by 2004, it was one in seven.

Q: You would think that given the large number of corporate backers, there would be more competition in terms of championing different types of breast-cancer research.

A: But when I call a corporation or go into a store and ask, “Do you know where this money is going?” oftentimes they don’t even know what organization it’s going to. Even if they do, they either don’t know exactly what kind of research it’s funding, or they’re not allowed to talk about it because they have confidentiality agreements with the Canadian Breast Cancer Foundation. There’s a real lack of transparency in terms of breast cancer marketing. And there’s a link between the commercialization of breast cancer and the narrowness of the research agenda. That agenda isn’t going to change as long as the main players in terms of educating the public about the disease are large corporations that are either implicated in environmental degradation or are producers of breast cancer detection equipment and pharmaceutical treatments.

Q: So you’re saying they have a vested interest in keeping thefocus awayfrom causes and preventative measures. But how is a company like Avon, which has a global breast cancer awareness campaign, implicated in breast cancer?

A Well, they use [chemical preservatives called] parabens in their cosmetics, along with other ingredients that have been linked to cancer. Rather than buying products or sponsoring someone for a run, I would encourage people to send their money to organizations that focus on prevention. The Canadian Breast Cancer Foundation is the biggest recipient of funds from cause-related marketing in Canada, and they spend only a very small amount on researching the primary causes of breast cancer. They make direct grants, but the major filter for their money is the Canadian Breast Cancer Research Alliance. And the alliance allocates just 177 per cent of its budget to prevention and risk factors combined, and of course they’re not the same thing.

Q: But people don’t just buy YoplaitorAvoti or sign up for Run for the Cure to raise funds for research. They do it to make themselves feel better and to show solidarity with women they know who have breast cancer.

A: I agree. I think people are really well-intentioned, and that it’s not a bad thing for people to feel they’re participating in a social movement and fighting a disease. In many respects it’s a good thing. But I’m concerned about whether these campaigns are exploiting people’s goodwill, at the same time that they might be making them feel good. And I do think that this trend toward buying products to show support for a cause reflects troubling general trends, such as the transformation of political action into consumption.

Q: Obviously there’s a huge difference between an intellectual understanding of the disease and the individual, subjective experience of it. Because from the point of view of the woman going through chemo, survival and cure is exactly what we should focus on.

A: It will be a great day when we find a cure for breast cancer. But that is approaching the problem from the wrong end, it’s the inversion of that old saying, “A pound of prevention is worth an ounce of cure.” We would be much better off if we could find out what causes breast cancer and stop it at its source. It’s important to remember that many women in the breast cancer movement came to it because of anger at governmental inaction and/or the direction of the research agenda. And I think that anger can be really socially productive in terms of bringing about change.

Q : Anger hasn ’t really worked for women as a feminist or political strategy, though, audit doesn’t play too well on an individual level, either. People discount angry women.

A: But the use of anger in the AIDS movement has resulted in a quite different approach to the disease than what we’ve seen with breast cancer. So I’m not sure actually that it doesn’t work. And I think about organizations like Breast Cancer Action in Montreal and BCA in San Francisco, which take a more critical stance. Their slogan is “Cancer sucks.” They have made the higher mortality rates among poorer women, particularly among African-American women, a priority. But it’s really hard to get a message out there about those concerns when the disease is so commercialized and the primary image in breast cancer marketing is a young, white, ultra-feminine, healthy-looking woman.

Q: It’s interesting that you mention the anger of AIDS activists. The most powerful activists right now are probably Bill Gates-who’s of course very corporate and doesn’t seem that angry—and Bill Clinton.

A: But they have attached themselves to an agenda that is much more wide-ranging and

innovative overall than the breast cancer agenda. That’s not to say that there aren’t absolutely terrible policies that are affecting AIDS and HIV rates, but the global movement around AIDS has really taken a broad approach to the disease, it’s been concerned about social conditions and economic conditions, and that is not the case with the mainstream of the breast cancer movement either in Canada or globally.

Q: Most women with breast cancer would argue that their experience is radically different from their mothers’. Are they just deluded?

'The consumer would have to buy and eat three cartons of yogourt a day just to raise $20.70!’

A: Certainly the emotional experience of breast cancer has changed for women who’ve been able to take advantage of the emergence of support groups and the survivor culture. But in terms of actual treatment options, not very much has changed. It’s still surgery, radiation, chemotherapy. We have slightly less invasive surgery.

Q: Come on. A lumpectomy is quite a bit less invasive than a radical mastectomy.

A: That’s true, but we still see radical mastectomies. And prophylactic radical mastectomies are one of the new forms of prevention, along with pills with toxic side effects.

Q: What were the old forms?

A: Okay, those are the only forms of prevention. And that’s why we need to keep funding innovative and less toxic treatments for the disease. M