You know that it's October when the leaves start turning and the world turns a glorious pink. Yes pink, the mascot color of National Breast Cancer Awareness Month (NBCAM). Each year we are exhorted to race for the cure and go for our mammograms because, according to the NBCAM mantra, "Early detection saves lives". We buy pink lipstick and wear pink ribbons because part of the proceeds goes to benefit breast cancer research.
The question we fail to ask however is does being 'aware' save lives? To begin with, it is inconceivable that there is a thinking adult in this country who isn't aware of breast cancer. According to the American Cancer Society, one in seven women will develop breast cancer during her lifetime (in 1975, the risk was only one in eleven). More than 250,000 women will be diagnosed with breast cancer this year. Each year, more than 40,000 women die from breast cancer. Maddeningly, the treatment options offered to women with breast cancer vary little from the treatments used 40 years ago, radiation, chemotherapy and surgery.
It would seem logical to start by asking why the incidence of breast cancer keeps increasing despite advancements in early detection and the continual development of new treatments. As any school child knows, you can't solve a problem if you don't know the variables. Yet most of the money that is thrown at breast cancer gets spent on finding cures and treatments, with very little of the research focusing on the cause.
This seems particularly odd since approximately half of all breast cancer cases are unexplained by personal characteristics, leading many to suspect that the cause might be environmental. Since the 1940's tens of thousands of synthetic chemicals have come into use yet only a small percentage have been tested for safety. Pollution has increased dramatically as well. A link has long been established between some pesticides and breast cancer and it is also known that nonsteroidal estrogens are carcinogenic. Chemicals with estrogenic activity include PVC and bisphenol-A (plastic additives found in many household products) and benzene (a gasoline additive). Other chemicals such as parabens and phthalates, which are found in many cosmetics, can act as hormone disrupters and have been linked to cancer. Other compounds that likely contribute to breast cancer include DDT, dioxin and PCB's.
Additionally, "State of the Evidence 2004: What Is the Connection Between the Environment and Breast Cancer?", jointly published by the Breast Cancer Fund and Breast Cancer Action, reported the following connections between chemical exposure and breast cancer:
Chlorinated chemicals, found in drinking water and many industrial processes such as computer component manufacturing, were associated with an elevated risk of breast cancer in three new studies;
A solvent used in many varnishes, paints, dyes and fuel additives (ethylene glycol methyl ether) was found to sensitize breast tissue cells to the effects of estrogens and progestins, thereby increasing the risk of breast cancer and;
The Million Women Study in the United Kingdom revealed that all types of postmenopausal hormone replacement therapy significantly increased the risk of breast cancer, underscoring earlier findings from the Women's Health Initiative study in the United States. Another study found that use of HRT after previously being diagnosed with breast cancer tripled a woman's risk of recurrence or development of a new breast tumor. (1)
Yet organizations like the American Cancer Society and the Susan G. Komen Foundation routinely fail to address these issues. As it turns out, both groups have connections with numerous corporations in the chemical, cosmetic and pharmaceutical industries, many of which have an enormous financial stake in breast cancer. Good intentions aside, it is far more profitable for these companies to detect and treat breast cancer than to prevent it, leading to an enormous conflict of interest between their corporate well being and their charitable public persona.
The primary corporate sponsor of National Breast Cancer Awareness Month is AstraZeneca, which makes the popular cancer drug Tamoxifen. Interestingly, Tamoxifen can also cause cancer and until recently, AstraZeneca also made a variety of other cancer-causing chemicals. Apparently the company has a thing about color marketing. Not only do they encourage you to think pink, they are also the maker of a frequent sponsor of the nightly network news, the little purple pill a.k.a. Nexium. Which begs the question of how corporate sponsorship of the news might impact how cancer ‘cures’ and causes are reported by the networks.
AstraZeneca is not the only company playing both sides of the cause/cure game. Dupont makes numerous chemicals that have been linked to cancer (including Teflon) as well as much of the film used in mammography. And General Electric makes nuclear power plants that produce ionizing radiation, a known cause of cancer as well as mammography equipment (which also perversely produces cancer-causing ionizing radiation). GE also owns NBC.
What these corporations understand is that supporting breast cancer awareness and funding is a great public relations gambit. As Barbara Brenner of Breast Cancer Action points out, "If you slap a pink ribbon on a product, people will buy it." But where does the money raised by the sale of all these products go? Some companies clearly state what portion of the proceeds are donated, but many just say something along the lines of, 'a generous portion of the proceeds will be donated to finding a cure for cancer'. The definition of 'generous' can vary widely and all too often there is no definitive accounting of how much was raised and who benefited from the proceeds. (2)
And what of organizations like the Susan G. Komen Breast Cancer Foundation, which sponsors the annual Race for the Cure? According to the Toxic Links Coalition, the race focuses on finding medical cures while ignoring environmental causes. In "Running From the Truth", Mary Ann Swissler reports that the Foundation's stock portfolio has included holdings in several large pharmaceutical companies as well as General Electric, one of the largest makers of mammographic material. (3) Their 2003-2004 Annual Report lists Ford (automobile exhaust has long been linked with cancer) and Johnson and Johnson (makers of numerous cancer drugs and diagnostic equipment) as Partners.
In 1998, Komen was the only national breast cancer group to back Tamoxifen as a preventative treatment for some women, which other advocacy groups objected to strongly. As it turns out, Tamoxifen's maker, AstraZeneca is a strong backer of the Race for the Cure and in 2003 received the "Friend of the Fight" award from Komen.
The Komen Foundation is also notably silent on environmental issues. Interestingly, Occidental Petroleum, a major environmental polluter (think Love Canal) is a big Komen supporter. While Komen may have the best of intentions, as breast cancer activist Judy Brady points out, the problem is that they simply don't see that "'business as usual' is why we have cancer". (4)
ACS and Komen are both big supporters of annual mammography for women over the age of 40. Over and over, both organizations tout early detection as a lifesaver. They both also receive substantial funding from makers of mammography equipment such as GE and DuPont.
Unfortunately, the truth about mammography and early detection is not so cut and dry. Mammograms may detect cancer earlier (although the majority of women detect their own cancers) but they do not prevent cancer or protect women from cancer and early detection does not necessarily translate into longer survival.
Many women whose cancer is detected by mammograms have slow-growing cancers that will never be life threatening while others are very aggressive and would be lethal no matter when they are detected. Early detection does not appear to impact the life expectancy of either of these groups of women. In addition, because breast tissue in pre-menopausal women tends to be denser, mammograms may miss suspicious masses. The breast tissue of younger women is also more susceptible to damage from radiation.
It is interesting to note that no nation other than the U.S. routinely screens pre-menopausal women by mammography. According to activist Jennifer Drew, in England the practice is for "women aged between 50 and 64 who are registered with a General Practitioner (to) receive a letter inviting them to attend a Breast Screening scan. The age is being raised to 70 years from 2004. Women between these ages can have free mammograms every 3 years. The Government here in the UK believes once every 3 years is sufficient based on medical research." In contrast with the United States, only one in nine women are stricken with breast cancer in the UK, a statistic also true in Canada. Routine screening guidelines for Canadian women are to be screened every two years after the age of 40. Only one in eleven women in Australia are stricken with breast cancer and women there are advised to get mammograms every two years between the ages of 50-69.
What is perhaps the most important to understand is that survival rates are counted from when a woman is diagnosed. So if a woman is diagnosed in 2000 and lives for 15 years, this is no different than if she was diagnosed in 2005 and lived for 10 years. She would still die in 2015. In other words, a woman may live longer past a diagnosis that occurs earlier, but not necessarily longer overall.
It seems likely that the corporate connections to organizations like ACS and Komen play a significant role in determining policy recommendations and how the funds that are donated to these organizations are spent and why funding is so clearly biased towards detection and pharmaceutical treatment. While many useful projects have undoubtedly been funded, the reality is that women, too many women are still dying from breast cancer and we still don't know why or how to stop it.
What is clear is that it is well past time to re-think the pink and to quit indiscriminately touting early detection and to focus much more of our research resources on the context in which breast cancer takes place and finding treatments for those women who currently do not benefit from treatment. As the comparison of mammography recommendations and breast cancer incidence in other countries indicates, some hard questions need to be asked as to the benefits of early and more frequent mammograms in this country and what other factors account for our higher breast cancer rates. The role of environmental pollutants and compounds with estrogenic activity in breast cancer must also be addressed in a much more comprehensive manner.
Efforts like that of Dr. Susan Love to learn more about the milk ducts where most breast cancer begins should be enthusiastically supported. We also need to focus research on understanding other issues such as how antibiotics may contribute to breast cancer and how breast cancer surgery itself may spread cancer. Above all, we need to make sure that public policy decisions are made in the best interests of the women whose lives are impacted by breast cancer, not for the benefit of corporate profit. (5)
Lucinda Marshall is a feminist artist, writer and activist. She is the Founder of the Feminist Peace Network, www.feministpeacenetwork.org. Her work has been published in numerous publications in the U.S. and abroad including Awakened Woman, Alternet, Dissident Voice, Off Our Backs, The Progressive, Rain and Thunder, Z Magazine, Common Dreams and Information Clearinghouse.
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