It’s Starting Again

Some Notes on Pink Ribbons and the Primacy of Breast Cancer Advocacy

By Karen Roush, MS, RN, FNP-C, AJN clinical managing editor

Breast cancer awareness giveaways/Wikipedia Commons

Breast cancer awareness cornucopia/Wikipedia Commons

It’s starting again. October is less than a week away and already they’re everywhere. But then again, they never really go away. Those darn pink ribbons.

Breast cancer is a terrible disease. My family has experienced its share and I know the anxious—it’s going to be fine, oh my god what will happen to my kids if I die—feeling of waiting for a path report after a lumpectomy.

But there are other terrible things that happen to women—and happen more frequently. And we don’t pay anywhere near the same attention to them. Take heart disease, for example. Heart disease is the number one killer of women. In 1999, according to the CDC, 24% of deaths in women were from heart disease, while 22% were from ALL types of cancer combined. Or consider domestic violence, experienced by one in four women during their lifetime while one in eight women will experience breast cancer.

So why is it that breast cancer garners so much of the public’s attention, and along with that, a disproportionate amount of its resources? It collects more funding than any other type of cancer. For example, lung cancer—according to a New York Times article, the National Cancer Institute spent $1,518 for each case of lung cancer in 2006 and $1,630 relative to each lung cancer death, compared to $2,525 per case of breast cancer and $13,452 per breast cancer death. Yet lung cancer is expected to kill 159,480 people in 2013, versus 39,620 deaths from breast cancer.

Breast cancer has got to be the most marketed disease ever. Every major brand has their pink-clad product, their pink ribbons and rubber bracelets. Now you can “support breast cancer awareness” with every action you take. From what you wear to what you eat, you can choose pink. You can meet all your hygiene needs while supporting breast cancer: soap, deodorant, make-up, shampoo, cologne,  manicure sets, teeth whiteners, and even when you use the best electric razor, the after-shave can be pink too.

Why? I have a few ideas, shared by others. First, of course, is the financial incentive, which is worthy of a whole blog post itself. But I want to talk here of the cultural and social aspects.

Breast cancer is the disease that is so easy to love to hate. Those who get it are blameless. People aren’t likely to think we might have prevented it by avoiding risk factors, like those for heart disease, by eating better, losing weight, or by quitting smoking, which presumably might have helped us avoid lung cancer, the cancer with the most deaths to its credit and the least funding. Breast cancer doesn’t happen because of personal weakness, as many continue to believe is the case with domestic violence. There are no moral judgments attached to breast cancer; it attacks ‘good’ women.

And specifically, of course, the breasts of good women. There may be no other body part that has such deep cultural and social symbolism. Breasts are not just mammary glands topped off with a nipple. They represent both mother and lover. They are sustenance, sexuality, beauty . . . life.

Breasts nurture new life. They provide sustenance and security to infants. Breast cancer threatens the first and one of the strongest human bonds we have—that of mother and child.

Breasts are an outward representation of sexuality. In our society it is one of the major physical determinants of a woman’s sexual attractiveness. From early puberty, breast size becomes one of the measurements girls use to judge themselves against others. Breast cancer threatens our self-concept, our self-image, our sense of ourselves as a sexual being.

But if this was a disease that affected only women, no matter how terrible, it might not garner the attention and resources it does. While breast cancer primarily strikes women (men do get it as well: see our CE article, “Men’s Awareness and Knowledge of Male Breast Cancer”), it threatens men. Men love breasts and so they have a stake in saving them. And they can do so while feeling good about themselves—protective of mothers, wives, and daughters, and even supportive of women’s issues (if not quite feminist). It’s a slam dunk all the way around.

And there is so much more. The complexity of the issues surrounding this disease extends to social, cultural, medical, and financial realms and would take multiple books to cover.

It’s time to untangle the suffering of breast cancer from the feel-good morality of the pink campaign. This year, go ahead—walk for the cure. But for every mile walked, walk another for victims of domestic violence or heart disease. Alternate your Feel Your Boobies T-shirt with a Love Shouldn’t Hurt shirt, and your pink cap with a Go Red one. Get your kid’s school involved in the anti-smoking Kick Butts Day ( Let’s spread the attention and resources around, not only to women’s issues but to all who need it as much or more, regardless of some misguided morality of who most deserves it.

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2017-04-21T22:20:27+00:00 September 25th, 2013|nursing perspective|6 Comments

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  1. painspeaks September 27, 2013 at 9:34 am

    Reblogged this on The Daily Advocate By Painspeaks.

  2. Peggy McDaniel September 26, 2013 at 7:04 pm

    Although I am fully in support of cancer research of any kind I do feel that other cancers should garner the same or at least reasonable support. Children’s cancer research is funded at drastically low levels and although there are some organisations to support this, this research is in great need of more funds. Please check out if you are looking for a fun, rewarding, and very deserving cause/fundraiser to cheer on!

  3. Brent Thompson PhD RN September 25, 2013 at 1:50 pm

    The other issue is the tired emphasis on “awareness”. How many adults are unaware of breast cancer? Does increasing awareness change behavior? I would argue that those who have good access to primary care providers, and have insurance that pays for mammograms, will get the recommended screenings regardless of how “aware” they are about the issue.

    The poor, or illiterate, or non-English speaking, or those who live in remote areas can be fully aware of breast cancer (or any other cancer) and still not be able to get the care they need.

  4. Betsy Marville RN September 25, 2013 at 12:57 pm

    As I understand the story, when Nancy Brinker’s sister, Susan Koman suffered and died from breast cancer, she vowed to work for a cure. Brinker used her intelligence, corporate skill and resources to build an organization that has transformed funding and marketing of disease research. I cannot fault a powerful woman who set a goal and used everything she had to educate, fund research and effect a cure for a disease that no one used to want to talk about. Unfortunately, the larger any organization becomes, politics and many negative aspects of power creep in. The Planned Parenthood decision was a bad one and there was an immediate outcry and exposure of internal political agendas and practices that veered from the non-profit’s purpose. Hopefully that has turned the organization back on its original course .
    Pink ribbons should remind us of a healthcare system gone awry. Disease research should not have to be based on marketing strategy, fundraising and competition. Such practices invite political agendas and corruption. Until everyone gets access to healthcare, and research is fully funded with the zeal and resources equal to that which we invest to develop weapons, the pink ribbons will be a part of our culture.
    Let’s work to get everyone healthcare, insist on safe staffing and nursing autonomy to ensure excellent patient care, and be active as nurses in reforming this broken health system.
    Although I do not share her politics, I still admire Brinker for building a movement that has no doubt saved lives, funded research and screening, has inspired so many to run, donate, educate, and cure women of this most terrifying disease.
    Let’s learn from the Komen pink ribbons to be as dedicated and proactive in transforming healthcare in the US for everyone.

  5. Chris Wentworth September 25, 2013 at 12:38 pm

    Excellent article, Karen! What you have said is right on! I have felt the same way and thought of how unfair it is that breast cancer gets so much attention even though it is not the #1 ‘cancer killer.’ So much of our society’s actions are determined by “feel-goodism,” (as I term it). We are saturated with “breast cancer awareness.” Maybe society should be made more aware of some truths as you have stated. Thank you for getting the information out there.

  6. Joe Niemczura, RN, MS September 25, 2013 at 10:09 am

    For me, when the Susan G Komen Foundation took steps to cripple Planned Parenthood, it was enough. They identified themselves with the anti-woman agenda of a political party. I will never wear a pink ribbon again, even though I support the ultimate goal. Women’s health encompasses a variety of needs.

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