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, after-shave, manicure sets, and even teeth whiteners.

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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