I was not aware breast cancer existed until I saw your pink ribbon.
As Breast Cancer Awareness Month just came to an end, we say goodbye to Halloween and pink ribbon paraphernalia. Pink merchandise, along with no-shave November, the ice-bucket challenge and a host of other forms of activism that generate a visceral response from the public, as I see it, create and sustain a model of competitive fundraising. We are made aware of these diseases, but do not discuss the implications of funding biomedical research that could lead to a cure. Have we become so far removed from the realities of these illnesses that our engagement with it is to romanticize them?
In her book “Pink Ribbon Blues,” sociologist and founder of the Breast Cancer Consortium Gayle Sulik writes that we must look at the agenda for each program. Is the goal of pink ribbons to eradicate breast cancer? A woman diagnosed with breast cancer today has relatively the same chances of dying from breast cancer 50 years ago. This is not a war we are winning. If the goal of pink ribbons is to spread awareness, what does that accomplish? If awareness simply requires visibility, what do pink ribbons accomplish? Who in our society is not aware of cancer? Sulik argues that the Susan G. Komen Foundation and the American Cancer Society maintain the focus of making the disease visible, rather than concentrating focus on the eradication of breast cancer through research. This effectively maintains “the issue of Breast Cancer” on the media spotlight while bringing in funds, year after year.
But these ribbons advocate annual mammograms. Is that not a good cause?
Cancer survivor Peggy Orenstein writes about a feel-good war on breast cancer, which fuels the optimism of mammograms to save lives. However, when she scrutinized the effectiveness of a mammogram, she discovered that “mammograms may catch breast cancer, but they reduce the risk of dying of the disease over the next 10 years by only .07 percentage points — from .53 percent to .46 percent.” In addition, these “reductions for women in their 40s are even smaller, from .35 percent to .3 percent.” Citing the fear of contracting cancer, the yearly ritual of getting a mammogram becomes a ritual, or the “only thing we can do to prevent ourselves from getting cancer.”
What about the Komen ad that professes that the five-year survival rate when caught early is 98 percent and that when it is not, it is 23 percent? Citing Steve Woloshin, Orenstein argues that this statistic, although accurate, is deceiving. Mammography often detects types of cancers that do not require treatment, while patients with lethal conditions seem to live longer due to the prolonged awareness of the condition. For instance, Woloshin writes that in a group of “100 women who received diagnoses of breast cancer because they felt a breast lump at age 67, all of whom die at age 70” the “five-year survival for this group is 0 percent.” However, if these women were screened and diagnosed years earlier but treatment does not work and they still die by age 70, “the five-year survival is now 100 percent, even though no one lived a second longer.”
If mammograms are less effective than we previously thought, then what about efforts towards the cure? Orenstein writes that “only 16 percent of the $472 million raised by Komen in 2011” went towards research, leaving a hefty $231 million on education and screening.
I argue for a more holistic education on mammograms. Rather than reassuring the public that “mammograms save lives,” campaigns should emphasize the highly personal nature of mammography. In fact, in a 2011 meta-analysis conducted by the Cochrane Database of Systematic reviews, breast cancer screening can lead to an over diagnosis and overtreatment of 30 percent. In other words, mammography can lead to an absolute risk increase of 0.5 percent.
So pink ribbons may be less effective than we had assumed, but does that make them harmful? The way I see it, though it may not directly and affectively hurt the cause, it works in tandem with most awareness campaigns. Not only are a good portion of them highly sexualized (think t-shirts saying “save second base” or “save a life and grope your wife”), studies indicate that something such as purchasing a pink ribbon will lead most participants to donate less or not donate at all in the light of other, less visible campaigns.
This creates extremely passive activism. By limiting our activism to buying that t-shirt, dumping that bucket over your head, buying that pink product or not shaving, we, as intelligent, capable and privileged students, are doing ourselves and our communities a disservice. While camping outside the offices of governmental officials seems impractical, I believe that activism is making conscious, deliberate lifestyle choices. Shop with your conscience, volunteer or tweet! Do not just donate because your friend’s Greek group needs to do well. Research, and evaluate whether or not the values of said organization align with your convictions. To be frank, I do not know completely what to do, as a fully-conscious, hyper-politically correct lifestyle seems exhausting and near-impossible to maintain.
At the very least, I do know that we should find ways of using symbols of buckets and ribbons in ways that do not divorce us from the realities to those suffering in our community. If we cannot fully help, at least let us not trivialize these illnesses out of our “good will” to feel good.
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Follow Justina Huang on Twitter: @huanderwoman
