In “1 in 8”: The Probability of Developing Breast Cancer, and Fear, I wrote about the overuse of incidence and mortality statistics to promote an unhealthy anxiousness about breast cancer. The hyper-alertness surrounding this particular type of cancer stems from the seemingly inevitable likelihood that a woman, any woman, will eventually develop the disease. This is simply not true. Seven out of eight women will eventually die from something besides breast cancer, maybe even old age. But the threat of breast cancer, the statistics, the personal stories, the millions of diagnosed women, all keep us on the edge of our seats wondering who the next victim will be.
Will it be me? Will I suffer the kind of death that my friend did at the young age of 40? I hope not. I understand the fear, and I understand the desire to do something to reduce the chances that I could some day end up willingly submitting myself to radiation, drugs, and toxic chemicals with the hope of selectively killing all of those noncompliant cells in my body that are threatening to kill me. But fear is stifling and sometimes causes individuals to accept conditions that would otherwise be unthinkable. The unthinkable has occurred. The war on breast cancer has taken on a life of its own.
While hundreds of thousands of women continue to suffer from the disease and its treatment, and while millions of women are concerned about their risk, the pink ribbon primarily serves industry—diagnostic technology, pharmaceuticals, large non-profits, and all those corporations participating in cause marketing. Revenues from the medical imaging equipment industry grew from about $3 billion in 1997 to over $9 billion 10 years later, and healthcare analysts predict that the market for medical imaging equipment (not including services) is expected to thrive at a 7.6 percent compound annual growth rate. Sales of oncology drugs grew from under $5 billion in 1998 to over $19 billion by 2008, and analysts predict that oncology drug costs will rise 20 percent each year for the next 5 years. Oncology drugs represent the largest share of the global drug market, and sales are projected to grow at a compounded annual rate of 12 to 15 percent, reaching $75 to $80 billion by 2012.
Deeply invested in the drug industry, mammography, and National Breast Cancer Awareness Month, the American Cancer Society, according to Samuel Epstein M.D., is the wealthiest “nonprofit” institution in the world with approximately $6.40 spent on compensation and overhead for every $1 that is spent on direct services. These profit centers within the cancer-industrial complex sell both fear and the alleged solutions to the breast cancer problem.
Though the fear has worked to keep breast cancer at the forefront of women’s concerns and advocacy, the solutions haven’t worked nearly so well—certainly not for my friend, for the more than 40 thousand women like her each year who die from the disease, for the approximately 30 percent of women treated for invasive breast cancer for whom the cancer recurs anyway, for those who suffer the side effects of treatments (and most women have lingering side effects after treatment), for the increasing numbers of diagnosed men, for the undiagnosed women who fear for themselves and the women in their lives, and for all of us who desperately want to find effective means for eradicating this disease. Fear mongering aside, if cancer is the second leading cause of death in America, accounting for 1 out of 4 deaths, it is in our national interest to deal with it—for the health of our citizens, their families, their jobs, and our national budget.
In the forty years since President Richard Nixon declared the war on cancer through the enactment of the National Cancer Act, there has been some progress, particularly with colorectal, lung, and childhood cancers. For colorectal and lung cancers there are modifiable behavioral lifestyle factors such as diet and smoking cessation that go a long way toward reducing incidence by avoiding the disease in the first place. For other cancers, behavioral factors alone are not successful preventive measures. According to the President’s Cancer Panel, the “true burden of environmentally induced cancers has been grossly underestimated.”
I frequently hear women diagnosed with breast cancer say, “But I did everything right: healthy diet, exercise, no smoking, and I still got cancer.” Though this statement could contribute to the mythology that breast cancer is inevitable no matter what a person does, it illuminates clearly that individuals can only do so much to ensure that our internal environments are hostile to cancer when our bodies are regularly exposed to external environments that provide cancer a safe haven.