2012 Edition, excerpt from the new introduction

Breast cancer is indeed one of the most popular and profitable social causes of our time. The pink ribbon not only signifies a good and moral cause but also functions as a proxy for awareness and support. Countless promotions and publicity materials are carefully crafted to capture the hearts, minds, and wallets of eager, well-meaning consumers as imperative language echoes across the pink cultural landscape: hope, fight, win, celebrate, give – now, today, forever. The formula morphs into any number of fun-filled activities from pub crawls and fashion shows to the now commonplace runs and walks “for the cure.” While these actions offer symbolic support and raise money, they sometimes do very little to help the diagnosed, promote real awareness, or impact the epidemic at large.

Pink Ribbon Blues is a heavily referenced critique, organized systematically to show the complexities and mutually reinforcing dimensions of the culture and industry that built up around breast cancer in the United States. It explains how the pink ribbon system works and how it can impact people, personally and collectively. It shows how public attention to breast cancer and the pink ribbon have grown over the past thirty years entwined with a medical system at once the hope and bane of the disease, situated within communities of advocacy and support that help as much as hinder, and popularized to the degree that pink consumption has become more of a trendy lifestyle choice than a rallying call for social change. The book also highlights a persistent reticence in the halo of sound bites, survivorship mantras, and product placements as well as an inattention to strategies and actions that may be more useful. At its core, Pink Ribbon Blues is meant to engage thoughtful and systematic dialogue about how to recalibrate a system gone awry.

Hidden beneath the highly publicized pink ribbon celebration, the push-pull of breast cancer advocacy gave way to those with the largest megaphones, political influence, and marketing potential. As pink ribbon promotions increasingly exploited the cause for public relations purposes and to keep revenues and profit streams flowing, tenacious groups continued to work on the margins to affect the epidemic and support the diagnosed in meaningful and healthful ways. This constellation of individuals and organizations goes beyond fundraising and self-promotion to consider issues of bioethics, evidence-based medicine, health communication, social justice, conflicts of interest, neglected areas of research, and the limits of consumption-based advocacy. Though they diverge in the problems they tackle and the methods they use, these groups share a critical stance that fosters new thinking about breast cancer and how to address it.

In recent years members of the public have joined their voices to a chorus of serious and uncomfortable questions about breast cancer, including:

• Are we any closer to knowing what causes breast cancer, how to prevent it, how to keep it from coming back, and how to keep people from dying from it?

• Why are the“slash,burn,and poison” approaches to treatment still the norm?

• Are pink ribbon products outpacing efforts to provide meaningful support to the diagnosed and to influence the epidemic?

• Where does the money go, and who/what does it help?

Not long ago, outside of trusted circles, such questions would have been uttered in hushed tones. Many, including those treated for breast cancer, felt guilty for doubting a cause that was commonly accepted as overwhelmingly good. As the inner workings of pink culture and industry become more visible, largely through the misconduct of breast cancer charities and profit-driven industries, growing numbers are calling for transparency, accountability, and alternatives.

In early 2012 the decision by Susan G. Komen for the Cure (“Komen”), and subsequent semireversal, to cut ties with one of its grantees, the health network Planned Parenthood, is one of the many vexing controversies to surface since the initial publication of Pink Ribbon Blues. The scandal involving one of the “most trusted” breast cancer charities in the United States and the nation’s leading provider of reproductive health care unleashed an international debate about breast cancer advocacy and industry that revealed some of what goes on behind the pink curtain. Charities and companies profit from a disease in the name of its cure. Corporate and political agendas stand in the way of patients’ rights and access to quality care. Profit motives supersede efforts to provide accurate and useful health information or to improve the lives of those who are living with, and at risk for, breast cancer; and billions of dollars are siphoned into branding efforts instead of the prevention and eradication of disease. The incident is an extraordinary object lesson in the political values and beliefs that, along with national and international politics, underlie different players in breast cancer advocacy. It is also a multifaceted example of how pink ribbon culture currently functions.

The remainder of this introduction centers on the Komen/ Planned Parenthood saga and its place within Komen’s political and social history. The analysis is not intended to chastise those who support Komen or any other advocacy group, nor is it meant to downplay the uplifting aspects of supporting an important social cause in a manner that is uniquely suited to one’s values and dispositions. The discussion here is designed to motivate people to cut through the rhetoric and hype to see what breast cancer organizations and other women’s health groups are really working toward. Learning about their histories and where these groups put their efforts and money is a useful place to start. People often ask me which breast cancer organizations they should support, and I typically refrain from answering this question. I believe people need to figure out for themselves which groups to support to end the breast cancer epidemic. This means asking tough questions and looking beyond well-meaning efforts to learn about the people, practices, and politics that shape the way these groups deal with breast cancer.

SUSAN G. KOMEN FOR THE CURE’S IN/ DECISION ABOUT PLANNED PARENTHOOD

The background leading to Komen’s Planned Parenthood decision, and its fallout, is likely to get more complicated as investigations into the giant breast cancer charity continue in the coming months and years. But here is a basic summary of the events…


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