A Metastatic Breast Cancer Patient’s View on Awareness
by Ann Silberman
To every thing there is a season, and a time to every purpose under Heaven,” goes the lyric in the song Turn, Turn, Turn, written by Pete Seeger in the 1950s. For those of us with metastatic breast cancer, that lyric takes on a deeper meaning. Not only do we live with the knowledge that our time is short and our season is waning, but we also exist within a culture that aims a pink spotlight at the wrong cause: breast cancer awareness.
Awareness, as defined by breast cancer organizations, means understanding that breast cancer exists and taking steps to get it diagnosed as early as possible. If you do those things, they contend, you will survive. But for those of us who are metastatic and whose disease is incurable – despite having had early detection – we realize that the focus on awareness is out of sync with the reality of the problem: a need for more research.
Over the past 30 years, billions of dollars have been spent on this concept of awareness. Despite these well-meaning campaigns, statistics show that the number of deaths from breast cancer has hovered around the 40,000 range for the past two decades. And there are still many gaps in our scientific knowledge of the disease itself.
At this point, everybody—from the second-grader down the street to your centurion great-grandfather—knows what breast cancer is, and that mammographic screening is the detection tool of choice. But this wasn’t always so. Back in the mid-1970s, the culture wasn’t as open. Just a few years earlier, Rob and Laura Petrie on the Dick Van Dyke Showhad to sleep in twin beds so as not to offend the public’s sensibilities. Breast cancer simply wasn’t talked about. Muscle and sometimes bone were removed along with breast tissue in mastectomies, which was extremely disfiguring, and women only admitted to undergoing them in hushed whispers.
First Lady Betty Ford was diagnosed with breast cancer, and in 1974, she publicly announced that she’d had a mastectomy. Ford was applauded for being open about the disease because many women felt that they could finally confess that they too had undergone mastectomies. There was even a jump in the number of breast cancer diagnoses after the announcement. Women with lumps cast off their embarrassment and flooded doctors offices to get them checked out.
When the main breast cancer charities came along in the mid-1980s, society had already begun to change. Women had burned their bras in the name of equal rights, and sexuality— including breasts—were becoming advertising vehicles. The time was right to bring breast cancer into the public spotlight.
The Phenomenon of Cause Marketing
Why Products Are Plastered with Pink Ribbons Every October
National Breast Cancer Awareness Month (NBCAM) was started by a pharmaceutical company that had ties to tamoxifen, an anti-cancer drug still used widely today. The aim of NBCAM was to make sure every woman was aware of this disease, and to promote mammography as the most powerful weapon in the fight against breast cancer. Back in the 1980s, this seemed like a reasonable goal. Is it still today?
Every October, companies plaster products from soup to vacuum cleaners with pink banners and those ubiquitous pink ribbons under the guise of helping cancer patients. Termed “cause marketing,” a percentage of the profits from these products are promised to breast cancer awareness charities, garnering companies the tax break they desire while advertising the good they want us to believe they are doing. Even small businesses, such as bars and restaurants, get in on the hype, promoting pink drinks and donating a portion of the profits. The White House, the Empire State Building, and the uniforms of NFL athletes all turn pink—all for the cause of breast cancer awareness.
The Susan G. Komen Foundation is the charity perhaps most closely associated with breast cancer. Despite having had “for the cure” in its name for most of its existence, this organization focuses on awareness rather than research. And many charities follow suit, raking in tens of millions of dollars yearly. But is spending money on all this awareness still necessary? Breasts are now out and proud—there’s no longer embarrassment associated with having them or having them removed.
Having worked as a school employee from elementary to high school, I know firsthand that children at every grade level are aware of breast cancer. “I heart boobies” bracelets are popular, especially among the middle school set. When you ask children why they’re wearing them, the universal answer is “To support breast cancer awareness.” (The real answer is because the message is subversively trendy.) Even third to fifth graders can converse on the topic. Many have had teachers or parents with breast cancer, and they too live in a culture that turns pink every October. I’ve seen small kids collect pennies for breast cancer awareness and wear pink at Little League games, saying the word “breast” as casually as they would any other body part.
For many women, their first mammogram is as much a rite of passage as is their first period, and women often talk about at what age they got their “baseline.” Today, women aren’t afraid to go see doctors for screenings. And now, cancer is the first thing they think of upon finding a lump, not the last.
If the goal of breast cancer awareness has been achieved—and I believe it has—then that still leaves early detection. Finding cancer early enough to prevent spread would be a worthy goal if that was all there was to curing cancer. Unfortunately, there’s no evidence to suggest that it is, and there’s plenty to prove that it isn’t.
The Dangers of Overscreening
The Well-Funded Awareness Machine
A Call to Action