Does Breast
Cancer
Awareness Save Lives?
By Lucinda Marshall
02 October, 2005
Countercurrents.org
You
know that it's October when the leaves start turning and the world turns
a glorious pink. Yes pink, the mascot color of National Breast Cancer
Awareness Month (NBCAM). Each year we are exhorted to race for the cure
and go for our mammograms because, according to the NBCAM mantra, "Early
detection saves lives". We buy pink lipstick and wear pink ribbons
because part of the proceeds goes to benefit breast cancer research.
The question we
fail to ask however is does being 'aware' save lives? To begin with,
it is inconceivable that there is a thinking adult in this country who
isn't aware of breast cancer. According to the American Cancer Society,
one in seven women will develop breast cancer during her lifetime (in
1975, the risk was only one in eleven). More than 250,000 women will
be diagnosed with breast cancer this year. Each year, more than 40,000
women die from breast cancer. Maddeningly, the treatment options offered
to women with breast cancer vary little from the treatments used 40
years ago, radiation, chemotherapy and surgery.
It would seem logical
to start by asking why the incidence of breast cancer keeps increasing
despite advancements in early detection and the continual development
of new treatments. As any school child knows, you can't solve a problem
if you don't know the variables. Yet most of the money that is thrown
at breast cancer gets spent on finding cures and treatments, with very
little of the research focusing on the cause.
This seems particularly
odd since approximately half of all breast cancer cases are unexplained
by personal characteristics, leading many to suspect that the cause
might be environmental. Since the 1940's tens of thousands of synthetic
chemicals have come into use yet only a small percentage have been tested
for safety. Pollution has increased dramatically as well. A link has
long been established between some pesticides and breast cancer and
it is also known that nonsteroidal estrogens are carcinogenic. Chemicals
with estrogenic activity include PVC and bisphenol-A (plastic additives
found in many household products) and benzene (a gasoline additive).
Other chemicals such as parabens and phthalates, which are found in
many cosmetics, can act as hormone disrupters and have been linked to
cancer. Other compounds that likely contribute to breast cancer include
DDT, dioxin and PCB's.
Additionally, "State
of the Evidence 2004: What Is the Connection Between the Environment
and Breast Cancer?", jointly published by the Breast Cancer Fund
and Breast Cancer Action, reported the following connections between
chemical exposure and breast cancer:
"Chlorinated
chemicals, found in drinking water and many industrial processes such
as computer component manufacturing, were associated with an elevated
risk of breast cancer in three new studies;
A solvent used in
many varnishes, paints, dyes and fuel additives (ethylene glycol methyl
ether) was found to sensitize breast tissue cells to the effects of
estrogens and progestins, thereby increasing the risk of breast cancer
and;
The Million Women
Study in the United Kingdom revealed that all types of postmenopausal
hormone replacement therapy significantly increased the risk of breast
cancer, underscoring earlier findings from the Women's Health Initiative
study in the United States. Another study found that use of HRT after
previously being diagnosed with breast cancer tripled a woman's risk
of recurrence or development of a new breast tumor."(1)
Yet organizations
like the American Cancer Society and the Susan G. Komen Foundation routinely
fail to address these issues. As it turns out, both groups have connections
with numerous corporations in the chemical, cosmetic and pharmaceutical
industries, many of which have an enormous financial stake in breast
cancer. Good intentions aside, it is far more profitable for these companies
to detect and treat breast cancer than to prevent it, leading to an
enormous conflict of interest between their corporate well being and
their charitable public persona.
The primary corporate
sponsor of National Breast Cancer Awareness Month is AstraZeneca, which
makes the popular cancer drug Tamoxifen. Interestingly, Tamoxifen can
also cause cancer and until recently, AstraZeneca also made a variety
of other cancer-causing chemicals. Apparently the company has a thing
about color marketing. Not only do they encourage you to think pink,
they are also the maker of a frequent sponsor of the nightly network
news, the little purple pill a.k.a. Nexium. Which begs the question
of how corporate sponsorship of the news might impact how cancer cures
and causes are reported by the networks.
AstraZeneca is not
the only company playing both sides of the cause/cure game. Dupont makes
numerous chemicals that have been linked to cancer (including Teflon)
as well as much of the film used in mammography. And General Electric
makes nuclear power plants that produce ionizing radiation, a known
cause of cancer as well as mammography equipment (which also perversely
produces cancer-causing ionizing radiation). GE also owns NBC.
What these corporations
understand is that supporting breast cancer awareness and funding is
a great public relations gambit. As Barbara Brenner of Breast Cancer
Action points out, "If you slap a pink ribbon on a product, people
will buy it." But where does the money raised by the sale of all
these products go? Some companies clearly state what portion of the
proceeds are donated, but many just say something along the lines of,
'a generous portion of the proceeds will be donated to finding a cure
for cancer'. The definition of 'generous' can vary widely and all too
often there is no definitive accounting of how much was raised and who
benefited from the proceeds. (2)
And what of organizations
like the Susan G. Komen Breast Cancer Foundation, which sponsors the
annual Race for the Cure? According to the Toxic Links Coalition, the
race focuses on finding medical cures while ignoring environmental causes.
In "Running From the Truth", Mary Ann Swissler reports that
the Foundation's stock portfolio has included holdings in several large
pharmaceutical companies as well as General Electric, one of the largest
makers of mammographic material. (3) Their 2003-2004 Annual Report lists
Ford (automobile exhaust has long been linked with cancer) and Johnson
and Johnson (makers of numerous cancer drugs and diagnostic equipment)
as Partners.
In 1998, Komen was
the only national breast cancer group to back Tamoxifen as a preventative
treatment for some women, which other advocacy groups objected to strongly.
As it turns out, Tamoxifen's maker, AstraZeneca is a strong backer of
the Race for the Cure and in 2003 received the "Friend of the Fight"
award from Komen.
The Komen Foundation
is also notably silent on environmental issues. Interestingly, Occidental
Petroleum, a major environmental polluter (think Love Canal) is a big
Komen supporter. While Komen may have the best of intentions, as breast
cancer activist Judy Brady points out, the problem is that they simply
don't see that "'business as usual' is why we have cancer".
(4)
ACS and Komen are
both big supporters of annual mammography for women over the age of
40. Over and over, both organizations tout early detection as a lifesaver.
They both also receive substantial funding from makers of mammography
equipment such as GE and DuPont.
Unfortunately, the
truth about mammography and early detection is not so cut and dry. Mammograms
may detect cancer earlier (although the majority of women detect their
own cancers) but they do not prevent cancer or protect women from cancer
and early detection does not necessarily translate into longer survival.
Many women whose
cancer is detected by mammograms have slow-growing cancers that will
never be life threatening while others are very aggressive and would
be lethal no matter when they are detected. Early detection does not
appear to impact the life expectancy of either of these groups of women.
In addition, because breast tissue in pre-menopausal women tends to
be denser, mammograms may miss suspicious masses. The breast tissue
of younger women is also more susceptible to damage from radiation.
It is interesting
to note that no nation other than the U.S. routinely screens pre-menopausal
women by mammography. According to activist Jennifer Drew, in England
the practice is for "women aged between 50 and 64 who are registered
with a General Practitioner (to) receive a letter inviting them to attend
a Breast Screening scan. The age is being raised to 70 years from 2004.
Women between these ages can have free mammograms every 3 years. The
Government here in the UK believes once every 3 years is sufficient
based on medical research." In contrast with the United States,
only one in nine women are stricken with breast cancer in the UK, a
statistic also true in Canada. Routine screening guidelines for Canadian
women are to be screened every two years after the age of 40. Only one
in eleven women in Australia are stricken with breast cancer and women
there are advised to get mammograms every two years between the ages
of 50-69.
What is perhaps
the most important to understand is that survival rates are counted
from when a woman is diagnosed. So if a woman is diagnosed in 2000 and
lives for 15 years, this is no different than if she was diagnosed in
2005 and lived for 10 years. She would still die in 2015. In other words,
a woman may live longer past a diagnosis that occurs earlier, but not
necessarily longer overall.
It seems likely
that the corporate connections to organizations like ACS and Komen play
a significant role in determining policy recommendations and how the
funds that are donated to these organizations are spent and why funding
is so clearly biased towards detection and pharmaceutical treatment.
While many useful projects have undoubtedly been funded, the reality
is that women, too many women are still dying from breast cancer and
we still don't know why or how to stop it.
What is clear is
that it is well past time to re-think the pink and to quit indiscriminately
touting early detection and to focus much more of our research resources
on the context in which breast cancer takes place and finding treatments
for those women who currently do not benefit from treatment. As the
comparison of mammography recommendations and breast cancer incidence
in other countries indicates, some hard questions need to be asked as
to the benefits of early and more frequent mammograms in this country
and what other factors account for our higher breast cancer rates. The
role of environmental pollutants and compounds with estrogenic activity
in breast cancer must also be addressed in a much more comprehensive
manner.
Efforts like that
of Dr. Susan Love to learn more about the milk ducts where most breast
cancer begins should be enthusiastically supported. We also need to
focus research on understanding other issues such as how antibiotics
may contribute to breast cancer and how breast cancer surgery itself
may spread cancer. Above all, we need to make sure that public policy
decisions are made in the best interests of the women whose lives are
impacted by breast cancer, not for the benefit of corporate profit.
------------------
Notes:
1. "State of
the Evidence: What is the Connection between the Environment and Breast
Cancer", edited by Nancy Evans, Breast Cancer Action and Breast
Cancer Fund, 3rd Edition, 2004.
2. "Breast
Cancer Month Spurs Pink-Product Debate" by Rebecca Vesely, Women's
Enews, October 21, 2004.
3. "The Marketing
of Breast Cancer" by Mary Ann Swissler, Alternet, September 16,
2002.
4. "The Marketing
of Breast Cancer" by Mary Ann Swissler, Alternet, September 16,
2002.
5. For more information
on these issues:
Breast Cancer Fund
Breast Cancer Action
#####
Lucinda Marshall is a feminist artist, writer and activist. She is the
Founder of the Feminist Peace Network, www.feministpeacenetwork.org.
Her work has been published in numerous publications in the U.S. and
abroad including, Awakened Woman, Alternet, Dissident Voice, Off Our
Backs, The Progressive, Rain and Thunder, Z Magazine , Common Dreams
and Information Clearinghouse.