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What Happened to Prevention: from Peach to Pink

It began as a true grassroots movement, with emphasis on prevention. The woman behind the movement was Charlotte Haley.

In 1991, Haley began hand-making peach-colored breast cancer ribbons in her dining room. To each packet of five ribbons she attached a postcard that read: “The National Cancer Institute’s annual budget is $1.8 billion, only 5% goes for cancer prevention. Help us wake up legislators and America by wearing this ribbon.” Her ribbons were a call-to-action: a demand for prevention and greater accountability. Haley was approached by Self magazine and Estée Lauder for permission to use her ribbon; Haley, with her emphasis on prevention, found them too commercial and turned them down. Undeterred, legal counsel crafted a workaround: use a ribbon of a different color. And so the pink ribbon was born, quickly eclipsing the original, grassroots peach.

Charlotte Haley’s reservations were prescient. In 2002, in response to the growing concern about the number of pink ribbon products on the market, the Breast Cancer Action group (an organization focused on the root causes of the breast cancer epidemic) launched Think Before You Pink, a campaign calling for more transparency and accountability by companies that take part in breast cancer fundraising. They encourage consumers to ask critical questions about pink ribbon promotions.

According to Think Before You Pink, “Any company can put a pink ribbon on its products. The widely recognized pink ribbon symbol is not regulated by any agency and does not necessarily mean it effectively combats the breast cancer epidemic.”

Just as more and more products sport pink ribbons every year, there has been a similarly exponential financial increase in the cancer industry. When President Nixon declared the war against cancer in 1971, the annual budget of the National Cancer Institute (NCI) was about $180 million. Today that annual budget is $4.6 billion dollars. In 2011, the Journal of the National Cancer Institute estimated that the total cost of cancer care in the U.S. will rise to $158 billion by 2020.

In 2004, Medicare payments for all Part B drugs for medical oncology reached a total of $5.3 billion (including $2.3 billion for chemotherapy and $1.5 billion for erythroid growth factors). A 2007 study revealed that drugs prescribed by oncologists account for more than 40% of Medicare spending. Today, more than 60% of cancer occurs in Medicare beneficiaries. By 2030 (due in large part to our aging population), that number is projected to grow to 70%. In the U.S., breast cancer receives the most gross funding, even exceeding that of lung cancer. In 2010, the NIH allocated $763 million to breast cancer research, more than double what it committed to any other cancer. Even the Department of Defense allocates more than $100 million each year to breast cancer research. The DOD Breast Cancer Research Program was created in 1992 as a result of the National Breast Cancer Coalition’s “$300 Million More” campaign to increase federal funding for breast cancer research. Since the program’s inception in 1992, the DOD has funded more than $3.1 billion total. This is in addition to the money raised by the roughly 1,400 IRS-recognized, tax-exempt charities in the U.S. devoted to breast cancer. They operate in every state and in just about every major city. The largest breast cancer charity is the Dallas-based Susan G. Komen for the Cure, which grossed $420 million in 2010 alone. All told, an estimated $6 billion is raised every year in the name of breast cancer. This money is allocated towards many sectors of the industry, but largely towards pharmaceutical research. Bear in mind that any research funded by foundations that are primarily created by Big Pharma stockholders must focus on orthodox research, or they will lose their funding. This includes medical schools. According to health studies researcher Samantha King: "Breast cancer has been transformed into a market-driven industry. It has become more about making money for corporate sponsors than funding innovative ways to treat breast cancer." In her book Pink Ribbons, Inc.: Breast Cancer and the Politics of Philanthropy, King traces how breast cancer has been transformed from a stigmatized disease and individual tragedy to a market-driven industry of survivorship. King questions the effectiveness and legitimacy of privately-funded efforts to stop the epidemic among American women. Pink Ribbons, Inc. challenges the commercialization of the breast cancer movement. Raising money, of course, all sounds good. Yet what many in the breast cancer industry loathe admitting is that despite all the money raised, we are really no closer to a cure than we were two decades ago. Breast cancer remains the leading cancer killer among women ages 20 to 59, and more than 1.4 million new cases are diagnosed annually worldwide. Roughly 5% of breast cancer patients, or 70,000, are diagnosed at late stage after the cancer has metastasized. This late stage rate has not changed since 1975, despite all the medical advances and awareness campaigns. For women diagnosed at late stage, the prognosis remains grim: only 1 in 5 will survive five years out.

Researchers ignore fundamental questions, such as why do a third of all women considered cured suffer recurrences? And, why are breast cancer rates rising in Asia, where they have been historically low? Clearly, the cancer industry has turned a blind eye toward environmental causes and resolving the exposure to chemical carcinogens. Both the NCI and the American Cancer Society (ACS) have focused their abundant resources and institutional mindsets not on preventing cancer, but on attempting to manage the disease once it occurs. The NCI, for instance, allocates less than an estimated 3% of its budget addressing environmental causes of cancer, while the ACS allocates less than 0.1% toward this goal. Samuel Broder, NCI Director from 1989 to 1995, stated the obvious: “The NCI has become what amounts to a government pharmaceutical company." Nobel Laureate Leland Hartwell, President of the Fred Hutchinson Cancer Research Center, endorsed Broder's criticism. He further stressed that most resources for cancer research are spent on "promoting ineffective drugs" for terminal disease. Until attention and money is focused on prevention and environmental causes, it is unlikely that cancer rates will decrease. As we come to view the hydra-headed monster that the cancer industry has become, we can only remain hopeful that this system will eventually change its objective from managing cancer for profit to finding cures. As consumers, we need more options. By understanding the limitations of the cancer industry, we can empower ourselves to seek knowledge and therapy from a cross-cultural, bioregulatory medicine perspective. Though her peach ribbon has long since been eclipsed by pink, inc., Charlotte Haley’s grassroots activism and commitment to breast cancer prevention continue to inspire members of our community. It's to Charlotte Haley's memory and motivating principles we dedicate this month of October.

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