A pink-striped sports car cruises down the highway. A female voice-over says enthusiastically, “When I was diagnosed with breast cancer, all I wanted to do was get into a Ford Mustang and go!”
The desire to flee, that I understand. I’m just not sure I’d complete the thought with “… in a muscle car that looks like Malibu Barbie’s.”
But as that television commercial for the special-edition “Warriors in Pink” Mustang illustrates, breast-cancer awareness is now big business, with the unnerving perkiness that seems permanently attached to any mention of the disease now firmly tied to any number of commercial products. There’s the pink KitchenAid “Cook for the Cure” collection (pink blenders, mixers, food processors, and mini-choppers), Glamor Glints pink rhinestones, ribbon-shaped fingernail appliqués, breast-cancer awareness alcoholic lemonade, and of course a pink Smith & Wesson handgun.
There’s even a “Buckets for a Cure” tub of KFC fried chicken. As the watchdog organization Breast Cancer Action’s site Think Before You Pink succinctly asks (about the pink chicken bucket, but hey, it’s a relevant question for all these products): “What the Cluck?”
The new documentary Pink Ribbons, Inc., which opened in New York and Los Angeles on June 1 and begins a national rollout on June 8, tries to answer that question. What’s the deal with the whole pink ribbon movement, and the related commercialized effort to “raise awareness” about breast cancer—a disease that’s of particular relevance to Ashkenazi Jews, who are disproportionately susceptible to it? Pink ribbons have garnered lots of attention and raised millions of dollars, but to what end?
The movie isn’t perfect, but it raises important points about how the pink-ification of breast cancer has come at a cost. It asks whether the vast sums raised are being used effectively; whether all those races and walks “for the cure” create an unrealistic portrait of breast cancer, waste money, and trivialize the disease; and whether companies capitalize on pink-ribbon culture to lure consumers while distracting attention from their own corporate sins.
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Pink Ribbons, Inc. is based on a very smart book of the same title, in which Samantha King, a professor of gender studies and health at Queens University in Ontario, looks at the business of pink-tinted, P.R.-oriented, corporate, breast-cancer fundraising.
Unfortunately, the documentary meanders away from the book’s central issue into a thicket of related issues: the potential environmental causes of breast cancer; how little we really know about the disease or how to cure it; where the money raised by various organizations actually goes. Then the filmmakers devote time to the toxic sins committed by purportedly breast-cancer-friendly car manufacturers (use of plastics, promotion of a bad-for-the-environment product), cosmetics companies (stuffing lead into lipstick, petroleum into moisturizer, and formaldehyde into nail polish), yogurt companies (using milk with bovine growth hormones), pharmaceutical companies (producing not only cancer drugs, but also pesticides that cause cancer). To call this approach diffuse is charitable.
The film also addresses the tone of the campaigns to raise awareness, arguing that the go-team-fight chipperness of the pink movement insults women with Stage IV cancer (“There is no Stage V,” the main character of Margaret Edson’s play Wit says drily) who have failed, in the happy language of the pink-pimpers, to “win the fight against breast cancer” and “be a survivor!”
I appreciate the way the movie wrestles with so many complicated issues. But as with the movie Bully, good intentions only go so far.
The movie is most effective when it sticks to examples of pink opportunism. For instance, the yogurt company Yoplait has long run a promotion called “Save Lids, Save Lives,” in which you send in yogurt lids (but only the pink ones, and only during specific periods, and no, you can’t save your pink lids until the next period because Yoplait tracks the codes on them), and Yoplait donates 10 cents per lid to the Susan G. Komen For the Cure foundation. Which sounds great, except that a stamp costs 45 cents. Why wouldn’t you donate your 45 cents directly to charity instead of going through the creamy yogurt middleman? Furthermore, as King’s book points out, if you ate three pink-lidded yogurts a day for four months, you’d wind up donating a whopping $36. Or you could just write a check to the women’s health organization of your choice. Maybe even Planned Parenthood!
(And speaking of Planned Parenthood: Unfortunately for the filmmakers, the documentary was made before the poop hit the fan about Komen pulling its support from that organization. Fortunately for the filmmakers, Komen’s president Nancy Brinker appears in the movie and still comes off as a fine villain, exuding money, privilege, and unnerving agelessness as the chant “There’s not enough pink! There’s not enough pink!” emanates from her hypnotically glossy pink lips.)
It would have been nice for the film to spell out how Komen spends its vast money: Since its founding in 1982, it’s raised nearly $2 billion; yet as Komen’s revenues have climbed, it has spent less and less on research. (According to Komen’s own figures, today it spends about 21 percent of its budget on research.) There are other strange gaps in the film, such as the fact that it glosses over whether breast cancer is more deadly or more prevalent than it was in the past. We’re told that around the world, someone dies of breast cancer every 69 seconds, and in North America over 59,000 women die from breast cancer every year—but how have those numbers changed over time? The movie doesn’t say.
However, in keeping with the excellent “what’s everyone’s agenda here” aspect of the film, it does tell us that Breast Cancer Awareness Month was invented in the early 1980s by a P.R. guy at what’s now AstraZeneca, then the American arm of the largest chemical company in the world. The goal: Promoting mammograms and not-so-incidentally increasing the profit potential of the company, which not-so-incidentally, makes breast cancer drugs. But again, that begs the question: Is breast cancer on the rise, or is it just more frequently diagnosed thanks to the push of people making money off it? The movie does point out that early diagnosis doesn’t always lead to increased survival rates. Breast cancer manifests itself differently in different people—sometimes, early detection finds a cancer that never would have become life-threatening, which can lead to overtreatment and panic; other times, a cancer detected early (especially in younger women) still leads inexorably toward an unhappy outcome. These facts don’t fit with the happy-happy-joy-joy messaging of the pink ribbon brigade. But to me, these facts say that money is still needed for both research and treatment. If we don’t understand something, how do we fight it? The movie implies that funds are being misspent but doesn’t tell us exactly how.
What is clear is that in the United States (and Canada, where the documentary hails from) breast cancer is deadlier in both young women and in the African-American community. That’s partially why Komen cutting funding to Planned Parenthood was so infuriating; the five-year survival rate for breast cancer diagnosed in African-American women is 78 percent, compared to 90 percent among white women, and Planned Parenthood provides health care for those women who are less likely to have access to prompt, high-quality treatment.
The upshot: While the gaps in the film and its scattershot approach are irksome, Pink Ribbons, Inc. still gives us a lot to ponder. It’s up to us to take the issues it raises and make our own decisions about our purchasing power, donations, approach to health care, and activism.
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Breast cancer brings up particularly knotty questions for us as Jews. Just ask Rochelle Shoretz, a former law clerk to United States Supreme Court Justice Ruth Bader Ginsburg. She was diagnosed with breast cancer at 28 and founded Sharsheret (Hebrew for “chain”), a nonprofit that supports young Jewish women with breast and ovarian cancers.
“Ashkenazi Jews carry an increased genetic risk for breast and ovarian cancers, because one in 40 Jews carries a mutation in the BRCA1 or BRCA2 gene that can trigger these cancers,” Shoretz explained to me in an interview. “That’s why our community has to pay attention to screening and to family history. This is a Jewish family issue, a Jewish community issue—and that’s where Sharsheret focuses our energy. So much of our family health history was destroyed in the Holocaust; we have to give our children a legacy of health information that they can use to be proactive.”
The fact that we Jews may have a genetic propensity toward the disease is proof that there shouldn’t be a one-size-fits-all approach to breast cancer. But that also means there shouldn’t be a one-size-fits-all approach to cancer awareness. When I watched the movie Bully, I was uncomfortable with all the balloon-releasing “yay, let’s end bullying!” rallies—they don’t offer kids the practical tools for becoming allies rather than bystanders, and they don’t change the culture of schools (in fact, research shows that the zero-tolerance policies the film’s website advocates do more harm than good). But my heart went out to the kids and adults whose intentions are clearly lovely. So it is with all the pink-clad participants in the Komen Races for the Cure and the Avon Walks for Breast Cancer. The film spends a lot of time visually snarking at all the women screaming “whoo!” and dancing to Kool and the Gang’s “Celebration” and acting as unwitting shriek-y shills for the companies giving out plastic-bottled tea beverages. But these women mean well … just as the filmmakers do. People are drawn to the idea of doing something, even if it’s not the most effective something. The Avon Walks for Breast Cancer have raised over $150 million; Susan G. Komen’s Races for the Cure raised over $120 million in 2010 alone. Yes, as with the yogurt lids, there are valid questions about whether the money is well spent. Barbara Ehrenreich, in her brilliant essay “Welcome to Cancerland,” points out that Avon spends more than a third of the money it raises on overhead and advertising, and Komen’s numbers are similar. And yes, it’s a valid question whether these events marginalize those who “fail” at being “survivors.” As Ehrenreich says in the film, “We found sisterhood from other women and looking critically at what was going on with our healthcare. The sisterhood of now is supposed to be supplied by the runs and races … the effect of the whole pink ribbon culture was to drain and deflect the kind of militancy we had as women who were appalled to have a disease that is epidemic and that we don’t even know the cause of.” Wearing a ribbon and tarting up the Empire State Building, Niagara Falls, and Canadian Parliament in pink lights won’t change that.
But portraying women as dupes isn’t really helpful, either. Frivolousness and silliness do have a place in activism, right alongside anger. We need optimism. The trick is making sure it isn’t naïve, roped into the service of consumerism or (another issue the film doesn’t address) sexualization. The whole leering, youthful Save the Ta-Tas! and I Love Boobies! movement, which Peggy Orenstein addresses so well on her blog, is as unnerving as the middle-aged matrons shaking their pink sweatpants-clad booties to “We Are Family.” The “tyranny of cheerfulness” (as King puts it in the film) is cross-generational. But surely we can find a middle ground of pressuring the medical establishment for answers and treatment for all while also getting to dance. We have made strides in treating breast cancer—support groups are ubiquitous, research is advancing (albeit more slowly than we might like), and activists have pressured companies (yogurt companies!) into removing potentially cancer-causing hormones from their products. And as Shoretz puts it, “You cannot underestimate the benefits to those of us living with breast cancer of the attention the pink ribbon has garnered. Talk to anyone who has a cancer that’s not breast cancer and they wish they were part of a bigger cancer movement. The ‘how much is too pink’ debate will continue. But at the end of the day it’s important to recognize that there are benefits as well as costs to a pink campaign that has raised billions of dollars for breast cancer research.”
If Pink Ribbons, Inc. educates women into considering where they donate and whether they’re getting the most for their money, that’ll be a huge service.
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Marjorie Ingall is a columnist for Tablet Magazine, and author of Mamaleh Knows Best: What Jewish Mothers Do to Raise Successful, Creative, Empathetic, Independent Children.
Marjorie Ingall is a former columnist for Tablet, the author of Mamaleh Knows Best, and a frequent contributor to the New York Times Book Review.
