Vassar, Why Doesn’t Breast Cancer Make the Political Agenda?

Tina McGarity was diagnosed with breast cancer in June of 2008. Since then she has undergone sixteen rounds of Chemotherapy and ten surgeries, including a Mastectomy.

“I was given six to eight months to live if my Chemo had not worked. I can no longer have children because the chemo messed up my Uterus so bad (sic) that it caused me to have a hysterectomy among other things. But wait… no one told me that I would not be able to taste food or that my hair would fall out with my first treatment while walking through Wal-Mart or that I would lose my sex drive and almost stop feeling like a woman. My nails turned black and some [fell] off. A few of my teeth rotted and [fell] out, the [scars] on my body look like someone threw me though a glass window and I even lost my home during the process. Trust me the list goes on.”

Breast cancer is not uncommon, with one in eight American women being diagnosed in their lifetime, up from one in twenty in the 1960s. One could say that McGarity is lucky to have had her life saved by chemotherapy, unlike the 40,000 women who die of breast cancer every year. Her story remains hard to stomach.

McGarity’s personal statement, found on the “Survivors’ Stories” section of the Susan G. Komen Foundation website, transitions from describing these side effects to explaining how she got through cancer.

“I surrounded myself around positive people who never felt sorry for me, but encouraged and motivated me. I felt normal, I felt alive. Even in my bad days, I understood that this was only a process that I would have to go through and if I could get through this process, I knew that I could get through anything.”

The Komen Foundation, in creating a community of breast cancer survivors, allows people like Tina McGarity to support and inspire each other by sharing their stories. These stories, reflecting a range of racial and class backgrounds, tend to feature themes of positive attitude and trust in oneself and science, and provide insight into how the Foundation views cancer and cancer patients. McGarity’s stands out to me because of the abrupt turn it takes from vivid description of medical symptoms to whole-hearted positivity and optimism. The idea that cancer is inevitable for some people–“I understood that this was [the] only process that [I] would have to go through”–and that having a good attitude is the best way to face it is suggested throughout the Komen website and reflected in mainstream approaches to cancer treatment. McGarity’s testimony does not question why she had cancer in the first place.

Was her illness inevitable? Did she have to lose her home and ability to have children? These are questions that Susan G. Komen does not encourage us to ask. This lack of questioning and dismissal of women’s anger is harmful to patients, and, apparently, lucrative.

It is through websites such as Susan G. Komen’s that many people learn about breast cancer, its causes, and how to move forward after a diagnosis. Medical experts are the first to admit that we cannot predict with certainty who will develop cancer and when; instead, the discourse is centered on “risk factors.” Komen presents risk factors as either beyond our control, such as one’s sex or family history, or within our control: “lifestyle factors” that include diet, exercise, and personal habits such as smoking. Women who want to decrease their risk of cancer are encouraged to exercise regularly and eat fruits and vegetables. The Komen Foundation does not, however, take a conclusive stance on the role of environmental toxins. While the website acknowledges that “many whether the increasingly polluted environment is contributing to increased breast cancer rates,” their main takeaway on the subject is that more studies are needed to conclusively link cancer and pollution. They do not advise people hoping to avoid cancer to limit their consumption of meat, stating that “results from two pooled analyses have found no link between meat intake and breast cancer risk.”

Conversely, health justice organization Breast Cancer Action favors taking the “precautionary approach” in regards to environmental toxins. In other words, “acting now, even before definitive scientific proof of harm, to reduce and eliminate practices that we suspect do harm to human health or the environment because lack of evidence does not equal lack of harm.” This approach involves shifting the burden of proof to corporations dispelling potentially harmful chemicals, rather than consumers who may or may not be suffering as a result. BCA points out that the United States lacks chemical regulation policies that would prevent companies from using chemicals that have not been established as safe, and that industrialized countries have higher rates of cancer than non-industrialized ones. In connecting corporate power to health issues, the discussion of breast cancer is politicized. Conversely, Komen’s de-emphasizing of environmental factors in causing cancer works to push the center of discourse towards individual choices and personal responsibility.

This focus on individual lifestyles is misguided. Less than one third of today’s breast cancer patients exhibit “known risk factors,” which include personal and lifestyle conditions yet exclude environmental risks. A healthy lifestyle is not enough to avoid or survive cancer. Highlighting the role of environmental factors in cancer rates provides incentive to both further investigate the role of corporate activity on health, and to hold companies and the government accountable for practices that endanger us. However, as a fundraising organization, Susan G. Komen has more to gain in presenting cancer as a disease for which no one is to blame.

Though Komen waits on solid evidecne to condemn environmental toxins, it is important to note that the Foundation is partners with many corporations, some of whom contribute to the deterioration of public health. The pink ribbon, adopted in 1991, has come to symbolize the fight against breast cancer and to serve as a guide for consumers who want to spend money on items produced by companies aligned with the Komen Foundation, with the expectation that part of the proceeds will be directed towards cancer research. Since the ‘90s, pink ribbons have appeared on products ranging from Adidas sneakers to KFC chicken buckets to fracking drill bits.

Although Komen no longer exclusively controls the use of the ribbon, they do collect a percentage of profit from sales of associated products. It is concerning that an organization dedicated to ending breast cancer would partner with a company that releases carcinogens into the water and food supply, as Susan G. Komen did in October of 2014, upon accepting a $1,000 donation from Baker Hughes, Inc., an oil and fracking company. Baker Hughes went on to release a line of pink drill heads, intended to show support for cancer patients. Instances such as these represent loss of credibility for the ribbon as a symbol, and for Susan G. Komen as an organization.

Pink Drill Bit

This pink drill bit, which appeared in a 2014 ad campaign, is an example of “pinkwashing,” the co-opting of a cause by corporations as part of marketing strategy

But beyond being misguided, buying into corporate pinkwashing of breast cancer is harmful. While Komen encourages us to see the pink ribbon as a symbol of hope and support for breast cancer patients and to buy from companies who tout it, we are discouraged from questioning the practices of these companies which may contribute, directly or indirectly, to the deterioration of public health and breast cancer itself. Holding corporations in higher esteem because they present themselves as standing against cancer reflects a gross misunderstanding of what it actually means to stand against cancer. The same culture that embraces pink ribbons also perpetuates the idea that no one, beyond perhaps the patient herself, is to blame for cancer.

In addition to obscuring the link between breast cancer and environmental degradation, Susan G. Komen is also a major proponent of the medical industry, buying into the notion that the primary goal in treating patients should be to minimize the actual or potential threat posed by tumors, at all costs. Healthcare providers tend to treat cancer diagnosis as having one solution, and often the most extreme: chemotherapy or mastectomy. While chemotherapy has saved many lives, it is not appropriate for every patient; some people, knowing in advance the toll it will take on their bodies, prefer to live with cancer. There are valid reasons for patients to refuse chemotherapy, yet the mainstream medical community portrays such instances as failures, stemming from a patient’s poor judgment or lack of a will to live. The Komen Foundation website presents chemotherapy as a given, offering a positive view of it, and providing tips on getting through chemotherapy, such as freezing one’s eggs beforehand so that a patient can still have children in the event that the chemo triggers early onset menopause.

Advances in mammogram technology have allowed us to discover smaller tumors at earlier stages, and more people than ever before are undergoing chemotherapy and mastectomies to ensure that these tumors will not be able to harm them. While in 1998, 3% of women with early-stage tumors chose to have both breasts removed, today that rate is at nearly 20%. Many of these mastectomies are done for reasons other than true need, according to Barbara Smith, director of the breast program at Massachusetts General Hospital: “Patients do this for peace of mind, for symmetry—but there’s no survival benefit for most of them.”

Some experts caution against overzealous screening, diagnosis and treatment. Otis Brawley, chief medical officer of the American Cancer Society, claims that “somewhere between 10% and 30% of women with localized invasive breast cancer would be just fine if we just watched them.” However, in a medical climate in which aggressive treatment of tumors is the norm, the option of waiting to see is unappealing to most doctors. Because medical companies make profit off of the surgeries and medications sold to cancer patients, it is in their best interest that as many women as possible undergo them.

It is not only doctors who are quick to call for surgery; patients eager to be cured as soon and as certainly as possible are often willing to undergo extreme treatments. One effect of the increase in public awareness of cancer over the past few decades has been the association of “cancer” with death and, along with that, unquestioning trust of medical professionals. Brawley puts it bluntly, “I cannot look into a patient’s eyes and say, ‘You’re one of the 10% to 30% that should not be treated.’” Women who do challenge their doctors’ advice are often met with derision, making the process of choosing an appropriate treatment exhausting and confusing.

Efforts to reduce unnecessary cancer treatments are most strongly opposed by breast cancer organizations such as the Komen Foundation. Hoping to reduce the overdiagnosis of harmless tumors, and spare women from unnecessary treatment, the American Cancer Society has adjusted its recommendation regarding mammograms to once every two years starting at the age of 50 for women considered to be at normal risk. Unsurprisingly, Susan G. Komen continues to push for yearly mammograms starting at 40.

This excess extends beyond those who are currently ill; Susan G. Komen recommends that women who have had cancer take Tamoxifen, an estrogen blocker with intense side effects, for five or even ten years after being declared cancer-free, following the advice of a 2012 study claiming that ten years on Tamoxifen reduces patients’ chance of dying of cancer more than does five years of the medication. The Komen website also promotes Tamoxifen as an option for women who have not had cancer, but display “high risk.

Lancet Oncology published the Atlas trial in 2012. The study was funded in part by Astra-Zeneca, the company that produced Tamoxifen

Lancet Oncology published the Atlas trial in 2012. The study was funded in part by Astra-Zeneca, the company that produces Tamoxifen

In encouraging patients to follow doctors’ advice and to opt for the most extreme treatments and medications, while not presenting balanced information, Susan G. Komen contributes to an atmosphere of fear over life-threatening illness which pushes many patients to undergo treatment that may not be necessary.

It is easy to dismiss the Susan G. Komen foundation on the grounds that it is corporatized and, as a result, less interested in curing cancer than in treating it. However, a subtler effect of pinkwashing has been the trivialization of breast cancer as a cause. It is easy for people who consider themselves sophisticated activists to dismiss Komen and anything pink. However, fighting breast cancer should not be discounted just because it has been coopted. In fact, the success of the pink ribbon to mask the complexities of breast cancer, which include treatment disparity across income level and race and the health dangers of corporate activity, calls for people truly concerned with supporting survivors to extend information and support. By ignoring Breast Cancer Awareness Month every October, we leave the job of educating sick people to foundations with questionable motives. Not all cancer patients have the education, means, and support to challenge traditional medical advice and seek less harmful options, and even for those who do, cancer is a frightening and draining experience. There is a serious need for information and support for all cancer patients, and for all people vulnerable to the medical-industrial complex.

I appreciate that I don’t see many pink ribbons in my own Facebook newsfeed. Few Vassar students participate in Susan G. Komen efforts, either out of disdain for pinkwashing or general apathy to the cause. However, it is troubling to me that more people at Vassar do not talk about breast cancer. Cancer is a political issue because of the disparities in treatment across race and class, the exposure to carcinogens and other toxins of people who live near resource extraction sites, and the profit that drug companies make off of selling medications to sick people who are not presented with other options. Thus, the fight against breast cancer, as well as opposition to the mainstream breast cancer movement, is relevant to people interested in social, environmental, and racial justice.

Divest VC promotes understanding of climate change as a social justice issue in that it disproportionally affects those marginalized by race and income

Divest VC promotes understanding of climate change as a social justice issue in that it disproportionally affects those marginalized by race and income

My sense is that cancer is often seen as strictly a medical issue. This oversimplification reflects a binary between objective scientific thinking and social justice, one which is familiar at Vassar and is often reflected in reluctance among activists to become involved in issues that read as scientific. Everyone has personal reasons for feeling more drawn to certain causes than to others, and those are valid. However, on a larger scale, when student activists become impassioned about one issue while largely ignoring others that share similar bases, it demonstrates a trend in how we conceive of issues relative to each other, one in which important intersections are obscured.

An example is the difference in reception between Vassar’s two current divestment campaigns, Divest VC and Boycott Divest Sanction, aimed at divestment from fossil fuel extraction companies and the Israeli government, respectively. While the two campaigns cover very different grounds, they share core concepts of racial justice, land sovereignty, human rights, and institutional accountability. Students for Justice in Palestine, I would argue, is widely understood as being about these goals. However, the fossil fuel divestment campaign has had to work hard to be understood as being driven by these same ideals. It may be that fossil fuel extraction is seen as a mainstream environmental issue, devoid of social implications and of interest primarily to upper middle class white people, while the social implications of Israel’s occupation of Palestine are more tangible. Furthermore, BDS invokes a clear antagonist in the Israeli government. However, not feeling strongly about fossil fuel divestment simply because it seems less political due to the scientific nature of environmental destruction reflects a lack of imagination.

In the case of breast cancer activism, Susan G. Komen capitalizes on this lack of imagination by encouraging us to see cancer treatment as one-size-fits-all, much to the disadvantage of patients. Viewing breast cancer as simply a medical issue to which the only solutions are those presented by the mainstream medical establishment allows the gender, racial, and socio-economic disparities it encompasses to be obscured. Current and future breast cancer patients need support and information that is relevant, accurate, and compassionate, rather than the biased and incomplete material provided by the Susan G. Komen Foundation and other corporatized cancer organizations. Those of us interested in social justice and with access to information have a responsibility to provide alternative measures of support to the people most vulnerable to the medical-industrial complex. When we dismiss the breast cancer cause because it is a problem of science or because pink ribbons are tiresome, we abandon vulnerable people to companies who profit off of their illness and off our collective lack of rage regarding cancer.

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