The following article was written in the late fall of 2013.
It is estimated that 232,340 new cases of invasive breast cancer in women will be diagnosed this year in the United States. There will be an additional 64,640 women who will get ductal carcinoma in situ, a breast cancer in which cancer cells do not spread to nearby tissue. Approximately 39,620 women are expected to die of the disease this year (American Cancer Society). And just a decade ago, more money was spent on breast cancer research than the combined totals for prostate, ovarian, colorectal and liver cancers (King xvi). Consumer advocacy groups like the Better Business Bureau and Breast Cancer Action, a grassroots education and activist group based in San Francisco, question how much is actually spent on effective research or to support patients. Research confirms that a close alliance exists between nonprofits and corporations to exploit breast cancer to increase their profits, to steer money away from preventive research, and to sell products with carcinogens that actually cause the disease.
Every October, which is National Breast Cancer Awareness Month, retail establishments flourish with pink products: coffee mugs, bracelets, t-shirts, lint brushes, shoelaces, ear buds, diapers, kitchen appliances, even handguns. If you’re a member of the American Airlines Admiral Club for frequent flyers, you can nibble on pink cookies while sipping pink champagne in the club’s lounges, located in airports across the country. There is also a multitude of food items one can purchase throughout the month with pink ribbons emblazoned across the packaging. This phenomenon is known as pink washing and is utilized by companies that manufacture and promote their pink products during marketing campaigns specifically designed to raise money for breast cancer awareness and research.
The first national breast cancer awareness campaign was launched in 1992 when cosmetics giant Estee Lauder handed out 1.5 million pink ribbons at its retail counters in high-end department stores. The “frothy pink frenzy” has not wavered in its momentum to today, writes Lea Goldman, features and special projects director for Marie Claire Magazine (1). Since then companies such as BMW, Verizon, Ford, Revlon, J.C. Penney and countless others have aligned themselves with the breast cancer cause and with the two most visible nonprofit organizations, the Susan G. Komen Foundation and the Avon Foundation for Women, to market their products for profitability. “Breast cancer has become the NFL of diseases, glutted with corporate sponsorships, merchandise deals and ad campaigns” (Goldman 1). One would think that corporations’ interest in the disease would have peaked a long time ago, but they continue creating new pink ribbon campaigns while consumers – mostly women – continue to buy the pink ribbon products, asserts Dr. Samantha King, associate professor at Queens University School of Kinesiology and Health Studies (23). In 2010, Dallas-based Komen, the largest of all tax-exempt charities, grossed $420 million. There is no denying that such cause-related marketing efforts are making money for these corporations and nonprofits, but it is at the expense of women afflicted with the disease and unwary consumers who want to do and feel good about supporting the cause.
A flagrant exploitation of breast cancer was by American Express in 2003 when it launched a charitable campaign entitled ‘Charge for the Cure.’ During the month of October that year, American Express told account holders it would donate to Komen based on their credit card usage. Investigative journalist Erin FitzGerald suggests that the promotion’s slogan – ‘In the search for the cure, every dollar counts’ – would lead consumers to believe that at least one dollar would be made to breast cancer research every time they used their credit card. But if customers read the fine print of the required legal terms for a charitable donation, they would have learned that only one cent per transaction actually would be donated by American Express to Komen. A consumer would have had to swipe their American Express credit card 100 times to make a $1 donation (FitzGerald 16). While the marketing pamphlet enclosed in customers’ statements may convince them they are doing a good deed by supporting breast cancer research with each swipe of their card, much to the delight of American Express they are actually supporting the company with higher balances resulting in more interest added to their accounts if balances are not paid in full each month.
This exhibition of greed does not apply only to large corporations. In an article posted on the Wall Street Journal’s website, Michael Rothfeld wrote about the Coalition Against Breast Cancer Inc., a former Long Island-based charity shut down for fraud in a lawsuit filed by New York Attorney General Eric Schneiderman. The lawsuit alleged that $9.1 million was raised by CABC who claimed that the money was used for breast cancer prevention and screenings of uninsured women. Less than .05 percent was used as intended; the money was spent on fund-raising fees, directors’ salaries, investments and other expenses, with almost 85 percent directed to Campaign Center Inc., a professional fundraising company also closed down in April 2013 by the lawsuit. The organizers of both nonprofit companies are prohibited from any authoritative positions in a New York charity, cannot participate in any charitable fundraising in the state and have been ordered to pay at least $1.55 million in restitution (American Institute of Philanthropy). Despite volumes of paperwork required by the IRS to launch a nonprofit, charity organizations do not get audited or have to be validated by a Certified Public Accountant (Goldman 2). The BBB says that there are approximately 1,400 tax exempt charities related to breast cancer in the U.S. listed with the Internal Revenue Service. All those nonprofit agencies keep the bureau alert and busy by making people aware of potential scams and bad buying decisions.
The BBB issued a consumer warning in 2012 to be leery of products packaged with pink ribbons and breast cancer charities in general. Just because there is a pink ribbon involved, the bureau advised, do not be fooled into thinking any of the proceeds are going where they claim. For-profit companies also can be vague about how much of the purchase price of pink ribbon merchandise goes to a charity or cause. Merchandise tags do not spell out for consumers how much of their money is going to the cause. “Peddling the logo has become a massive racket, overrun by slick profiteers exploiting the public’s naïve assumption that all pink purchases help the cause” (Goldman 3). The BBB asserts some charities falsify reports by calling telemarketing efforts educational if the phrase ‘don’t forget a mammogram’ is stamped on their stationery. While there seem to be countless organizations that deserve scrutiny, not every one of them is corrupt and out to scam consumers with soft hearts and open wallets.
More than $6 is raised annually for breast cancer research, screening tests, and services for cancer patients. Among the good that has come from donations: false-positive diagnoses have been reduced because of sophisticated mammography equipment, and genetic markers have been discovered, allowing women with hereditary cancer genes to consider preventive options earlier (Goldman 1). However, Komen and Avon have joined forces with the largest government-sponsored research organization, the National Cancer Institute (NCI), creating a formidable front that wiels a lot of persuasion over the direction of breast cancer research and how much is allocated to it (FitzGerald 14). Still, there are many questions eluding researchers, such as why do 33 percent of all women who are declared cured by their doctors get breast cancer again, why are rates rising in Asia, where they’ve always been low, and can breast cancer be prevented? The National Institutes of Health, this country’s top agency for health-related research and affiliated with the NCI, allocated $763 million in 2010 to study breast cancer, a figure that is more than double of any other cancer research funds (Goldman 1). Breast cancer activists criticize that too much money is being spent on campaigns to raise funds and awareness instead of research to find out what causes it and how to prevent it, creating a great divide between corporations, charitable foundations and the activists over where the money should go.
Most marketing campaigns declare the money is being raised for breast cancer research, which to most people sounds wonderful and prudent; however the marketing materials do not explain specifically what type of research donations are for. Two notable drugs developed in the last 20 years have made remarkable inroads to stop or slow down breast cancer advancement in the body: Tamoxifen, a pill taken daily for at least five years; and Herceptin, a liquid given intravenously for a minimum of one year. A one-month supply of Tamoxifen costs about $350 while Herceptin treatments, given every two or three weeks at an infusion center, cost about $8,600 per treatment, or roughly $70,000 per year. Genentech, the maker of Herceptin, in 2007 earned $336 million in revenue in just the fourth quarter. These drugs are quite effective in treating a woman who already has breast cancer, but advocates want the research taken to the next step of prevention.
In the article “The Big Business of Breast Cancer,” Goldman maintains that researchers are no closer to a cure today than they were 20 years ago (1). In 1991, every day in the U.S. 119 women died of breast cancer; in 2011, that number only dropped to 110 women per day. This rate, claims Goldman, has remained the same since 1975 even though medical advances such as Tamoxifen and Herceptin and a plethora of awareness campaigns have been developed (1). This trend has become the focus of several initiatives urging researchers and breast cancer benefactors to divert more money to find why women get the disease and how they can prevent it.
The advocacy groups criticize the nonprofits and corporations using breast cancer for financial gain and through these groups’ watchdog efforts also have found that the funding organizations are too closely connected in some cases. Two of the largest and most organized women’s health advocacy groups in the nation are Breast Cancer Action (BCA) and the Cancer Prevention Coalition (CPC) in Chicago. Both groups believe that to win the war on breast cancer, researchers need to know what causes it and find ways to prevent it. The National Cancer Institute along with the Komen and Avon foundations do fund the most money toward important research, but the research does not focus enough on prevention or root causes of cancer (FitzGerald14).
The CPC contends that funds are directed by policymakers, nonprofits and large influential corporations to find a cure rather than prevention because without breast cancer, these entities would have no way to funnel money, thus ensuring continued profits. If researchers could pinpoint what causes breast cancer and how to prevent it, there would be less or no need to find the cure if women could avoid getting it altogether, just as scientists were able to locate the cause of polio and developed a vaccine to prevent against getting it. That scenario is what the CPC claims to cause some worry among pharmaceutical and imagery manufacturers such as AstraZeneca, Lilly, Bristol-Meyers Squibb, Merck, General Electric, DuPont and Kodak. These and other big-name companies have figured prominently, and generously, at Komen’s annual Race for the Cure events across the United States by helping to underwrite much of the costs associated with the fundraiser, touted by the foundation as the largest of its kind.
The Race for the Cure began in Dallas in October 1983 with the stated purpose to raise money for breast cancer research, screening and education. Since then, the very well organized and centrally administered events have raised tens of millions of dollars to promote awareness, particularly early detection by mammography (King 37). At the ten-year anniversary in 1993, thousands of race participants were joined in Washington, D.C., by speech-giving celebrities, politicians, Komen Foundation members and corporate CEOs of pharmaceutical companies that sell cancer products. In keeping with its stated purpose, the Race’s media releases said the importance of the day’s events were to stress the importance of mammograms for the early detection of cancer. According to King, who was at the Race that day, the energetic and upbeat messages by the guest speakers were directed toward race participants and supporters to give generously, to commerce and to the importance of science (37). A photograph in King’s book shows the banner that decorated the main stage that day served as a giant advertisement that displayed the logos of numerous corporate sponsors, many of which manufacture products in the forefront of breast cancer detection and treatment.
Furthermore, in an investigative journalism article by the Sacramento News & Review Newspaper, writes FitzGerald, the Komen Foundation’s stock ownership in pharmaceutical companies and in General Electric, a maker of mammography equipment, supports the belief of activist groups that the nonprofits and corporations have vested interests in each other for profit. The Cancer Prevention Coalition reported that in 1998 the National Cancer Institute, a U.S. taxpayer funded research institute, gave financial aid to AstraZeneca, a major pharmaceutical company (FitzGerald 15). AstraZeneca and Bristol Myers Squibb, another pharmaceutical company, along with DuPont and Kodak, manufacturers of mammography equipment and film, respectively, also have generously sponsored and figured prominently at Komen’s major fundraising events (King 37). Yet attendees at these events do not question the presence of the corporations; it is largely assumed they are just writing a check for research or sponsoring a tent. Event participants are aware of the partnerships, but do not fully understand how interwoven they are.
Another major facet of these close alliances closely watched by the activist groups is the failure of research “to focus significantly on prevention or the root causes of cancers despite significant evidence that exposure to toxic chemicals and industrial pollutants increases a person’s cancer risk” (FitzGerald 14). This lack of attention to the correlation between cancer-causing toxins and the businesses who market products every October is a highlight of a documentary based on Dr. Samantha King’s book “Pink Ribbons, Inc.” In the film of the same name as the book, director Lea Pool delves deeper into some of the environmental and chemical-cancer link issues raised by King.
For example, General Mills’ Yoplait Yogurt is a major participant every year in the cancer awareness cause. For every pink foil lid consumers send to the company, a 10 cent donation is made to Komen. All well and good, according to the film, but the milk used to make the yogurt contained rBGH, a synthetic hormone given to cows and known to cause breast cancer. The documentary looks closer at these allies, explaining that Zeneca, now AstraZeneca, the multinational pharmaceutical giant that founded National Breast Cancer Awareness Month in 1985 and at the time was a subsidiary of Imperial Chemical Industries, manufactured carcinogenic herbicides and other products linked to breast cancer. Adding insult to injury, the film mentions, is that the herbicides were used on corn that was eaten by cows that produced the milk to make Yoplait Yogurt. Yoplait has since changed its milk source and AstraZeneca is out of the pesticide business, focused only on pharmaceuticals. They also are the producers of Tamoxifen (Pink Ribbons Inc). Women in general have been educated about early detection and regular screenings but they are largely clueless to these behind-the-scenes affiliations in the big business that is breast cancer. The advertising associated with the breast cancer awareness movement focuses mostly on some ‘feel good about yourself’ mentality.
The link between cancer fundraising products and known carcinogens goes further to include skin and makeup products, an industry aimed at women that has no federal safety laws in place requiring companies to make public the test findings on their products. Government chemical regulatory policies are weak, allowing companies to create and sell chemicals without ever establishing safety to humans, while cancer rates have increased in the United States and other industrialized nations as use of chemicals has risen (Breast Cancer Action). What research has not shown is how much women trust and believe what they are fed by sleek and flashy advertising campaigns that inundate them every October. What is known is that women, with or without breast cancer, buy a lot of pink things, improving nonprofits’ and corporations’ bottom line.
But there is a degree of hypocrisy among those corporations and philanthropic organizations that have used breast cancer research as their poster child for cause-related marketing. The emphasis on only one type of research plays an important role in the alliances formed between those companies and the two largest breast cancer nonprofit organizations, Komen and Avon, mostly so they can all stay in business. Perhaps the biggest outrage of all is that those entities market products containing known carcinogens to women by using a disease that overwhelmingly afflicts only women as the basis for their acts of goodwill.
American Cancer Society. Breast Cancer Facts & Figures 2013-14. Atlanta: American Cancer Society, Inc. 2013. Web. 7 November 2013.
American Institute of Philanthropy d/b/a Charity Watch. May 2013. Web. 8 November 2013.
Better Business Bureau. “Breast Cancer Charities Are Big Business.” September 2011. Web.
8 November 2013.
Breast Cancer Action. San Francisco, California. 2000-11. Web. 16 November 2013.
Cancer Prevention Coalition. Chicago, Illinois. 2003. Web. 19 November 2013.
FitzGerald, Erin. “The Cause.” Revolution (Oakland, Calif.) 5.6 (2004): 12-9. EBSCO. Web.
7 November 2013.
Goldman, Lea. “The Big Business of Breast Cancer.” Marie Claire. 14 June 2011. Web. 10 November 2013.
King, Dr. Samantha. Pink Ribbons, Inc.: Breast Cancer and the Politics of Philanthropy. Minneapolis: University of Minnesota Press, 2006. Print.
Pink Ribbons, Inc. Lea Pool. Toronto Film Festival, 2011. Netflix.
Rothfeld, Michael. “Charity Accused of Fraud.” Wall Street Journal. 29 June 2011. Web. 8 November 2013.