Pink Ribbon Blues: How Breast Cancer Culture Undermines Women’s Health

Sulik, G. Pink Ribbon Blues: How Breast Cancer Culture Undermines Women’s Health. New York: Oxford University Press, USA, 2010 29. 95 (hbk) 424 pp. ISBN-10: 9780199740451 Have you ever wondered when football players wear pink ribbons or don their pink wristbands, how much they are really helping women with breast cancer? Pink Ribbon Blues: How Breast Cancer Culture Undermines Women’s Health, is an uncompromising look at what Gayle Sulik calls ‘Pink Ribbon Culture’. Sulik demonstrates how cause-marketing serves not only to influence our understanding of breast cancer and how to support recovery, but actually functions to undermine women’s health. Pink Ribbon Blues covers an array of topics on the culture of breast cancer from ‘What is Pink Ribbon Culture? ’ to ‘Consuming Pink’ to ‘Selling Survivorship’ to ‘Rethinking Pink’. The nine chapters are well written in an interesting style which is part academic, part journalistic. Sulik analyses large amounts of information, drawing upon interviews with patients to illustrate her arguments. The book is extremely well researched, filled with personal stories and health statistics. It takes a broad interdisciplinary theoretical approach, from sociological theory to media studies to feminist criticism. Using a range of examples, Sulik traces the linkages between the disease itself and the ‘pink culture’ that has arisen around it. She also examines the role that this culture has played in shaping our thoughts, and the selling of pink paraphernalia in the name of saving lives. For Sulik, it is clearly time to ‘rethink pink’. She questions the conceptualisation of the ‘War on Cancer’, noting that some women are too sick to fight the war, race for the cure, or be cheerful and optimistic in the face of a drastic diagnosis. Additionally, in regard to the economic motivation for the war on cancer, Sulik notes, ‘The economic incentives of the cancer industry help to create a consumer-oriented environment that shapes the medical and scientific enterprise … The social and clinical investment in diseases with large markets (e. g. women at risk for, or diagnosed with, breast cancer) supplies a huge number of customers for a broad range of cancer-related products and services’ (pp. 160-1). For example, General Electric, which makes very expensive mammography machines, overstate the cancer survival facts when they advertise that early detection saves lives. Sulik also notes how some late stage cancers are undetectable through mammograms, the most widely-pushed tool for detecting breast cancer. Nonetheless, mammograms also contribute to over-diagnosis and over-treatment of conditions that are not life threatening. The research also shows that early detection does not always make a big difference in women’s survival rates, especially in those who have limited resources, since they do not necessarily have the insurance or assets to follow up medical recommendations. For Hispanic and African American women, these and other factors contribute to poorer survival rates compared to those of white women. Sulik is particularly insightful when taking to task those organisations at the centre of Pink Ribbon Culture. For example, Susan G. Komen for the Cure (which held the name the Susan G. Komen Breast Cancer Foundation from its founding in 1982 until an official name change in 2007) paired with fast food restaurant chain KFC to offer ‘Buckets for the Cure’, a promotion in which fried and grilled chicken was sold in pink branded buckets. The collaboration garnered criticism and raised concerns about the promotion of unhealthy eating habits and obesity. In addition, the Komen cancer organisation continues to promote early detection as the primary tool for preventing breast cancer deaths, despite the evidence that indiscriminate mammography screening results in overtreatment of some women whose cancer may regress on its own or would grow so slowly that it would never harm them. Sulik argues that for every one woman whose life may be saved by screening mammography, others may receive completely unnecessary treatment. By contrast, since these screening programs save relatively few lives, and even harm healthy women through needless surgical biopsies, there is a need for more research into cancer prevention and the environmental causes of breast cancer. Another illustration of the ‘competing interests that undermine pink ribbon culture’ (p. 19) is the pharmaceutical conglomerate AstraZeneca. Sulik notes that National Breast Cancer Awareness Month was founded in the 1980s by AstraZeneca, the same corporation that manufactures a range of oncology drug treatments for cancer. Ironically, through their parent company, AstraZeneca also manufactures carcinogenic insecticides and pesticides. Pink Ribbon Blues demonstrates how pink consumption has transformed breast cancer from a stigmatised disease and individual tragedy to a market-driven industry of survivorship. The book reveals a different viewpoint about pink ribbon culture that will help many women (and men) with breast cancer broaden their understandings of, and consider other realistic choices that may help them with, their illness. As well as being of interest to those with breast cancer this book would be useful for both academic and clinical audiences, in addition to serving as an excellent discussion text for courses in medical sociology and anthropology.