Breast Cancer Awareness Month: Seeing red over pink!

image of pink lit White House from CBC News

It's that time of year when I see red, even though October is all about the color pink. That's because it's Breast Cancer Awareness Month. Here in the states it's referred to as National Breast Cancer Awareness Month (NBCAM), and even the White House is wearing pink! This whole pink thing is really getting old and frankly, since going through my own breast cancer experience, I find I'm actually angered by it all. Now that I've gotten that off of my, er, dare I say, chest - I'll get straight to the issue. How could a positive thing like raising awareness about cancer rouse me to anger?

Well, before I tackle that question, I want to be clear that this isn't going to be a post bashing America, or medical experts, researchers, charities or any others that have made a positive difference in the diagnosis and treatment of breast cancer or any cancer. My family and I have personally benefited from these things, and I am especially grateful for early detection. My hope is that this post will provide some food for thought.

Experts agree that an increased awareness about a disease may encourage a person to receive medical screening that can lead to early detection (6). Obviously, this is a good thing. But after more than 25 years of raising awareness, is NBCAM actually impacting the early diagnosis of breast cancer? A recent study published in the Journal of Health Economics researched this question and they found the answer is no, not any more (1). So, if NBCAM is no longer effectively raising public awareness about breast cancer or encouraging early detection via screening, than why is it we are seeing more pink than ever? I believe it's because breast cancer has turned into a profit generating industry, and I'm not alone in this thinking.

Profiteering of breast cancer? -
What ever happened to the thinking that:

"An ounce of prevention is worth a pound of cure." Benjamin Franklin 

Benjamin Franklin's quote holds true for those of us health seekers doing our best to prevent disease. But how does this resonate with, for example, a pharmaceutical company, whose bottom line is to make a profit? Let's face it, there's just not much money to be made in preventing breast cancer, or any cancer for that matter. Consider the primary breast cancer treatments to date: slash, burn and poison, otherwise known as surgery, radiation and chemotherapy. In a previous post I discussed an instance where a pharmaceutical company that produced a chemotherapy drug also made a bovine growth hormone being used in dairy cows. This hormone has been linked to an increased risk of breast cancer (5). But, hey, we've got a drug for that.

Whose interests are being served here? This is just one sad example of how some corporations have turned breast cancer into a profitable industry. Breast Cancer Action explains it this way:

 "The cancer industry consists of corporations, organizations, and agencies that diminish or mask the extent of the cancer problem, fail to protect our health, or divert attention away from the importance of finding and working to prevent the disease. This includes drug companies that, in addition to profiting from cancer treatment drugs, sometimes produce toxic chemicals that may be contributing to the high rates of cancer in this country and increasing rates throughout the world. It also includes the polluting industries that continue to release substances that are known or suspected to be dangerous to our health, and the public relations firms and public agencies that protect these polluters. The cancer industry includes organizations like the American Cancer Society that downplay the risk of cancer from pesticides and other environmental factors, and that historically have refused to take a stand on environmental regulation. " (3). 

More to NBCAM than meets the eye?-
So what does National Breast Cancer Awareness Month (NBCAM) have to do with this? Well, let's see. According to Wiki, NBCAM "is an annual international health campaign organized by major breast cancer charities every October to increase awareness of the disease and to raise funds for research into its cause, prevention, diagnosis, treatment and cure. The campaign also offers information and support to those affected by breast cancer. As well as providing a platform for breast cancer charities to raise awareness of their work and of the disease, BCAM is also a prime opportunity to remind women to be breast aware for earlier detection." This sounds great doesn't it?

Well, if we look a little deeper, we find that NBCAM was formed by Imperial Chemical Industries, the creator of Tamoxifen, a breast cancer treatment drug. In the 90's, Imperial Chemical Industries spun off Zeneca Group. Then Zeneca merged with Astra and became Astra Zeneca, which formed a non profit arm that is known today as AstraZeneca Healthcare Foundation, one of the largest financial contributors to NBCAM.  Astra Zeneca also created and markets Arimidex, another breast cancer treatment drug. CancerCares was also involved in the formation of NBCAM. A look at their donors reveals several pharmaceutical companies as well. So, what message would you want to spread if you were a drug manufacturer financially invested in breast cancer treatment medications? Probably not prevention.

I do want to acknowledge again that cancer treatment drugs are not bad. I'm just saying that it's a fact that pharmaceutical companies spend a lot of money on the research and development of new drugs. Forbes  published an article earlier this year that puts the dollar amount between a high of $12 billion and a low of $55 million (4). Considering the magnitude of expense to produce a drug, pharmaceutical companies must be under an enormous amount of pressure to deliver a drug that will generate revenue and for that they need a disease to treat. As I said earlier, there's no profit in prevention.  

Pink washing -
This brings me to what has come to be known as the "pink washing" of breast cancer. You can read more about this here. The term "pink washer" has been used to describe a company "that purports to care about breast cancer by promoting a pink-ribboned product, but manufactures products that are linked to the disease" (Breast Cancer Action) (2). The point is non-profit organizations accepting donations from companies that stand to gain from their philanthropy seems to represent a conflict of interest to me. It's no wonder that little focus is being placed on breast cancer prevention! It's much more profitable for these powerful industries to keep the emphasis on looking for the so-called "cure", which is really just another word for drug treatment.

Awareness, screening and a cure are NOT prevention -
Let's face it,  awareness, screening and early detection is a means to find disease, not prevent it. A cure is defined as the "restoration of health; recovery from disease" (7). Primary prevention of disease is about avoiding or reducing the risk factors for disease. After over 25 years of seeing pink, I think it's safe to say we are aware of breast cancer. I can't help but wonder where we would be now if that focus had been directed toward the prevention of breast cancer.

Well, we can't go back, but we can take action going forward! Let's think before we let our emotions be swayed by all things pink. Let's do some due diligence when donating to a charity.  Where does our money go?  How much of what is spent on that pink colored item will go toward breast cancer prevention research? What chemicals are in my pink marketed cosmetics or foods that my be adversely affecting my body? What's my elected official's stance on this topic? Let's tell those in government how we feel about these issues. Going forward we can shift the focus from awareness to prevention, because the only way we can be cancer free is by preventing cancer from occurring in the first place! 

GO TO: http://org2.democracyinaction.org/o/6098/p/dia/action/public/?action_KEY=11729

Resources

(1) Health awareness campaigns and diagnosis rates: Evidence from National Breast Cancer Awareness Month

Grant D. Jacobsena, Kathryn H. Jacobsen, Journal of Health Economics http://www.sciencedirect.com/science/article/pii/S016762961000144X

(2) Breast Cancer Action, http://bcaction.org/

(3) Breast Cancer Action, 

(4) Forbes - http://www.forbes.com/sites/matthewherper/2012/02/10/the-truly-staggering-cost-of-inventing-new-drugs/2/

(5) Breast Cancer Fund - http://www.breastcancerfund.org/clear-science/chemicals-glossary/bovine-growth-hormone.html

(6) Planning Implementing and Evaluating Health Promotion Programs, James McKenzie, et al, 4th ed., Pearson, 2005.

(7) The Free Dictionary http://www.thefreedictionary.com/cure

The pinkwashing and profitizing of breast cancer

It's that wonderful time of year again, and I'm not talking about the upcoming joyous holiday season. Please forgive my sarcasm, but the reason for my less than mirthful attitude about October is because it's officially National Breast Cancer Awareness Month.  I have come to prefer Breast Cancer Action's more accurate designation of National Breast Cancer Industry Month.  

I've shared my feelings about this month-long marketing extravaganza in a previous post, along with a little background on the origin and history of pink ribbons and breast cancer.  You can read more about that here.  Unfortunately, not much has changed in the world of pinkwashing since I wrote that post a year ago. In fact, it appears things are getting worse.

First, however, the good news is that our awareness of this practice is increasing. This is evidenced by the creation of a new word to describe the phenomenon, i.e. pinkwashing. The term comes from a mash up of the words pink - the color of the ribbon used to commemorate breast cancer, and whitewashing - which means to gloss over or cover up vices or scandals (1).  The Urban Dictionary defines pinkwashing as "the use of breast cancer by corporate marketers in which companies promote their products with claims to donate a percentage of proceeds to the cause" (2). In the spirit of creating new words, let's throw in "profitizing" while we're at it because that's exactly the action that is occurring in what has become the industry known as breast cancer.

Now the bad news. Sadly, it's no longer uncommon for corporations to put profits before the welfare of people. However, things have gone from strange to bizarre considering the fact that joining the long line of companies marketing their products under the pink ribbon is the queen of breast cancer charities - the Susan G. Komen Breast Cancer Foundation.  Evidently, the Komen Foundation has enlisted a company to manufacture a fragrance for them called Promise Me (4).  The slogan listed on the ShopKomen webpage reads, "purchase with purpose to end breast cancer forever" (4).  Have you ever wondered how much of the purchase price of a product that is marketed as "pink" actually goes toward the noble mission to "end breast cancer forever"? At ShopKomen it's 25% (5) (see the small print at bottom of the Komen webpage).

Now, if you're reading this blog you are probably clued in to the fact that the beauty industry is unregulated and as a result most beauty care products, including fragrances, contain chemicals that are proven to be unhealthy. Can you believe that the safety testing of personal care products is left up to the manufacturers? You read that correctly! According to the Environmental Working Group, they police themselves. So, considering this revelation, it will probably come as no surprise to learn that the original Komen Promise fragrance contained at least 2 chemical toxins (8):
• Galaxolide – a synthetic musk that works as a hormone or endocrine disruptor and has been detected in blood, breast milk, and even newborns.
• Toluene – a potent neurotoxicant linked to a variety of demonstrated negative health effects and is widely known as one of the toxic trio. Toluene is banned by the International Fragrance Association.

HELLO!! Endocrine disrupting chemicals are linked to cancer (6). This is outrageous and appalling to me. The Susan G. Komen Foundation is an organization whose mission is to "eradicate breast cancer as a life-threatening disease by advancing research, education, screening, and treatment" (3), yet they are marketing and selling a product containing chemicals that are suspected cancer causing agents.

That's why at this wonderful time of year, when everything is awash in pink, it is especially important to "think before you pink." This phrase, coined by Breast Cancer Action, suggests we ask the following questions before we generously support a charity or buy a pink ribbon product (9):

1. Where does the money raised by pink ribbon products go?
2. How much money goes towards breast cancer programs and services?
3. How are the funds being raised? For example, is it through the sale of cosmetics that contain potential cancer causing chemicals?
4. What types of programs are being supported? Is the money being used to conduct research to understand the causes of breast cancer, or in support of the prevention of the disease?

Check out the video below and please spread the word. Let's join together to let those who are choosing to profit from this disease that we won't be pinkwashed anymore!

Sources
(1) Wikipedia - definition of whitewashing - http://en.wikipedia.org/wiki/Whitewash_%28censorship%29
(2) Urban Dictionary - pinkwashing - http://www.urbandictionary.com/define.php?term=pinkwashing
(3) Susan G. Komen Breast Cancer Foundation - http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1508105/ 
(4) Shop Komen - http://www.shopkomen.com/cart.php?m=product_detail&p=1687
(5) Shop Komen homepage - http://www.shopkomen.com/
(6) http://www.ewg.org/skindeep/2011/04/13/why-this-matters/
(7) Endocrine Society - http://www.endo-society.org/journals/scientificstatements/upload/edc_scientific_statement.pdf
(8) Breast Cancer Action - Think before you pink - https://org2.democracyinaction.org/o/6098/p/salsa/web/thank_you_page/public/thankYou.sjs?thank_you_page_KEY=1654
(9) http://bcaction.org/our-take-on-breast-cancer/politics-of-breast-cancer/the-cancer-industry/#anchor2 
 

Chemical body burden: Are you toxic?

As the Britney song goes, "Don't you know that you're toxic?" Given that the belt I purchased on sale recently contained lead, these lyrics could be prophetic. I just might be toxic! Of course, the toxic love Britney sings about isn't to be taken lightly. Thankfully, we usually have the option to walk away from a toxic relationship. I wish the same could be said about the toxins in our environment.

Toxins in our environment-

How did we get here? Warning labels attached to accessories? You would think that the past experiences of public safety concerns due to chemical risks would have brought about a change in practice. For example, toys, jewelry, accessories, clothing, furniture, crafts, foodware and office supplies have been recalled because they were found to contain dangerous levels of heavy metals, usually lead and/or cadmium. Evidently, if we are warned about something containing a toxic substance, that somehow makes it OK to be sold. 

I know, "caveat emptor" and all that. Given that you're reading this it's probably safe to say that you're concerned about your health and all that influences it. So, when we choose our purchases we try to consider their impact on us and our environment. I could simply choose to buy a different belt.  One that doesn't contain lead. But how would I know which belt doesn't contain a toxic substance given that this warning label isn't required by every state government? How are we to ascertain whether something we are purchasing contains a toxic substance known to cause harm to our health and well being?

Toxins in our bodies: biomonitoring and body burden-

An even bigger question for me is how many of these toxic substances are we exposed to in our environment, and what are the cumulative health risks, if any? In the bigger scheme of health hazards, wearing a belt that may expose me to a low dose of  lead might seem relatively benign. However, when you combine that particular exposure with the multitude of other toxins we encounter daily, the health risks increase and we end up with something scientists call the body burden (1).

According to the Environmental Working Group (EWG), body burden is the total amount of of toxic chemicals that have built up over time in our bodies (1). "Scientists estimate that everyone alive today carries within her or his body at least 700 contaminants, most of which have not been well studied" (3). To my horror I learned that the presence of toxic chemicals is found even in fetuses (2)(3). Evidently, pregnant mothers unintentionally pass toxins on to their babies through the placenta. According to the EWG, "358 industrial chemicals, pesticides and pollutants [were found] in the cord blood of American infants" (6). One expert calls this the state of being born "pre-polluted" (4).

The knowledge of body burden is available because scientists are now better able to measure and track the levels of chemicals present in us through blood, urine, breast milk and hair specimens. This process is called biomonitoring. According to Commonweal Breast Cancer Fund, biomonitoring is an important process for monitoring public health because it indicates "trends of exposure, identifies highly exposed communities and helps in setting priorities for legislative and regulatory action" (10). You can find one overview of some of the chemicals currently being biomonitored here, as well as the CDC's 4th Report on Human Exposure to Environmental Chemicals here. Interestingly, biomonitoring is also being used to watch wildlife that inhabit chemically contaminated environments like toxic waste dump sites. Scientists find that biomonitoring these animals serves as a "front line indicator of pollutant levels and potential health impacts" (7). You can read more about this here at the National Institute of Environmental Health Sciences.

Chemical regulation - Innocent until proven guilty-

When it comes to the chemical industry and our government's regulation of it, it appears their thinking is that chemicals are innocent until proven guilty. Historically speaking, it hasn't been until recent times that chemicals and their link to ill health effects have come under closer scrutiny. Back in the 1970's, the US Environmental Protection Agency (EPA) began to regulate a limited number of chemicals, mostly pesticides, under the Toxic Substance Control Act (TSCA). In 1992, the TSCA was amended to include a Lead Exposure Reduction Provision.

Toxins and health effects-

The health problems resulting from lead exposure are documented and well-known, with children being the most adversely effected. It took years, but health advocates pushed for tighter regulation of lead. As a result unleaded gas, paint and plumbing components are now the norm (5). However, as is evidenced by the warning label attached to my belt, lead is still finding its way into our lives. The lead example highlights what is broken with the current laws: 1) poor control of the import of goods made in countries that still allow the use of toxic substances and 2) current regulations are outdated.

The TSCA was enacted before the current scientific findings that show even small levels of chemical exposure, which were once considered harmless, actually do cause detrimental health effects. In addition, there are now hundreds of new chemicals that have been created since the TSCA went into effect. These chemicals aren't being regulated. Also, the present regulation of chemicals tends to focus on the effect that just one chemical has on our health and not the effects of total body burden. Given the past negative history of, for example, lead, one would expect that the government would choose to err on the side of caution and at least restrict the use of newer chemicals until more is known about their effects on us. Sadly, this just isn't the case. This wait and see attitude is like playing a game of chemical roulette. 

Since this post is focusing on what we can do to limit our body burden, I won't go into a lot of detail about the ill health effects of toxins.  Suffice to say, current scientific evidence clearly shows increased risk for birth defects, as in genetic mutations, reproductive issues, and cancers (3). These risks, combined with the fact that babies are being born pre-polluted is compelling enough to take at least a little protective action.

How are we exposed? The biggest chemical culprits-

One of the biggest areas of our exposure comes from the consumer products we use. Government health authorities have identified the following chemicals as being "human carcinogens, serious neurotoxins or well-established hormone disrupters" (4), so it would seem prudent to try to limit our exposure to these (click on each if you want to learn more):

• Brominated flame retardants
• pesticides
• the Teflon chemical PFOA
• the Scotchgard chemical PFOS
• BPA
• lead
• cadmium
• mercury
• perchlorate
• dioxins
• furans

Several other areas of exposure include the air we breathe, the water we drink and the foods we eat. If you've just thrown your hands up in surrender, I share your frustration. However, the situation isn't hopeless.  We may not be able to avoid toxins, but there are things we can do to reduce our level of exposure. Checking to see what your body burden currently is might seem like a logical place to begin.  However, at this point experts are saying that individual biomonitoring is difficult to use for specifically assessing how relevant your individual results are to your actual risk for disease. So, where do we begin?

What we can do to limit our body burden:

1. Let our government officials know that:
• we find the current regulation of chemicals unacceptable.  Public outcry was exactly what prompted the chemical DDT to be banned. The EWG states that "Proper environmental regulation does work to reduce people's chemical burdens" (8). The Toxic Substances Control Act must be amended to at least require that the complete health and safety data on chemicals be known and disclosed to the public. No more innocent until proven guilty. Dangerous chemicals should be phased out and safer alternatives assured.
• we desire community biomonitoring programs. The Centers for Disease Control (CDC) has been conducting biomonitoring for the past 30 years and several states are also biomonitoring for a small number of specific toxins only. One example is the program in Pennsylvania that tracks blood lead levels (9). You can read more about this at the CDC site here. However, more wide-spread biomonitoring of the chemicals experts have linked to increased risk for disease needs to be conducted in communities.
2. Support "watch dog" organizations that advocate for us by keeping an eye on the largely unregulated chemical industry, like the Environmental Working Group,  The Natural Resources Defense Council, or the Children's Environmental Health Network.
3.  Filter your water.
4. Buy organic foods if possible, especially if you have young children. If this isn't an affordable option, try to focus on buying organic products that make the most difference.  EWG has a handy list of the most pesticide laden produce here and it's also available as a free Iphone app.
5. Know what's in your personal care products and household cleaners and what chemicals to avoid. The list above gives you a good head start. Try to use natural products. You can read more about the natural personal care products at Skin Deep here and the household cleaning products here.
6. Know what kind of plastics are safer and avoid plastic baby bottles, water bottles, toys, teethers and  pacifiers and canned foods whose cans are lined with BPA. Avoid microwaving foods in plastic containers.
7. Throw away aluminum cookware and pans with non-stick coated surface. 
8. Avoid fabrics treated with flame retardants, wrinkle relaxers or stain repellents and limit use of fabric softeners and air fresheners.
9. Use low VOC (volatile organic compounds) paints whenever possible.
10. Try not to use chemical pesticides on your lawn, pets or in your home and take your shoes off before you walk in the house.

The evidence linking toxins to deteriorating health is mounting and seems compelling. The good news is that by becoming educated about the situation we can take steps to decrease our chemical body burden. While making these changes in our lifestyle are important to reducing our chemical exposure, it is critical that we also push for improved government and industry standards regulating chemicals.

As for the lead belt that prompted this post, it went back to the store, along with a letter to the company letting them know how I feel about their sale of a lead laced accessory! I like a bargain, but with this purchase I got more than I bargained for!    


Sources
(1) Environmental Working Group (EWG) http://www.ewg.org/news/proof-burden 
(2) Biomonitoring http://www.cdc.gov/biomonitoring/
(3) Chemical Body Burden http://www.chemicalbodyburden.org/whatisbb.htm
http://frwebgate.access.gpo.gov/cgi-bin/usc.cgi?ACTION=RETRIEVE&FILE=$$xa$$busc15.wais&start=9720137&SIZE=4204&TYPE=TEXT
Environmental Protection Agency (EPA) http://www.epa.gov/lead/pubs/titleten.html
(4) EWG http://www.ewg.org/minoritycordblood/pressrelease
(5) EWG http://www.oregon.gov/DHS/ph/lead/docs/introhealtheffectsmedicalprovider.pdf?ga=t  
(6) EWG http://www.ewg.org/files/2009-Minority-Cord-Blood-Report.pdf
(7) National Institute of Environmental Health Sciences - http://www.niehs.nih.gov/research/supported/srp/products/products2_s3_s1.cfm 
(8) EWG http://www.ewg.org/news/proof-burden
(9) Centers for Disease Control (CDC) - http://www.cdc.gov/nceh/tracking/trackbiomon.htm