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Reproduced by permission of the author, Rose Marie Williams  Think Before You Pink, October, 2005

Donating Wisely During Breast Cancer Awareness Month  

By Rose Marie Williams                  

October conjures up visions of shiny red apples, orange jack-o-lanterns, multicolored foliage, and in honor of Breast Cancer Awareness Month, pink ribbons, pink pens, and more pink. But when it comes to the green stuff, an ounce of prevention is the real gold standard.
Breast Cancer Has Become a Champion of Charities.

In October, its adopted color, pink, is everywhere. You can run, walk, bike, climb, even test drive a car "for the cure." Many retail companies claim to donate a percentage of profits "for the cure," and numerous charitable organizations raise money for research.

For three decades and through many avenues, Americans have generously donated billions of dollars to breast cancer research. Just what has been accomplished? Sadly, we have no cure. What we do have includes more diagnostic equipment, more invasive and expensive procedures, and a higher incidence of breast cancer. From 1950 to 1991 the incidence of breast cancer in the US increased 90 percent.

That doesn't mean there aren't some dedicated researchers and phenomenal organizations out there doing their best, but the San Francisco-based Breast Cancer Action group urges donors to look beyond the pink ribbon philanthropy and join their Think Before You Pink campaign . They encourage us to put our money in places that will revolutionize breast cancer research, away from the current focus on screening and treatment, to prevention—which includes looking for causes in places that corporate supporters of "cancer awareness" might not favor.

In The Cancer Syndrome, Ralph Moss, a former director of public relations at Memorial Sloan-Kettering Cancer Center in New York City, reveals a complex arrangement of interlocking committees and boards of directors between industry and research centers. Big corporations exert substantial influence over cancer funding, research, and advocacy, and some sponsor "awareness" fund-raising. But some, as illustrated here, benefit handsomely from the occurrence of the disease.

The Cancer Industry

Among the largest donors to cancer research are companies that profit either from its treatment or from selling products that contain carcinogenic chemicals. For example, the Breast Cancer Research Foundation was founded in 1993 by Evelyn H. Lauder, Senior VP of the Estee Lauder Companies, Inc., an international giant in the cosmetics industry. The foundation receives annual donations of a million dollars or more from within its own ranks (Estee Lauder Companies and Clinique, a subsidiary of Estee Lauder Cosmetics). Other donors include pharmaceutical or biotechnology giants like Roche, Aventis, and Genentech, all of which profit from their cancer drugs and treatments.

AstraZeneca is another pharmaceutical that donates to Estee Lauder's Breast Cancer Research Foundation, but it does much more. In fact, the concept of designating October as Breast Cancer Awareness Month was the brainchild of the Zeneca Corporation, as it formerly was known. AstraZeneca pays for and controls all media advertising about the October Breast Cancer Awareness campaign.

But there is a conflict of interest between AstraZeneca's income generating sources and its support of  cancer awareness. It produces Nolvadex (tamoxifen), the most widely prescribed breast cancer drug, which in 1994 brought in $470 million, as reported by Monte Paulsen in Mother Jones, and which continues to earn hundreds of millions annually, though it's being phased out in favor of a different lucrative drug. (The company's earnings from all oncology drugs in 2004 were $3.4 billion.) Another example: It derived $300 million in 1994 from acetochlor, a carcinogenic herbicide implicated as a breast cancer risk. (In 2000, AstraZeneca sold its herbicide division to Dow Agorsciences.) Furthermore, since the late 1990s, AstraZeneca has bought and managed cancer treatment centers in California, Florida, and New York.
The focus of the pharmaceutical industry's research and awareness campaigns are on screening and treatment, not prevention. Less than five percent of the research money spent in this country addresses cancer causes.

Putting an a Pretty Face

Cosmetics companies are among the most visible participants in the fight against breast cancer, garnering an excellent public relations image for this $35 billion industry. It knows well that image is everything. In this case, however, appearances are only skin deep. Health advocates find myriad toxic chemicals, dyes, fragrances, and preservatives in cosmetic and personal care products. Increasingly, these are suspect as health dangers. Phthalate plasticizers, found in skin lotions and nail polish, are also hormone mimics, and have been removed from baby toys because of an association with birth defects.

The FDA does not regulate the safety of cosmetic ingredients, and very little government or industry funding is designated to study the relationship of environmental toxins to cancer. A 2004 study by the Environmental Working Group, a nonprofit consumer advocacy organization, found that only 18 of 7,500 cosmetics had their ingredients fully tested for safety. The remaining 99 percent had never been fully tested for links to cancer and birth defects. A recent independent report co-sponsored by the Breast Cancer Fund and Breast Cancer Action, "State of the Evidence 2004: What Is the Connection Between the Environment and Breast Cancer?" details new links between environmental toxins and breast cancer.

Breast Cancer Action and other advocacy groups believe it is time for the cosmetics industry to replace these toxic chemicals with safer alternatives, and to clearly list all ingredients. After years of pressure, Avon, Estee Lauder's Mac and Clinique lines, and Procter and Gamble's Max Factor and Cover Girl lines finally agreed to remove phthalates from their nail polish, but the battle over parabens continues.

Breast Cancer Action continues to use media advocacy, public education, grassroots organizing, and shareholder activism to challenge companies like Avon (the largest corporate funder of breast cancer research) to be more candid about how much money is raised and spent, and to finance research on the environmental links to breast cancer. Avon's Walks for Breast Cancer raise the most money, but costs associated with producing and advertising the events are taken from funds raised by the walkers—something that diminishes the direct application of hard-earned dollars to cancer research, little or none of which will research prevention.

Detection is not Protection

The State of the Evidence 2004 report also found exposure to ionizing radiation to be the most clearly established cause of breast cancer. The American Cancer Society (ACS) and National Cancer Institute (NCI) began promoting mammograms, which use radiation, in the early 1970s as a tool in the war against breast cancer. Today, mammography is AstraZeneca's focus for Breast Cancer Awareness Month. Yet as early as 1976, John Bailar III, then editor of the NCI's journal, questioned the procedure. "The possible benefits of mammography have received more emphasis in the clinical literature than have its defects," he said, adding, "mammography may eventually cause more deaths from breast cancer than it prevents."

Little, if any, research has followed up this concern, though it has been endorsed by other medical experts, including John Gofman, MD, PhD, founder of the Committee for Nuclear Responsibility (CNR) and author of Preventing Breast Cancer: The Story of a Major, Proven, Preventable Cause of This Disease; Janette D. Sherman, MD, toxicologist, patient advocate, and author of Life's Delicate Balance, Causes and Prevention of Breast Cancer; and Samuel S. Epstien, MD, outspoken critic of the cancer industry and author of The Politics of Cancer and the recently published Cancer-Gate: How to Win the Losing Cancer War.

Women are urged to get yearly mammograms with the claim that "Early detection is the best protection." But, if something has been detected, then you have not been protected. There has been much controversy about when women should begin mammography screening for breast cancer. A report in the January 2004 Public Citizen Health Letter showed that screening women aged 40 to 49 resulted in an increase in deaths from breast cancer for the first 10 years after beginning screening, and a significant two-fold increase in breast cancer deaths after three years of screening. Women are not told this. If they are not given this information they cannot make the right choices about their own health.

The ACS still encourages women to begin mammograms in their forties, and as early as their twenties for women of high risk, even though mammography is not effective for younger women with denser tissue. Dr. Sherman reminds women that "mammograms do not prevent cancer, they can only find an existing cancer." Further, the cumulative radiation damage from yearly mammograms increases the risk of developing breast cancer later on. Incidentally, General Electric manufactures all the mammography equipment used in this country (and is heavily invested in the nuclear industry), and DuPont produces all the film. Both companies have been big supporters of the ACS.

The ACS advises women with an inherited sensitivity to developing breast cancer (those with BRCA1 or BRCA2 genetic mutations), to combine annual mammograms with bi-annual clinical breast exams by a trained professional, beginning at age 25, even though these techniques can only find cancers at a relatively advanced stage, by which time malignant cells may already have spread. Two German radiologists from the University of Göttingen now say that women with inherited breast cancer risk should avoid frequent and early mammograms because the low-dose x-ray exposure is nearly three times more likely to cause gene mutation than conventional x-rays. They advise high-risk women to insist on other screening techniques.

I clearly recall a panel discussion of experts at the second World Conference on Breast Cancer in 1999 in Ottawa, Canada, at which a young woman asked how ethical is it for women with a predisposition for breast cancer to begin mammography screening at a young age, when further damage from radiation exposure might hasten the onset of the disease. I do not recall her getting a satisfactory answer at that time, though I will never forget the poignancy of her question.

Further, mammograms have only a 50 to 75 percent accuracy rate, with many false positives leading to anxiety, stress, over-treatment, and unnecessary medical costs. More frustrating is that many tumors are missed. Not all equipment produces high- quality results, and interpretation is subjective. Studies published in 2000 and 2001 in the Journal of the National Cancer Institute and in Lancet concluded that mammograms are no better than clinical exams in saving women's lives.

Fortunately, there are other options to mammograms. Ultrasound scans (sonograms) and MRIs are already recommended for women with dense breast tissue because they are more successful than mammography in identifying small tumors. Neither uses radiation, so they are particularly useful for high-risk women and for women who may have a recurrence of breast cancer. Thermography is another option, which can identify suspicious activity much earlier than mammograms. It is an FDA approved technology that uses infrared cameras to produce diagnostic images of temperature variations in tissue. (See "Beyond the Mammogram," in Chronogram's June 2005 issue.)

Thinking Before Pinking

When you reach into your pockets this October, remember that virtually all breast cancer research today supports treatment, not prevention. There is no mention of environmental risk factors from toxic chemicals or of radiation, the best documented cause of breast cancer, in the hype provided by the big corporate sponsors.

Dr. Kenneth Olden, Director of the National Institute of Environmental Health Science (NIEHS), believes there is a need for new thinking in science, and encourages researchers to think outside the box. He reminds us that scientists will research whatever the grant money allows them to study. It is the funding agencies that control what studies receive grants.

As individual consumers, we can assist a transition to research that is outside the box, and much needed. Think Before You Pink this October by asking how our donations will be used by cancer charities. What percentage goes to administrative and advertising costs? How much will be used to research the cancer link to toxic chemicals and radiation exposure? What are the links between the foundation you will be supporting and the corporations that promote pollution, whether pollution of the environment or of ourselves? Then donate to those that are leading the way to prevention, which is the real cure.

Another choice is to direct your donations locally, to benefit individuals struggling with cancer in our own community. The Oncology Support Program at Kingston's Benedictine Hospital (845-338-2500) is one example. It provides comprehensive support groups, educational presentations, consultations, and healing arts classes for cancer patients and their families.

Hope Nemiroff is executive director of the Mid-Hudson based Breast Cancer Options (845-657-8221; www.breastcanceroptions.org). She reminds people that "breast cancer is not pink and feminine. It is painful, life-threatening, and real." Her organization offers trained companions to go with patients to medical appointments and to help interpret medical tests and treatment options. It also sells calendars about risk reduction and safer product information ($10) and organizes health conferences covering many aspects of treatment options and environmental links to breast cancer.

Breast cancer is a terrifying disease, and it is possible this fear is being exploited by companies that profit from cancer treatment, and by advertising to raise money "for the cure." Environmental advocates are finally demanding to know how the money is spent, and why there aren't more studies looking at the cancer link to toxic chemicals and radiation. Cosmetics companies that promote pink-ribbon fund-raisers are being challenged to eliminate carcinogenic and mutagenic chemicals from their products. You can do your part by looking more deeply into where your well-intended donations are going, and supporting progress and accountability. 

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