Everything's Pink... So Why Isn't There a Cure?

The HWN Team | Insider
Everything's Pink... So Why Isn't There a Cure?

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Pink marketing has added millions of dollars to breast cancer research but breast cancer continues to be a major killer of women worldwide. Is pink marketing better for business or finding the cure for breast cancer?

The ubiquitous pink ribbon – everyone knows it symbolizes the search for a breast cancer cure. But now, not only is the pink ribbon everywhere, it seems that the whole world has turned pink. You can buy a pink frying pan or spatula, pink Barbie doll or boxing gloves, pink M&Ms or tic tac breath mints, even a limited edition Ford Mustang with a 'Pink Package!' These pink product purchases generate money for breast cancer research, mammograms for detection or treatment help for people without means.

Well then, if everything's pink, why does breast cancer still kill over 500,000 women (and men) worldwide each year? This has a simple two-part answer. First, breast cancer is a multifactorial disease that we've made progress in overcoming, but there's still a ways to go and second, the 'pinking of the world' has as much to do with product merchandising as it does with funding cancer research. But of course, since nothing is ever really simple, especially when it comes to healthcare, let's take a closer look at these somewhat general answers.1

As the second most common cancer (lung cancer is first), breast cancer is a major health concern, especially for women who are 100 times more likely to develop breast cancer as men. Breast cancer is the leading type of cancer diagnosed in women and is much more prevalent in well-developed nations.  The incidence of Breast Cancer per 100,000 Population is as follows;  Eastern Asia 18, North Africa 28, South America 42, Western Europe 78 and North America 90. Women in the U.S. have a 1 in 8 chance of getting breast cancer and a 1 in 25 chance of dying from breast cancer.2

The good news is, death rates from breast cancer have been declining since about 1990, with larger decreases in women younger than 50. There are millions of breast cancer survivors worldwide with at least 3 million in the United States. These decreases are believed to be the result of earlier detection through screening and increased awareness, improved treatment and extensive research somewhat fueled by pink marketing.3

Yet, there is still no cure for breast cancer. Why?

The causes of breast cancer are varied and interrelated.

Breast cancer, while making itself known in a seemingly simple way, as a lump in the breast detected by feel or by mammogram, is actually considered to be the final outcome of many factors, both hereditary and environmental. This includes gene mutations that can occur by exposure to estrogen, viruses and/or radiation, production of growth factor chemicals that speed tumor growth, inherited defects in DNA repair functions, and such factors as age, childbearing, hormone exposure, high fat diet, tobacco and alcohol use, obesity and shift work.

Consequently, while these patterns of breast cancer causation can be identified across large groups of people, it is nearly impossible to determine what mix of elements creates the cancer in any given individual. This situation suggests that there may be many possible approaches to defeating breast cancer. However the interrelationship among the factors makes it difficult to create one successful approach or to even figure out which combination of approaches can be most successful in any individual case.4

The diagnosis is not easy.

Breast cancer is typically discovered by palpation of a lump or by changes in a mammogram. The diagnosis of breast cancer is then confirmed by biopsy. i.e., tumor tissue is removed and microscopically examined. Once a diagnosis of breast cancer has been made, the individual woman’s disease state is carefully studied to learn as much as possible about the specific circumstances of her breast cancer and includes staging, grading, evaluation of receptor sites, growth factor hormones and gene expression.

Staging is important as a tool to evaluate treatment options. The tumor is staged by size, involvement of other tissue and presence in the lymph  system or other organs.  About 90% of new cancer cases in the U.S.  are classified as “early stage” due to early detection and prevention. Tumors are graded by how biopsied cells behave. The more the cancer cells behave like normal cells, the less aggressive they are. The less mature and less differentiated, the more rapidly they will divide and grow.

Receptor site evaluation includes testing tumors for sensitivity to the hormones estrogen and progesterone. Those that are sensitive can be treated with hormone-blocking therapy. Tumors are also tested for the presence of growth factor hormone, HER2. This hormone can accelerate the growth of the tumor and often suggests treatment with a drug called trastuzumab that targets this specific protein. Newly developed tests for gene expression can help predict the likelihood of relapse which is useful in determining how aggressively to treat an initial tumor.

Treatment options are as complex as the disease itself.

The constellation of tests combined with factors such as age determine treatment.  There are currently a variety of treatment options available that may be used in conjunction with one another including surgery, radiation therapy, multi-agent chemotherapy, immunotherapy and hormonal therapy.

Surgery to remove the tumor as well as any affected lymph nodes is the most common first treatment.  Newer breast-conserving surgeries combined with radiation have proved just as effective as complete breast removal (mastectomy). Radiation therapy uses high dose radiation to destroy cancer cells. Although some surrounding cells can also be affected, radiation is considered to be a localized treatment.

Multi-agent chemotherapy is usually used for women with potential for or evidence of breast cancer spread.  Chemotherapy uses toxic drugs that destroy all cells, cancerous and non-cancerous. Since cancer cells grow more rapidly, they are killed more rapidly than non-cancerous cells. Chemotherapy often negatively affects other fast growing cells in the body such as stomach lining cells and hair cells.

Immunotherapy uses the immune system to fight cancer. Women who are positive for HER2 can be treated with trastuzumab (Herceptin), a monoclonal antibody which blocks the action of this growth hormone, slowing tumor growth. Hormonal therapy is used in situations where some breast cancer tumors grow faster in the presence of female hormones. Drugs like Tamoxifen and the aromatase inhibitors (anastrozole, letrozole, and exemestane) either lower estrogen levels or prevent cancer cells from being able to use it.

The good news is that current management, along with earlier diagnosis, have decreased breast cancer death rates for women.

Since 1990 death rates are 25 percent lower for women 20-69 years old. Tamoxifen has cut breast cancer incidence by 49 percent in high-risk women and the genetically engineered antibody Herceptin has improved the survival rate for women with advanced breast cancer, thanks to early detection and treatment.

One of the greatest advances in cancer research is the discovery of therapies that target only cancer cells versus surgery, chemotherapy and radiation which can damage healthy cells as well. Because drugs can now be better targeted to the cancer cells, stronger doses of those drugs can sometimes be given and patients experience fewer side effects.  In some cases these targeted approaches stop the growth of existing tumors and prevent new tumors from developing but don’t eliminate the cancer altogether.5

OK, what's on the horizon?

In the future, some cancers may be managed over long periods of time with regular drug therapies, similar to the management of other chronic diseases such as heart disease and diabetes.

  • Cancer vaccines - A protein called carcinoembryonic antigen is present in 40 to 60 percent of breast tumors, as well as others. Researchers are putting the gene for CEA in the virus formerly used to vaccinate against smallpox and using it to produce both antibodies and immune cells against the tumors.
  • Angiogenesis - A tumor needs a constant supply of blood and nutrients to grow; the process is called angiogenesis. A number of drugs that may block angiogenesis are under development.
  • Photodynamic therapy - a photosensitizing agent is either injected into the bloodstream or put on the skin. After the drug is absorbed by the cancer cells, light is applied only to the area to be treated. The light causes the drug to react with oxygen, which forms a chemical that kills the cancer cells.

How is pink marketing playing a role?

The marriage of breast cancer research fundraising with product merchandising has inspired a whole new generation of cause-based product promotion…and that’s not necessarily a bad thing. According to Nick Mulcahy the first breast cancer ribbon was peach. In 1991, an executive at Estee Lauder changed the ribbon to pink and began distributing them in the name of breast cancer research. Interestingly, there is no specific organization that owns the pink ribbon symbol. So, when you see a pink ribbon or some variation of the pink ribbon, there’s no way to tell which organization will receive donated funds unless you investigate further. October is National Breast Health Month. You are likely to see an enormous variety of additional pink products arrive on shelves, each pledging some level of support for prevention, detection, treatment or cure research.6

Each company that chooses to associate itself with this fundraising cause makes its own decisions about how it will apportion the money received from product purchase and to whom the money will be given.

Kitchen Aid, the manufacturers of many pink appliances, agreed to donate $50 for each pink stand mixer purchased, and varying amounts for each of the other qualifying pink products, to Susan G. Komen for the Cure. In conjunction with its pink product collection sales, Kitchen Aid will donate a minimum of $1,000,000 to Komen.

Avon donates 50 to 87 percent of the purchase price from sales of pink ribbon fundraising products to the Avon Foundation Breast Cancer Crusade. Conair will donate 15 percent of proceeds from the Power of Pink mini hair dryer and Power of Pink hair straightener to the Breast Cancer Research Foundation.

Although the amount of money raised for breast cancer research through product pinking is not known, industry analysts estimate that cause-related marketing has generated about $1.44 billion in donations to causes. The Susan G. Komen for the Cure Foundation alone has raised $267 million through partnerships with 129 other organizations. Clearly, cause-based marketing has been very successful in garnering additional funds for breast cancer research as well as to support many other worthy causes.

However, here’s the rub.

In some cases, corporations involved in “pinking” have placed less emphasis on supporting a worthy cause and more emphasis on riding the coattails of the pink ribbon. Some corporations pledge a percent of sales to breast cancer research, up to some limit. If the limit is low, then your purchase made to support breast cancer research, may simply end up as their profit if they’ve reached their tax-deductible donation limit.  Whereas some corporations make a onetime donation such as $10,000 from sales of their product, again enticing people to spend money to support a cause that may never see their money.

In fact, some corporations that use the pink ribbon to drive sales may actually be selling products that may increase the risk of breast cancer. For example according to the Think before You Pink project (TBYP) of Breast Cancer Action (BCA) Yoplait’s fall 2008 campaign, Save Lids to Save Lives, urges consumers to buy pink-lidded cups of Yoplait yogurt. For each pink lid mailed back to the company by December 31, Yoplait donates ten cents to Susan G. Komen for the Cure, up to $1.5 million. A woman would have to eat three containers of Yoplait every day during the four-month campaign to raise $36 for the cause–and the yogurt is made from cows treated with recombinant Bovine Growth Hormone (rBGH).

There are numerous health concerns, including breast cancer, surrounding the use of rBGH.   In a good news flash, on February 9, 2009, General Mills announced that they will take rBGH dairy out of Yoplait yogurt, due primarily to the efforts of the BCA.

While it’s no crime to make money from a good idea like marrying up products with causes and it’s generally good for cause fundraising, it’s also good to be mindful of where and how your donation money is being spent.

BreastCancerAction’s Think Before You Pink project suggests that you ask the following questions before buying pink to support breast cancer research.

  • How much money actually goes towards breast cancer research and is it a reasonable donation, given the price of the product? After it was discovered and publicized that a company was donating $1 for every $250 product purchased, the company agreed to contribute more.
  • What is the maximum amount that will be donated?  If the maximum is too low, your purchase may not result in any contribution at all.
  • How are the funds raised? If you will have to cut out a coupon or go to a website and do something more, are you really going to do it?
  • Where does the money go?  Breast Cancer Action suggests that the greatest needs are funds to treat low income women who develop breast cancer (not for screening which is already available through the efforts of other groups) and support for underfunded, innovative research.
  • What is the company doing to assure that it’s not contributing to the incidence of breast cancer? You can go to the BCA website to read about possible conflicts.7

The Bottom Line

Despite pink marketing breast cancer continues to be a major killer of women primarily because it's the result of a constellation of hereditary and environmental factors. At the same time it’s difficult to treat for the same reasons.

Make sure that the pink product you’re buying donates sufficient funds and just as important does not contribute to the risk of developing breast cancer. If you’re not sure about a pink product 'Think Before You Pink' or make a donation directly to the dozens of breast cancer research, education or support organizations.

Breast cancer research has made enormous strides in treating the disease and may one day render breast cancer as manageable as diabetes. Nevertheless, breast cancer continues to be complex whereas 'pink marketing' remains complicated.

Published May 12, 2009, updated August 15, 2012


  1. Cancer, World Health Organization, February 2006
  2. Boyle P et al, World Cancer Report 2008, International Agency on Cancer Research, WHO
  3. What are the key statistics for breast cancer? Learn about Cancer, American Cancer Society, 2012
  4. Do We Know What Causes Breast Cancer? Learn about Cancer, American Cancer Society, 2012
  5. Despite progress, breast cancer is still a major killer of women, Lubbock Avalanche Journal, October 2, 2008
  6. Harvey J, The Power of Pink: Cause-Related Marketing and the Impact on Breast Cancer, Journal of the American College of Radiology/ Vol. 6 No. 1 January 2009
  7. ThinkBeforeYouPink

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