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Q and A with Samantha King

Table of Contents
Book Information
Breast Cancer Fact Sheet
Excerpt

$24.95 cloth/jacket
ISBN 0-8166-4898-0

1. Can you provide us with a history of how breast cancer has been viewed culturally?

For much of the twentieth century women with breast cancer were objects of stigma. A positive diagnosis was viewed as an individual tragedy best dealt with privately and in isolation. That began to change in the 1970s with the emergence of the women’s health movement and the decision of prominent women such as Betty Ford and Shirley Temple Black to speak publicly about their diagnoses. Following heightened political activism around breast cancer in the 1980s and 1990s, the emergence of large well-funded breast cancer organizations, the development of corporate interest in the disease, and a broader cultural awareness of the importance of patient empowerment, women with breast cancer began to be viewed as “survivors” and the disease itself is frequently portrayed as an enriching or affirming experience.

In some respects, this is clearly a change for the better: women who are in a position to take advantage of the cheerfulness of breast cancer culture are likely to find that it aids in their recovery. Unfortunately, however, the new image of breast cancer can be enormously alienating to women who cannot share this positive embrace of the disease. It also has the effect of denigrating those who have succumbed to the disease as somehow having not fought hard enough.

2. What is the connection between the feminism of the last two decades and the emergence of the breast cancer movement?

The early years of breast cancer activism clearly drew personnel and other resources from the feminist movement. In addition, the notion of a “woman’s right to choose” in all decisions affecting her health—a notion popularized by the women’s health movement—became a key facet of the breast cancer agenda. The individualist and corporate form that the movement has taken since the 1990s, however, must be understood within the context of the powerful antifeminist backlash that characterized this period. This backlash had the effect of stifling radical political ideas, encouraging women’s movements to distance themselves from feminism, and urging participants to engage in internal transformation rather than institutional change.

3. How have social inequalities been reflected in the campaign to fight breast cancer?

In terms of its agenda, the campaign to fight breast cancer is characterized by a historically entrenched concern with funding research rather than access to treatment. This prejudice has arisen because the cancer control establishment (the American Cancer Society, the NCI, the CDC, the FDA, pharmaceutical companies) has from its inception been composed of affluent individuals for whom the costs or availability of medical care are irrelevant. It’s also the case that the consumption-based nature of the campaign excludes women without the financial resources from participating in it and perpetuates through advertising the idea that breast cancer is a disease which predominantly effects young, slim, ultrafeminine, white women.

4. Where is the place of prevention education and research within the current breast cancer movement?

There is a clear divide within the movement between organizations that are fighting for preventative research and those that follow the historically entrenched bias towards screening and treatment. The latter group, moreover, has the support of huge corporations such as AstraZeneca, maker of tamoxifen, and creator of National Breast Cancer Awareness month. Although this situation has altered slightly in recent years, thanks to pressure within the movement, it is still the case that the leading organizations—such as the Komen Foundation—make prevention a low priority. The seriousness of the situation is illustrated by the fact that the only options we have for prevention right now are pills with dangerous side effects, and surgery more drastic than that often prescribed for women with the disease.

5. How has cause-related marketing altered corporate philanthropy and consumer culture?

Until the 1980s, corporate philanthropy was a relatively random, eclectic, and unscientific activity based largely on the individual preferences of high-ranking executives. Since then, it has been transformed into a highly calculated, quantified and planned approach, often called “strategic philanthropy” or “charitable investing.” Of all the tools that have emerged during this time, cause-related marketing—when a company allies itself with a specific cause, and contributes money, time or expertise in return for the right to make publicity or commercial value--is among the most popular and publicly visible. The effect of this transformation has been to place philanthropy at the center of business activity and to transform it into a revenue-producing mechanism.

6. What is the significance of the change from “cancer victim” to “cancer survivor” in the cancer establishment?

There are both positive and negative implications to this shift. Cancer activists now share a sense of the importance of disease identity categories that suggest active and empowered individuals. The transformation from “victim” to “survivor” has been given institutional legitimacy with the emergence of organizations dedicated specifically to survivorship and with existing organizations placing survivorship at the center of their missions. This is nowhere more clearly than in the case of breast cancer. However, although breast cancer survivors, like AIDS activists before them, have won involvement in the allocation of research funds and the conduct of clinical trials, groups that embrace patient-empowerment as a way to mobilize critical engagement with government agendas, biomedical research, or social discrimination remain a small minority, swimming against the tide of pink ribbon perkiness.

7. What is the disadvantage of having large single-issue health foundations and advocacy groups instead of more expansive health movements?

It is unlikely that the battle against breast cancer will be won so long as it is approached as a single-issue problem that is unrelated to other health conditions or to broader social issues. Large, corporate-funded, single-issue foundations have come to dominate health advocacy and, as a result, questions related to universal healthcare, discrimination, or the impact of the environment on disease have been pushed to the margins. Instead what we see is intense lobbying for greater funding for each individual disease and a focus on inspiring individuals to take responsibility for their health. Research shows us that factors such as education, employment and working conditions, food security, health services, housing, income, and racial nondiscrimination are the key determinants of health in the United States and these are issues that are best approached by more expansive movements.

8. Why are groups like Breast Cancer Action so important to the breast cancer movement?

Because they represent one of the few voices within the movement to challenge the consumer-oriented approach to advocacy and the over optimism that characterizes many of the big breast cancer foundations. More fundamentally, they are there to remind us that women diagnosed with breast cancer today face essentially the same options (if they can afford them)—surgery, radiation, and chemotherapy—that were offered when the War on Cancer was first declared 35 years ago. They draw our attention to the lack of coordination of money flooding in for the cause and how this has produced an approach to research that is utterly fragmented with needless repetition and massive gaps. Without BCA there would be little challenge to the business as usual approach of the cancer control establishment.

9. What do you say to people who think you are against breast cancer support?

I believe in support that will lead us to better understandings of the causes of breast cancer, more effective, less toxic treatments, and greater access to care for all women and men with the disease. My concern is thus not with support per se, but with the particular forms of support that are marketed most heavily to concerned members of the public—shopping for pink ribbon products and participation in costly fundraising events. These modes of approaching the disease, I believe, exploit the public’s goodwill by making big promises that are not being fulfilled.

10. Should people stop buying pink ribbon products?

I suggest that concerned members of the public ask the following questions before they purchase a pink ribbon product: How much money actually goes to the cause? (If very little it’s best to give directly to organizations whose work you support rather than filtering it thorough a large corporation). Where will the money end up? (Information about this is usually hard to find and often vague: If you can’t tell, don’t buy the product). What types of programs will benefit? (If we want to see real innovation in the breast cancer research agenda, we should target our generosity to those organizations that focus on the causes of the disease and how to prevent them).

Samantha King is associate professor of physical and health education and women’s studies at Queen’s University, in Kingston, Ontario.

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Q and A with Samantha King Table of Contents Book Information Breast Cancer Fact Sheet Excerpt		$24.95 cloth/jacket ISBN 0-8166-4898-0
1. Can you provide us with a history of how breast cancer has been viewed culturally? For much of the twentieth century women with breast cancer were objects of stigma. A positive diagnosis was viewed as an individual tragedy best dealt with privately and in isolation. That began to change in the 1970s with the emergence of the women’s health movement and the decision of prominent women such as Betty Ford and Shirley Temple Black to speak publicly about their diagnoses. Following heightened political activism around breast cancer in the 1980s and 1990s, the emergence of large well-funded breast cancer organizations, the development of corporate interest in the disease, and a broader cultural awareness of the importance of patient empowerment, women with breast cancer began to be viewed as “survivors” and the disease itself is frequently portrayed as an enriching or affirming experience. In some respects, this is clearly a change for the better: women who are in a position to take advantage of the cheerfulness of breast cancer culture are likely to find that it aids in their recovery. Unfortunately, however, the new image of breast cancer can be enormously alienating to women who cannot share this positive embrace of the disease. It also has the effect of denigrating those who have succumbed to the disease as somehow having not fought hard enough. 2. What is the connection between the feminism of the last two decades and the emergence of the breast cancer movement? The early years of breast cancer activism clearly drew personnel and other resources from the feminist movement. In addition, the notion of a “woman’s right to choose” in all decisions affecting her health—a notion popularized by the women’s health movement—became a key facet of the breast cancer agenda. The individualist and corporate form that the movement has taken since the 1990s, however, must be understood within the context of the powerful antifeminist backlash that characterized this period. This backlash had the effect of stifling radical political ideas, encouraging women’s movements to distance themselves from feminism, and urging participants to engage in internal transformation rather than institutional change. 3. How have social inequalities been reflected in the campaign to fight breast cancer? In terms of its agenda, the campaign to fight breast cancer is characterized by a historically entrenched concern with funding research rather than access to treatment. This prejudice has arisen because the cancer control establishment (the American Cancer Society, the NCI, the CDC, the FDA, pharmaceutical companies) has from its inception been composed of affluent individuals for whom the costs or availability of medical care are irrelevant. It’s also the case that the consumption-based nature of the campaign excludes women without the financial resources from participating in it and perpetuates through advertising the idea that breast cancer is a disease which predominantly effects young, slim, ultrafeminine, white women. 4. Where is the place of prevention education and research within the current breast cancer movement? There is a clear divide within the movement between organizations that are fighting for preventative research and those that follow the historically entrenched bias towards screening and treatment. The latter group, moreover, has the support of huge corporations such as AstraZeneca, maker of tamoxifen, and creator of National Breast Cancer Awareness month. Although this situation has altered slightly in recent years, thanks to pressure within the movement, it is still the case that the leading organizations—such as the Komen Foundation—make prevention a low priority. The seriousness of the situation is illustrated by the fact that the only options we have for prevention right now are pills with dangerous side effects, and surgery more drastic than that often prescribed for women with the disease. 5. How has cause-related marketing altered corporate philanthropy and consumer culture? Until the 1980s, corporate philanthropy was a relatively random, eclectic, and unscientific activity based largely on the individual preferences of high-ranking executives. Since then, it has been transformed into a highly calculated, quantified and planned approach, often called “strategic philanthropy” or “charitable investing.” Of all the tools that have emerged during this time, cause-related marketing—when a company allies itself with a specific cause, and contributes money, time or expertise in return for the right to make publicity or commercial value--is among the most popular and publicly visible. The effect of this transformation has been to place philanthropy at the center of business activity and to transform it into a revenue-producing mechanism. 6. What is the significance of the change from “cancer victim” to “cancer survivor” in the cancer establishment? There are both positive and negative implications to this shift. Cancer activists now share a sense of the importance of disease identity categories that suggest active and empowered individuals. The transformation from “victim” to “survivor” has been given institutional legitimacy with the emergence of organizations dedicated specifically to survivorship and with existing organizations placing survivorship at the center of their missions. This is nowhere more clearly than in the case of breast cancer. However, although breast cancer survivors, like AIDS activists before them, have won involvement in the allocation of research funds and the conduct of clinical trials, groups that embrace patient-empowerment as a way to mobilize critical engagement with government agendas, biomedical research, or social discrimination remain a small minority, swimming against the tide of pink ribbon perkiness. 7. What is the disadvantage of having large single-issue health foundations and advocacy groups instead of more expansive health movements? It is unlikely that the battle against breast cancer will be won so long as it is approached as a single-issue problem that is unrelated to other health conditions or to broader social issues. Large, corporate-funded, single-issue foundations have come to dominate health advocacy and, as a result, questions related to universal healthcare, discrimination, or the impact of the environment on disease have been pushed to the margins. Instead what we see is intense lobbying for greater funding for each individual disease and a focus on inspiring individuals to take responsibility for their health. Research shows us that factors such as education, employment and working conditions, food security, health services, housing, income, and racial nondiscrimination are the key determinants of health in the United States and these are issues that are best approached by more expansive movements. 8. Why are groups like Breast Cancer Action so important to the breast cancer movement? Because they represent one of the few voices within the movement to challenge the consumer-oriented approach to advocacy and the over optimism that characterizes many of the big breast cancer foundations. More fundamentally, they are there to remind us that women diagnosed with breast cancer today face essentially the same options (if they can afford them)—surgery, radiation, and chemotherapy—that were offered when the War on Cancer was first declared 35 years ago. They draw our attention to the lack of coordination of money flooding in for the cause and how this has produced an approach to research that is utterly fragmented with needless repetition and massive gaps. Without BCA there would be little challenge to the business as usual approach of the cancer control establishment. 9. What do you say to people who think you are against breast cancer support? I believe in support that will lead us to better understandings of the causes of breast cancer, more effective, less toxic treatments, and greater access to care for all women and men with the disease. My concern is thus not with support per se, but with the particular forms of support that are marketed most heavily to concerned members of the public—shopping for pink ribbon products and participation in costly fundraising events. These modes of approaching the disease, I believe, exploit the public’s goodwill by making big promises that are not being fulfilled. 10. Should people stop buying pink ribbon products? I suggest that concerned members of the public ask the following questions before they purchase a pink ribbon product: How much money actually goes to the cause? (If very little it’s best to give directly to organizations whose work you support rather than filtering it thorough a large corporation). Where will the money end up? (Information about this is usually hard to find and often vague: If you can’t tell, don’t buy the product). What types of programs will benefit? (If we want to see real innovation in the breast cancer research agenda, we should target our generosity to those organizations that focus on the causes of the disease and how to prevent them). Samantha King is associate professor of physical and health education and women’s studies at Queen’s University, in Kingston, Ontario.