Wretched Pink Ribbons. Again.

So here we are again awash in these wretched pink ribbons. They must constitute the most successful marketing campaign ever.

And they are so pernicious. They make us feel touched by and involved in something significant by merely wearing them or buying something with their picture attached.

But what do they say? Nothing, except that thousands of women still go through breast cancer every year. And that is the problem. There is so much that needs to be said that gets buried under the ribbons.

What do we need to be saying?

1. We need to say that detection is not prevention. Actually bringing down incidence rates has been completely removed from all important discussions. We hammer women with the need for them to individually bring down their risk without a proper public health strategy to bring down breast cancer rates with a strong, public health program that incorporates environmental health as a central component. Also, in working to prevent breast cancer, we work to prevent a range of diseases.

2. We need to say that breast cancer incidence is directly related to hormone disruptors (or endocrine disrupting chemicals) that are ubiquitous and completely unregulated. We need to say that right now, we have the chance to start to reign in these destructive chemicals with a proper reform of the Canadian Environmental Protection Act (CEPA). The Parliamentary Standing Committee on the Environment and Sustainable Development has developed an excellent report on reforming CEPA. We have the roadmap. We just need the political will to move forward. We need to say that it is immoral for the federal government to not act on this issue when the health consequences for citizens is so great.

3. We need to say that many of the products bearing pink ribbons are filled with the estrogenic hormone disruptors phthalates, parabens and triclosan, particularly in make-up and perfumes.

4. We need to say that we need much more research on prevention, stopping the development of the disease and not just treatment. Treatments have been vital and we are thankful so all that have been developed. But they have sidelined the work on prevention. An eminent researcher on hormone disruptors described to us how difficult it is to get his work funded. It consists of a lot of bad news with no money to be made. But it is essential if we are to change the future of this illness.

5. We need to say that overdiagnosis and overtreatment of breast cancer are very serious issues and that mammography screening programs cause many women serious harm. Our approach to screening must be completely rethought and used to target populations at particular risk, but not population wide programs. Then we need to de-escalate our approach to many treatments. Both of these approaches would be more effective and reduce the burden on our health care system caused by overtreatment.

6. We need to say that anyone with breasts can develop breast cancer. This marketing campaign that has wrapped the disease in an ugly pink does harm to many who are not gender-conforming women. Men with breast cancer most often feel very uncomfortable with disease and do not know to watch out for it as it has been portrayed as an ultra-female disease. Gender nonconforming people are equally uncomfortable as a biological fact has been made into a highly normative, feminine disease.

7. We need to say that women need to get mad. We will not shop and ribbon our way to less breast cancer. But we can change the future course of this disease. And many others along with it. But we’ve got to fight for it. And get the pink ribbons out of our lives.