It seems that the whole world has turned pink. You can buy a pink frying pan, pink Barbie doll, pink M&Ms, even a limited edition Ford Mustang with a 'Pink Package!' These pink product purchases generate money for breast cancer research and treatment. So, 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 and second, the 'pinking of the world' has as much to do with product merchandising as it does with funding research. 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 also the leading type of cancer diagnosed in women and is much more prevalent in well-developed nations. Women in the US have a 1 in 8 chance of getting breast cancer and a 1 in 25 chance of dying. The good news is, death rates from breast cancer have been declining since about 1990, with larger decreases in women younger than 50. These decreases are believed to be the result of earlier detection through screening and increased awareness, as well as improved treatment. Breast cancer 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, 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. 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. 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. Tumors are graded by how biopsied cells behave. The more the cancer cells behave like normal cells, the less aggressive they are. Receptor site evaluation includes testing tumors for sensitivity to the hormones estrogen and progesterone. Tumors are also tested for the presence of growth factor hormone, HER2, which can accelerate tumor growth and newly developed tests for gene expression can help predict the likelihood of relapse. TREATMENT OPTIONS ARE AS COMPLEX AS THE DISEASE. (1) Surgery to remove the tumor is the most common first treatment. Newer breast-conserving surgeries combined with radiation have proved just as effective as mastectomy. (2) 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. (3) Multi-agent chemotherapy is usually used for women with potential for or evidence of breast cancer spread. 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. (4) 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. (5) Hormonal therapy is used in 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. One of the greatest advances in cancer research is the discovery of therapies that target only cancer cells. 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. The following therapies, currently in clinical testing, show promise. (1) Cancer vaccines - A protein called carcinoembryonic antigen (CEA) 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. (2) 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. (3) 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. The marriage of breast cancer research fundraising with product merchandising has inspired a whole new generation of cause-based product promotion. 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. 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. 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. As an example, some corporations pledge a percent of sales to breast cancer research, up to some 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 companies may actually be selling products that may increase the risk of breast cancer. Yoplait's 2008 campaign "Save Lids to Save Lives", urged consumers to buy pink-lidded cups and for each pink lid returned, Yoplait would donate 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. However the yogurt is made from cows treated with recombinant Bovine Growth Hormone(rBGH) and interestingly there are numerous health concerns, including breast cancer, surrounding the use of rBGH. Due primarily to the efforts of the Think Before You Pink project of the Breast Cancer Association, General Mills announced in February 2009 that they will take rBGH dairy out of Yoplait yogurt The Think Before You Pink project suggests that you ask the following questions before buying pink. (1) How much money actually goes towards breast cancer research and is it a reasonable donation, given the price of the product? (2) 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. (3) 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? (4) Where does the money go? The Breast Cancer Association 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. (5) What is the company doing to assure that it's not contributing to the incidence of breast cancer? You can go to the Think before You Pink website to read about possible conflicts. THE BOTTOM LINE IS BREAST CANCER IS COMPLEX WHEREAS PINK MARKETING REMAINS COMPLICATED. Breast cancer continues to be a major killer of women worldwide because it occurs as the result of a constellation of hereditary and environmental factors. It's difficult to treat for the same reasons. However, breast cancer research has made enormous strides in treating the disease and may one day render breast cancer as manageable as diabetes. Pink marketing has certainly added millions of dollar to breast cancer research efforts but you may want to be sure that the pink product you're buying donates sufficient funds to the most important areas of need and does not contribute to the problem by offering products that are associated with the risk of developing breast cancer. If you're not sure about a pink product check out the website Think Before You Pink or make a donation directly to the dozens of breast cancer research, education or support organizations available. Until medical research has solved the problem of breast cancer, do your part to improve early detection, make a commitment to regular breast self-examination and be sure to undergo mammogram examination on the schedule your doctor suggests.
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