Scholarly Publications

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Pink Ribbon Blues: How Breast Cancer Culture Undermines Women’s Health

Oxford University Press, 2011. (400 pp.)

Pink ribbon paraphernalia saturate shopping malls, billboards, magazines, television, and other venues, all in the name of breast cancer awareness. In this compelling and provocative work, Sulik shows that although “pink ribbon culture” has brought breast cancer advocacy much attention, it has not had the desired effect of improving women’s health. It may, in fact, have done the opposite. Based on eight years of research, analysis of advertisements and breast cancer awareness campaigns, and hundreds of interviews with those affected by the disease, Pink Ribbon Blues highlights the hidden costs of the pink ribbon as an industry, one in which breast cancer has become merely a brand name with a pink ribbon logo. While survivors and supporters walk, run, and purchase pink products for a cure, cancer rates rise, the industry thrives, and breast cancer is stigmatized anew for those who reject the cheerful, pink ribbon model. Even as Sulik points out the flaws of this system, she outlines alternatives and presents a new agenda for the future.

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Pink Ribbon Blues: How Breast Cancer Culture Undermines Women’s Health

Oxford University Press, 2012. (480 pp.) – Updated Paperback Edition

The paperback edition of Pink Ribbon Blues includes a new Introduction on the recent developments in breast cancer culture as well as a new four-page color insert with images of, and reactions to, the pinking of breast cancer.

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What Survivorship Means

Sulik G. In Virtual Mentor, the American Medical Association Journal of Ethics. 2013; 15:697-703.

According to the National Cancer Institute Office of Cancer Survivorship, a person is considered a cancer survivor at the time of cancer diagnosis and remains so for the remainder of his or her life. By this definition there were about 13.7 million cancer survivors in the United States as of January 2012, a number projected to reach 18 million in the next decade. Sixty-four percent of the 2012 survivor population had survived 5 or more years; 40 percent had survived 10 or more years; and 15 percent had survived 20 or more years. But, contrary to the common definition of survival (i.e., to live), many cancer survivors do not actually survive cancer—according to an 18-year study by the American Association for Cancer Research, just over half of people labeled cancer “survivors” ultimately died of cancer. This contradiction creates confusion about the meaning of survivorship for patients, caregivers, and health practitioners. What’s more, it influences social support, policy guidelines, health care delivery and research, and survivors’ lives.

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Pink Ribbon Campaigns

by G. Sulik and E. Zierkiewicz. In Cultural Encyclopedia of the Breast, edited by Merril Smith. Alta Mira Press, 2013 (forthcoming).

In the last two decades pink ribbon campaigns have, perhaps inadvertently, forged a profitable pink ribbon industry in which breast cancer awareness has given way to pink ribbon visibility. Investigations into products, companies, and charities have found little transparency, accountability, or evidence-based practice. Yet the industry spends billions to promote the pink ribbon while marketing products and services, some of which involve the production, manufacturing, and/or sales of products linked to the disease (i.e., “pinkwashing”). With the general populace still unaware of the complexities of breast cancer or barriers to ending the epidemic, many pink ribbon campaigns profit from hope while selling the image of the courageous warrior to anyone who buys, displays, or thinks pink. Fortunately, strains within the breast cancer movement continue to resist commercialization and promote evidence-based information and analyses of the systemic factors influencing breast cancer.

Breast Cancer Support Groups and Advocacy

by G. Sulik and E. Zierkiewicz. In Cultural Encyclopedia of the Breast, edited by Merril Smith. Alta Mira Press, 2013 (forthcoming).

For over a century women in the United States have worked to become empowered when dealing with breast cancer. In 1920 Barbara Mueller wrote letters to her surgeon, William Halsted – the father of the radical mastectomy (a standard but invasive and debilitating treatment for breast cancer into the 1970s). By the early 1990s women’s organizing resulted in a successful social movement with hundreds if not thousands of community-based organizations across the nation. After two decades of advocacy breast cancer was out in the open, support systems were in place particularly for early stage women, screening programs were widespread, research programs were infused with money, patient advocates influenced research agendas and medical practice, the pink ribbon became the movement’s official symbol (1992), awareness activities such as the popular Race for the Cure were common, and breast cancer awareness became part of the American mainstream as well as a profitable item of popular consumption.

Aspects of the American approach to breast cancer have gone global. Yet the extent to which the American approach applies to other settings is a crucial consideration. Breast cancer as a social cause is highly contested in the United States, particularly in terms of the commercialization of a disease and the role of social movements and culture in promoting or resisting medicalization. American Influences in Poland provide an illuminating counterpoint.

The Future of the Cancer Prevention Education Workforce: Why Health Literacy, Advocacy, and Stakeholder Collaborations Matter

by G. Sulik, R. Chamberlain, and C. Cameron, Journal of Cancer Education Vol. 27 (no. 2), 2012.

The “Future Directions in Cancer Prevention and Control: Workforce Implications for Training, Practice, and Policy” — sponsored by the Cancer Prevention Research Training Program at the University of Texas M. D. Anderson Cancer Center– focused on two central questions: 1) How can cancer prevention take a central role in the strategic planning to meet and minimize the effect of the future cancer burden? 2) Given the shortage anticipated for the oncology workforce by 2020, does the cancer prevention workforce face a similar shortage? And, what must be done? In considering these questions, it is vital to address the considerable gaps in information, communication, training, professional development, roles, and levels of collaboration among multiple disciplines, key stakeholders, and diverse constituencies. A Health Policy and Advocacy Working Group discussed key barriers to closing these gaps and mechanisms for addressing them.

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Our Diagnoses, Ourselves: The Rise of the Technoscientific Illness Identity

Sociology Compass Vol. 5 (no. 6): pp. 463-477, 2011.

Biomedicine situates the definitions, practices, and controls of the medical system within the field of technoscience, which relies on new knowledge, high technology, and biomedical health and risk surveillance. Though there has been a major shift in the role of the medical consumer since the 1970s and a general recognition of patients’ rights, biomedicine holds significant authority over peoples’ lives. Individual and collective identities are now routinely constructed through technoscientific means.

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Managing Biomedical Uncertainty: The Technoscientific Illness Identity

Sociology of Health and Illness Vol. 31 (no. 7), pp. 1-18, 2009.

This paper analyzes how the uncertainty of breast cancer contributes to the development of a new type of illness identity – thetechnoscientific identity (TSI) – which is grounded in biomedical knowledge, advanced technology, and surveillance of one’s health and risks.

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Cancer and Motherhood

In Encyclopedia of Motherhood, edited by A. O’Reilly and J. Geoffrey Golson. New York: Sage, 2010.

Every year 700 thousand women in the United States are diagnosed with cancer. Excluding skin cancers, breast cancer is the most frequently diagnosed cancer in women. In 2008, the American Cancer Society projected over 182 thousand new cases. Although 80 percent of these were in women over age fifty, nearly 33,000 diagnosed women were under the age of forty-five. Younger women with breast cancer face some issues that older women do not. In addition to frequently having more advanced cancers at diagnosis and higher mortality rates, these women potentially face infertility, early menopause, and implications for pregnancy after diagnosis. They are also likely to have dependent children and a greater responsibility for family care.

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Breast Cancer

In The Multimedia Encyclopedia of Women in Today’s World, edited by M.S. Zeiss, C.K. Oyster, and J.G. Golson. New York: Sage, 2010.

Breast cancer is the most common cancer in women worldwide yet there is considerable variation in incidence and survival rates depending upon geographic location. As breast cancer has become more public especially in the United States since the early 1990s, some statistics (particularly those that generate fear) have dominated the public imagination and furthered the common sense message that “early detection” vis-à-vis mammography screening, “saves lives.” This entry will discuss often misunderstood elements of this statement, including the crucial role of disease classification, age, mortality, and the enduring controversy in western countries surrounding mammography screening.

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Pink, In Advertising

In The Multimedia Encyclopedia of Women in Today’s World, edited by M.S. Zeiss, C.K. Oyster, and J.G. Golson. New York: Sage, 2010.

The color pink has been used in advertising and popular culture since the 1940s. Drawing upon and reinforcing gender stereotypes, the subtlety and consistency of pink symbolism has adapted to different generations and contexts to shape popular understandings of what it means to be a woman in America. The color pink gained new momentum in the form of the pink breast cancer ribbon, established in 1992 as the symbol for breast cancer awareness. The pink ribbon easily conjured feminine imagery and discourse that was already prevalent in popular culture. Focusing on goodness, morality, and woman’s domain in the private sphere, pink was used to evoke innocence, thereby rendering breast cancer a virtuous illness, and a good cause.

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