What heart patients can learn from Pinktober pinkwashing

by Carolyn Thomas  @HeartSisters

October (also known as Pinktober in corporate brand marketing circles) is the annual holy month of breast cancer awareness-raising, a month of feel-good retail branding opportunities, bathed in a pretty cloud of pinkwashing, a campaign once described by author Barbara Ehrenreich (a breast cancer patient herself) as the cult of pink kitsch”.  You’ve seen these marketing campaign ads:

“For every _______ (insert name of the company’s special pink product, e.g. a pink-labeled can of Campbell’s soup or a pink-handled Smith & Wesson handgun) that you purchase this month, we’ll make a donation to help raise breast cancer awareness!”

As the late Barbara Brenner reminded us: If breast cancer could be cured by shopping, it would be cured by now.”

I worked in the field of public relations for well over three decades, and I can tell you that my colleagues working in breast cancer fundraising have done a  remarkable job of raising both awareness and money for their cause. So remarkable, in fact, that women have been mistakenly convinced that breast cancer is our biggest health threat – which, of course, is not true.

It was only after surviving my own misdiagnosed heart attack that I learned heart disease kills six times more women than breast cancer each year.  Only about half (56%) of women recognize that heart disease is the number 1 killer of women worldwide.(1) 

Please don’t misunderstand. This isn’t a spitting contest around who suffers more. None of us would ever argue that a diagnosis of breast cancer – and indeed any form of cancer – is not a horrific experience for both patient and family. . This is about my annual question at this time of year about why heart patients and those who care for us seem so quiet by comparison.

Yes, we heart patients do have our very own month for raising awareness (February is Heart Month) and our own colour (red) and even our very own awareness-raising lapel pin (the Red Dress).  But that’s where our two “branding opportunity” similarities end.

Much of the growing controversy over the Pinktober commercialism of breast cancer awareness comes, surprisingly, from breast cancer patients themselves. Nancy Stordahl, for example, who was diagnosed with the same type of breast cancer that had killed her own mother just two years earlier, once wrote in her no-nonsense breast cancer blog, Nancy’s Point, that breast cancer is not pretty, pink or party-like.  Period.

And Dr. Gayle Sulik, researcher and author of Pink Ribbon Blues:  How Breast Cancer Culture Undermines Women’s Health, warned:

“Breast cancer is not a ribbon, a screening test, or a leisure activity. It is not a sassy t-shirt, a proclamation of survivorship or a gift worth giving. It is a disease process that ignites what is all too often a cycle of medical surveillance and interventions. For too many, it will be the eventual cause of death.They deserve better than this, and so do we.”

Here are some observations about why heart disease faces an uphill slog to catch up with all that pink:

1. “It’s not my fault” –  First, it helps to have one of those diagnoses that strikes innocents out of the blue, just as breast cancer seems to do. Heart disease is still perceived by many to be self-inflicted.  Read this before you decide: Heart Attack:  Did You Bring This On Yourself? 

2.  “Pick a sexy cause” –  Breast cancer, unlike other health threats to women, was described as “loaded”  by The National Alliance of Breast Cancer Organizations in The New York Times magazine:

“Breast cancer is all about body image, it’s about nurturing – it’s certainly about femininity.”

Heart disease, by comparison, is apparently just not that feminine. And unlike diseases like AIDS or lung cancer, breast cancer is relatively free of what some marketers euphemistically call “lifestyle issues.”  PR consultant Carol Cone of Boston once said, simply:

“Companies want to support breast cancer. Breast cancer is safe.”

3.  “Get the Big Guys on board” –  Breast cancer meshed very nicely with the corporate world’s discovery during the mid-1980s of cause-related marketing. Research showed that, given the same cost and quality, more than half of consumers would switch from a particular store or brand to one associated with a good cause.

But many large companies seek higher sales from cause-related packaging without pledging much – if anything – in return. It’s left up to shoppers to read the labels on pink-packaged products and determine if their purchases will actually help a breast cancer charity. For more about how to tell, visit the non-profit Think Before You Pink a very useful project of Breast Cancer Action. Here’s an example of a common consumer concern:

“If the label says ‘Money will go to support breast cancer’ – what does that mean? If it just says it ‘supports breast cancer awareness’ without being specific, it’s not going anywhere!”

Under the noble auspices of charity, argues Queen’s University professor Dr. Samantha King in her book, Pink Ribbons Inc: Breast Cancer and the Politics of Philanthropy,  global corporations and politicians are all getting a big shot in the arm from this pink ribbon juggernaut. She calls breast cancer “a corporate dream come true.”

Dr. King also suggests that, before you purchase any pink product this month, you should ask the following questions:

1.  How much money actually goes to the cause?  (If very little. it’s best to donate directly to organizations whose work you support rather than filtering it through a large corporation).

2.  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).

3.  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, on prevention, and on the largely ignored subject of end-stage metastatic breast cancer ).

Meanwhile, we can all do our part, big or small, in helping to raise awareness of a condition that women really do need to know more about.  See also: When a red dress just isn’t enough to raise awareness

We know that there is a profoundly significant gender gap in cardiology, and we can help to shrink that gap by sharing with other women what they need to know about women’s unique cardiac risk factors and symptoms.

This October, decide to learn all you possibly can about women’s heart disease (and the fact that you’re reading this Heart Sisters post means you may already have some interest).

Without asking anybody to buy a pink-handled gun, I believe that we can move the needle to help inform the women we care about. Knowledge, as we know, is power.

But I want more than just increased awareness of heart disease (although that would be nice!)  Want to know just how bad women’s awareness of heart disease actually is? The most recent American Heart Association’s National Survey reported that women are far less aware than they were 10 years earlier!  For some demoralizing examples of this awareness-raising disaster, read: Women’s heart disease: an awareness campaign fail?

Other ways I want to move that needle for women’s heart health:  start with cardiac research, which for decades has focused only on (white, middle-aged) men. Even the lab animals used in early cardiac research were male animals. Diagnostic tools, drugs and treatments have all been developed with men in mind, NOT women.

I want that research to be sex specific so that female participants are not lumped in with males when arriving at conclusions or publishing scientific guidelines.

I want medical and nursing schools to start teaching students that, when it comes to our hearts, women are not just small men.

I want to see every major teaching hospital opening up a Women’s Heart Clinic that hires staff with specific expertise in women’s cardiac diagnoses, treatment and outcomes.

I want women to take our own troubling symptoms seriously so that we stop this insane cycle of what researchers call treatment-seeking delay behaviours even while suffering distressing symptoms that, if happening to anybody else we loved, we’d be forcibly dragging them to seek immediate help.

I want paramedics and Emergency Department staff to believe women when we tell you we’re sick.

One last voice in this mix:  the late Shelli Ray Gibbons, a woman with metastatic breast cancer and the founder of the popular site, The Dirty Pink Underbelly, once wrote this to me:

“Breast cancer gets the attention because of society’s objectification and sexualization of women and breasts. Can we please spread the word that it’s not about ‘boobies’ – it’s about life and death, like every other cancer out there.

I wish that October were about women’s health in general, and I wish we could get away from the commercialization of it all, and the trivialization of women and the disease that Pink Industry Month perpetuates.

“I have cancer. It happens to have started in my breast. It has metastasized to my bones. It will eventually spread. It will kill me –  if heart disease doesn’t sneak up on me first.”

©Carolyn Thomas – Heart Sisters www.myheartsisters.org

1. Mosca L et al. American “Fifteen-year trends in awareness of heart disease in women: Results of a 2012 American Heart Association national survey.” Circulation. 2013;127(11):1254–63.


NOTE FROM CAROLYN:   I wrote much more about differences between how men and women are researched, diagnosed and treated in my book, “A Woman’s Guide to Living with Heart Disease” . You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from Johns Hopkins University Press (and use the code HTWN to save 20% off the list price).

Q:   Have we gone too far with Pinktober?


See also:

  A heart film to watch before “Pinktober” arrives

  Fewer lights/sirens when a woman heart patient is in the ambulance

  Same heart attack, same misdiagnosis – but one big difference

  The sad reality of women’s heart disease hits home

When cancer treatment damages your heart

  The trailer for the National Film Board of Canada’s documentary Pink Ribbons Inc. based on Dr. Samantha King’s book.

11 thoughts on “What heart patients can learn from Pinktober pinkwashing

  1. HI Carolyn,

    I love this blog post. It’s all so true. I’m a pancreatic cancer advocate and earlier this year, I had someone from a well-known brand tell me “more people have to die” when I asked for their help in funding and raising pancreatic cancer awareness. I heard these words as my Aunt lay dying in excruciating pain from this disease, and a few months after my father-in-law passed away it. The personal connection made this response particularly hurtful.

    It’s worth noting that the same organization that thinks ‘more people needs to die” gives millions to breast cancer and proudly markets their support. Apparently they aren’t “aware” that pancreatic cancer kills more people than breast cancer each year!

    Finally, your post provided me with more insight into the motives of corporate philanthropic campaign, and on the more positive side, prompted me to read about heart disease, something I’d never done before. 🙂

    Thank you,
    http://www.thepurposefuladvocate.com (pancreatic cancer awareness blog)

    Liked by 1 person

    1. Thanks so much for sharing your perspective here, Kim. I love your blog, by the way. (Note to Readers: please take a look at this link especially if you know somebody diagnosed with pancreatic cancer!)

      “More people have to die” is just about the most cruel and thoughtless response ever, e.g. your cause has to be REALLY heartbreaking (involving kittens or babies might also be effective!) before we’d bother to support you…

      But as this article suggests, the cause of breast cancer awareness is “safe” and “a corporate dream come true” as Dr. Samantha King says. What a horrible yet true way to differentiate diagnoses: what’s in it for CORPORATIONS?! Which makes the anti-pink backlash from breast cancer patients themselves even more ironic…

      When I first started my blog 10 years ago, I was puzzled by the number of women with breast cancer who started following my posts (and frequently commenting in response to them) given that I never write about breast cancer – except for during Pinktober, of course! But I suspect that what they – and you – might be responding to is the reality of “becoming a patient”, which is such a profoundly surreal transformation in life, no matter what the diagnosis, as you yourself have had to learn from your own family members’ devastating experiences.

      I’m so glad you found my blog. Tell your friends… 😉 ♥


  2. Hi Carolyn,

    I think you nailed it as to why breast cancer gets so much attention and not just during October. Breasts, marketing opportunity, shopping, we all have/had moms, and so on. There’s just so much to exploit.

    When companies slap on pink ribbons and tout all that they’re doing to “support breast cancer” (dumb phrase when you think about it) they come out feeling and looking pretty good, often while mostly lining their own pockets.

    Heart disease is not quite so sexy, splashy or something. For whatever reason, it’s a quieter noise that is made in this advocacy arena. All the more reason why your voice is so critical and so appreciated.

    I love that you quoted the late Shelli Ray Gibbons. She was always so spot on with her observations. I miss her.

    And I love that quote of Gayle Sulik’s so much I stuck it in my memoir as a sort of finale statement. It sure speaks to me.

    Thank you for writing this and for being such a staunch advocate for women’s health. And thank you for mentioning my blog post too, Carolyn.

    Liked by 1 person

    1. You are so welcome, Nancy – I consider you one of my ‘go-to’ resources when I’m writing or thinking about breast cancer (you know, in a “What would Nancy say?” sort of way!) And I know that if there’s an issue unique to women living with breast cancer, you have likely already written about it!

      I was surprised to learn recently that, although annual breast cancer death rates have been decreasing among older women since 2007, they have NOT decreased in women under age 50 – which begs the question about what the hundreds of organizations raising funds in the name of breast cancer research are doing with the billions of dollars raised each year for this cause?

      You’re so right – companies claiming to “support breast cancer” this month somehow have that backwards!

      Thanks, Nancy!

      Liked by 1 person

  3. Wearing a Red Dress taught me nothing about AFib, ablation, and any connection to stroke.

    Ads saying Heart Disease is a leading killer of women. So, what do I do with that? Why not some hard info, one condition/aspect a month or a year?


    1. I had a similar reaction when I followed Red Dress Fashion Show events. I just didn’t get how a bunch of celebrities walking the runway in red designer gowns “raised awareness” of heart disease? But I have seen a number of specific campaigns like the one you mention (e.g. the 2018 “Ms. Understood” report from Canada’s Heart & Stroke Foundation that focused entirely on women’s cardiac research, diagnostics, treatments and outcomes – one of the most comprehensive reports I’ve seen yet).

      That “leading killer of women” message was actually a game changer because it was developed in direct response to the reality that (thanks to the pinkwashing avalanche) the majority of the general public, especially women, had long believed something that simply was not true. As this study in the journal Circulation reported, in 1997, women were more likely to cite cancer than cardiovascular disease as the leading killer (35% versus 30%), but by 2012, the trend was significantly reversed (24% versus 56%). That 56% stat is still not great, but it’s almost double what it had been 15 years earlier.


  4. My answer is Yes…I actually get sick to my stomach over the pinkness…

    I have developed over the years a pretty good sense of motivating energies behind things and the motivating energies behind most pink campaigns has little to do with the cause itself.

    I am currently support and medical POA for my best friend who has breast cancer that has metastasized to every bone in her body…. She is not dying, she is fighting and subduing the cancer … the fight is painful and heart wrenching and debilitating and draining. It is not pink or pretty but it is beautiful to see how the human spirit can prevail in the worst of circumstances.

    An interesting point I just remembered after reading your article. When my friend was first diagnosed, already at Stage 4, no one ever asked her did you do breast self-exams? Did you have annual mammograms? How did it get this far without you knowing something was wrong?

    As compared to the constant questions I get concerning my heart disease and diabetes… Are you exercising? Have you changed your diet? Have you lost any weight?

    It is this pervasive mental /emotional abuse of shame and blame that has got to stop. Yes… there are certain causative factors associated with certain diseases …. education about these is important but accept ME now exactly as I am and KNOW I am unapologetically doing the best I can do every single day.

    My disease is not my fault and my cure is not your victory.

    Liked by 1 person

    1. Thanks for this, Jill. “My disease is not my fault and my cure is not your victory.” I’m going to embroider that on a pillow…

      Interesting perspective on your friend (stage 4) who was not asked about how she might have caused her own breast cancer. Simply “being a woman and getting older” have long been considered the big risk factors. But emerging research suggests that there are in fact a number of personal risk factors for breast cancer that weren’t openly discussed until recently, e.g. smoking, being overweight, sedentary behaviour and alcohol consumption are now known to contribute to that risk.

      In my own case, when I was recuperating from my heart attack in the CCU, every nurse and every cardiologist I met during my stay asked me the same questions: are you a smoker? did you have a family history? high cholesterol? high blood pressure? Not one person asked me the one question that likely did make a significant difference: have you ever had pregnancy complications? I did have preeclampsia during my first pregnancy, which we now know is a strong predictor of future heart disease. I didn’t learn that until two years AFTER my heart attack.

      No matter the risk factor, does “WHY?” really matter when we’re in the hospital being treated? (Remind me not to have a family history or pregnancy complications in the future…)


      1. You probably already read this…. but I will pass it on anyway. There was an article in the health section of my BBC newsfeed today about Women and heart disease, based on a study by British Heart Foundation,
        cover article on the subject.

        Liked by 1 person

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