Lessons Learned From the Framing of Breast Cancer

Hey all, the following is just a little musing on an issue I have been thinking about lately. It lacks solid research, but in the future I may pursue the topic a little more in depth.

Pink ribbons are everywhere. The universal symbol for breast cancer awareness, the pink ribbon, has completely saturated almost all facets of our culture. It is not surprising to see the ribbon on chocolates, energy drinks, billboards, on TV ads and anything and everything in between. While this awareness (and hopefully increased prevention, treatment and research) is encouraging, one has to wonder how exactly breast cancer awareness advocates were able to get their message heard above all others within the cancer community. There are a variety of cancers that have higher mortality rates, lung cancer for instance, and cancers that have higher incidence rates, the various skin cancers have a significantly higher rate of incidence, yet breast cancer continues to dwarf all other cancers in advocacy and monetary support for research. It is this unprecedented groundswell of support from both women and men alike that begs the question, what is it about breast cancer that caused such a spike in advocacy? It is my belief that how breast cancer advocates frame the disease (i.e. how they presented breast cancer to the public) was the key to making breast cancer a key public health issue.

More than just a disease, breast cancer has become a rallying point for both men and women across the nation. Its place as the cancer with the highest incidence amongst women, adding to the fact that it mostly afflicts women, would conceivably make it simply a "women's issue". While it is true that some of the most fervent breast cancer awareness advocates have been women, there has also been a high amount of support from men for this cause. This is not surprising, as females close to a man, such as mothers, sisters, aunts or close friends, may have survived or succumbed to breast cancer. This proximity may have caused a need to act, a need to further the cause of breast cancer research and prevention. Yet, this explanation cannot fully uncover the reasons behind the success of breast cancer awareness, prevention and research campaigns. Similar support has not been shown for testicular or prostate cancer, a disease that afflicts only males, or even cervical cancer, another disease that afflicts only women. What is it then about breast cancer then? What makes breast cancer different from any other cancer? In part, the answer may relate to ingenious messaging strategies and an awareness of how to utilize socially held standards of beauty to raise awareness.

When a woman is diagnosed with breast cancer, it can be quite traumatic to not only their sense of healthiness but also to their identity as a woman. The breasts have been socially constructed as a symbol of femininity within our culture and therefore the impact of a breast cancer diagnosis not only threatens a woman's life but it also affects their whole identity. While any cancer diagnosis has the ability to challenge an individual's identity (i.e. their identity as a healthy individual, as youthful, as strong or proud), breast cancer can impact a whole series of avowed identities (i.e. being attractive, feminine, a woman, a caretaker) that would not be considered with other cancers. This presented a serious issue for breast cancer advocates, as the stigma associated with the disease created only silence amongst women regarding breast cancer. No one was talking about breast cancer because they were ashamed to have the disease; it posed a threat to their health and identity. This silence could also be seen within efforts to raise awareness about other diseases such as AIDS, cervical cancer and lung cancer. Unfortunately, I saw this stigma firsthand as a young boy when my Aunt Phyllis was diagnosed with breast cancer for a second time. While it was a late stage cancer, the doctors believed that a radical mastectomy would have given her a chance to survive. My Aunt Phyllis denied this treatment though because she was afraid that if she lost her breasts, her husband would no longer find her attractive. In the end, she chose death over the stigma and shame that she associated with losing her breasts.

My point in mentioning the cultural meaning attached to the breasts, as well as the difficulties one faces when diagnosed with cancer, is to point out how breast cancer advocates were able to adapt their messages to de-stigmatize breast cancer and empower women who had this disease. Quite possibly the most recognized breast cancer advocacy non-profit organization is the Susan G. Komen for the Cure Foundation. Named in honor of a woman who succumbed to breast cancer, the Komen foundation has raised over $1 billion in funds to help raise awareness and promote research. Their message, "I am the cure", is simple and empowering yet speaks volumes about how to successfully frame breast cancer. This message, along with a variety of older messages, promotes a sense of agency for breast cancer survivors, a sense of empowerment that helps to rally advocates together. Instead of portraying those who had breast cancer as victims, they paint them as survivors who should be proud that they were strong enough to overcome this disease. In altering the frame from one of pity to one of empowerment, organizations such as the Komen foundation have successfully inspired women to not only discuss their cancer but to be advocates on behalf of themselves and others. Messages from other organizations mirror these sentiments, as in giving these advocates a voice (both literally and figuratively) they have effectively stripped away the stigma that may come from a breast cancer diagnosis. In regards to addressing issues of identity (i.e. attractiveness and femininity), making breast cancer normative in the culture has also helped to re-shape perceptions of what it means to be a woman. Breast cancer is slowly becoming a symbol of femininity, a battle scar if you will, that many women are proud to have symbolize their survival and strength. While many will still deal with threats to their identity, at least they will have somewhere to turn to now to aid in helping them make sense of their disease.

So what could we learn from the framing of breast cancer? In my opinion, three main things. First, empowerment must be emphasized so those with a disease do not feel victimized. Any serious disease has the potential to make patients despondent, thereby making them feel like a victim who is powerless in their fight against the illness. Messages that stress empowerment may help patients re-consider their psychological stance against the disease and, to put it bluntly, make them a fighter. Secondly, reducing the stigma associated with a disease is an important first step towards awareness, prevention, treatment, etc. Messages that aid in reducing the stigma associated with a disease, effectively making it "normal" and "ok" to have the disease, give patients a fighting chance to come to terms with their illness. Finally, the re-framing of breast cancer from a symbol of losing femininity to gaining femininity has shown to be a very effective tool in grouping advocates together. While not all diseases can follow this exact formula, many can take what was a deficiency and turn it into a positive by changing the cultural perception of the disease. This is not an easy or quick process but it can be effective, just take a look at the work of breast cancer advocates.

While I did not do a large amount of legwork to craft this piece, I believe there is potential for moving forward with this concept. I have personal ties to breast cancer so I have been considering these points for a long while now but any criticism is welcome and encouraged. I hope you gleamed something from this writing and please, if you are passionate about a health topic go out and do something about it...be the change you want to see in the world.