the image of zoomed out hands gathered together in front of the body, with open palms holding a pink ribbon inside the palm

Pink October: Breast Cancer Awareness Month and What You Need to Know

Breast Cancer Awareness Month starts on October 1. It is an annually-held campaign organized by charity organisations to raise awareness about breast cancer and funds for research in the international domain. In the US, this month is also named as National Breast Cancer Awareness Month (NBCAM). The main aim of this monthlong program is to arrange events such as concerts and sporting events to raise funds and inform people about the methods of prevention and what to do for early detection of the disease. Non-profit organizations, government agencies and medical societies work together to promote breast cancer awareness.

Also known as pink month, October promotes pink as the color-symbol of breast cancer awareness. However, this pink-coloured month could also lead to a misperception of what this month really means to women with breast cancer and breast-cancer survivors. This blog is concerned with introducing basic information about how cancer develops, what breast cancer is, and why the post-surgical process is important. In addition to medical conditions, it also addresses issues such as pinkwashing and how cultural and social mechanisms build cancer-semantics.

History of Cancer

the orange image of cancer cells floating in an orange environment
Credit: medicinenet.com

… in Atossa, the Persian queen who swaddles her cancer-affected breast in cloth to hide it and then, in a fit of nihilistic and prescient fury, had a slave cut it off with a knife. The Emperor of All Maladies- Siddharte Mukherje

The history of cancer is as old as human life. Edwin Smith Papyrus (3000 BC) illusturating a case of breast cancer survives as the first description of this disease. In Greece, there were two physicians who studied cancer. One of them was Hippocrates, who named cancer karkinos. The second one was Galen, who used the word onkos for cancer, from which today’s term oncology comes. Onkos refers to “a mass and a load”. According to Galen, cancer would occur due to excess of black bile. Actually, the Galenic theory accepted that four humoral states were the main reasons for all sorts of diseases. This belief continued until the 17th century. According to National Cancer Institute, Gaspare Aselli discovered the vessels of the lymphatic system in the 17th century. He suggested abnormalities of lymph as the primary cause of cancer.

In the 18th century, Giovanni Battista Morgagni performed autopsies to study the disease. Thomas Venner and John Hill linked tobacco to cancer. With the use of microscopes in the 19th century, theories in regard to malignant cells developed. But it was the 20th century when there was a great progression in coming closer to understanding what cancer is. Scientists were working on carcinogens, chemotherapy and radiation. Yet, it still continues to be one of the biggest threats to our health.

What is cancer?

Diseases grown desperate
By desperate appliance are relieved,
Or not at all.—
William Shakespeare, Hamlet

To start with, the human body is made up of trillions of cells forming our tissues and organs. Cells are the basic building units of all living things. They are like the microcosmic structure of the human body with organelles/ organs and nucleus/brain. Inside the cell, there are organelles surrounded by a liquid called cytoplasm. The most important part is the nucleus of the cell, which carries the DNA and functions like the human brain. In other words, it tells the cell organelles when to grow, divide and die. Basically, it knows when the cell is ready to perform these actions.

an illustration of multiple normal cells aligned together signified by pink dots while in the middle of the cell group, grows blue colored cancel cells damagin the healthy normal cells
Credit:cancerresearchuk.org

If any changes or mutations occur in DNA, these mutated genes become uncontrollable and start dividing as they wish, even if  they are not ready to divide. This genetic mutation-caused uncontrollable cell growth leads to cancer. Cancer cells are immature (they don’t perform their duties) and immortal, refusing to die when they are supposed to. They damage the tissues and organs. To put it differently, cancer cells are selfish, borrowing resources from the nearby cells. In time, sometimes these cells also spread to other tissues nearby through the blood and lymph nodes, which becomes metastasis. As Mukherje states, cancer cells grow faster and adapt better. They are more perfect versions of ourselves (14).

What is breast cancer?

the illustration of female breast which signifies s how the breast cancer is linked to different parts of the breast
Credit: cancer.org

The number of cancer-types is quite high, and they are named after specific body parts where the malignant cells start multiplying. One of them is breast cancer, which is the cancer type that develops in the breast. Depending on its nature, it has four sub-types, which are ductal carcinoma, lobular carcinoma, inflammatory breast cancer, and Paget’s disease of the breast (involving the skin of nipple which gets darker). With 1 in 8 women diagnosed with breast cancer, it is one of the most common cancer types. Contrary to common knowledge, breast cancer is not exclusive to women. Men can get breast cancer too, even though it is rare.

The symptoms of breast cancer include breast-pain, nipple discharge, change of colour in the nipple area, size or shape change of breast, a nipple turned inward, and a lump near the armpit or breast. Mammography (screening and diagnostic mammograms), breast biopsy, ultrasound, MRI, clinical breast exam and some blood tests are some of the methods used to diagnose breast cancer.

Mammogram refers to an x-ray picture of the breast, allowing a tumour to be detected in its very early stages. In other words, a screening mammogram helps to diagnose the breast cancer even if the concerned person doesn’t have any signs or symptoms of the disease. The second type of mammogram is a diagnostic mammogram, which exposes the body to more radiation but is more effective for giving a detailed diagnosis of a breast-tumour.

How to prevent breast cancer

Lifestyle plays a significant role in protection from diseases. And cancer is not an exception. The factors like weight, physical activity, diet and alcohol consumption of individuals, and hormone therapies might increase the potential to get breast-cancer. In particular, the kind of food that triggers not only breast- cancer but many other diseases is fast food, processed food and sugar. Also, one must take caution of their family history. The highly risky groups include the ones with breast cancer family history, which might be a sign of an inherited genetic mutation.

What is the Angelina Jolie Effect?

the image of a statement made in relation to Angelina Effect, which demonsates the rise in the number of people getting mammographies
Credit: Twitter @ Sunnybrook

Angelina Jolie has become an inspirational figure in raising awareness about breast cancer. She lost both her mother and grandmother to breast cancer, which worried the Hollywood star about her own future. Concerned about having a carrier status of mutation of the BRCA1 gene due to her family history, Angelina Jolie underwent genetic screening. The results showed that she had a high risk of developing breast cancer. In 2013, she underwent double (bilateral) mastectomy, which is the removal of both breasts through a surgical operation. Later, she reconstructed them.

Angelina Jolie said that “I think our scars remind us of what we have overcome. They are part of what makes each of us unique. That diversity is one of the things that is most beautiful about human existence.” What she did was quite inspirational for many women. Statistics show that people started to have more information on breast cancer and get mammography. Even though this looks like a good picture, some are concerned that regular check-ups with mammography might cause stress and anxiety issues. For instance, the executive director of San Francisco-based Breast Cancer Action, Brenner, stated: ““Mammograms and better drugs won’t stop cancer rates from rising, but stopping these companies from dumping millions of tons of cancer-causing chemicals into the air and water might.” From this standing point, it makes sense to question what corporations and this monthlong awareness program actually should put their effort into.

Who can get a mastectomy?

As stated by the American Cancer Society, mastectomy can be done only under specific circumstances:

  • When a woman cannot be treated with breast-conserving surgery (lumpectomy), which spares most of the breast.
  • If a woman chooses mastectomy over breast-conserving surgery for personal reasons.
  • For women at very high risk of getting a second breast cancer, who sometimes choose to have a double mastectomy (the removal of both breasts).

Post-Surgery Period

illustration of a female figure showing post-breast cancer operation streatchin and physical exercises and breathing techniques,
Credit:ndcs.com.sg

The post-surgery period is as important as the treatment process. After the operation, people should take care of themselves well. Given that it is a very exhausting process both mentally and physically, the ex-patients might struggle to adapt. It might take time for them to regain their previous physical strength and mental perseverance. To revive, they can do physical exercises and participate in art and music therapy classes, which could be attended during the treatment process too. Also, bonding with the people they love helps them to improve their mood. Families should also inform themselves about how they can be more supportive.

Exercises for breast-cancer survivors

Doctors usually recommend breast-cancer survivors to do exercises a week after surgery. Every breast-cancer survivor should consult their doctor about what kind of exercises suit them best. Before starting to exercise in comfortable and loose clothes, taking a warm shower helps muscles relax. Breathing exercises are very important to expand the chest wall. Additionally, during the exercises, one shouldn’t forget to take deep breathes, exhale and inhale at a certain rhythm. Other exercises might include shoulder blade stretch, chest wall stretch, side bend, and wand exercise. This physical activity keeps the muscles working. According to a study,” home-based exercise programs could provide benefits for participants, ranging from enhanced self-esteem, improved mood, to greater aerobic fitness, higher level of functioning, and decreased pain was observed following just one exercise session” after breast surgery.

Post-surgical self-examination is a must

Post-surgical life is deeply important. Women should listen to their body even more and track the changes in the body. Especially, after breast-cancer surgery, they might have pain at the back of the arm, which is normal in the early aftermath of surgery. However, they should track it in case it gets any worse. According to the American Cancer Society, if there is heaviness, aching, tightness, or other strange sensations in the arm, unusual swelling, numbness, blurred vision, tingling, they should immediately contact their doctor.

Art and Music Therapy

a caricature of a man in three image- sequence: sharpening his pencil with tangled thoughts in his head, reflecting the thoughts on paper, relief and tangled circles on paper
Credit:medium.com

Art and music therapy are some relaxing practices used to increase self-esteem and help patients use their creativity as a non-verbal self-expression. To begin with, art therapy is expressive psychotherapy that uses the art-making process to improve social, mental, and emotional functioning and increase feelings of well-being (Rowe 26). Studies show that art helps to relieve stress, anxiety, and the negative effects of diseases. As a non-verbal communication, it allows you to be in the moment with yourself, reflecting on how you feel and getting out whatever is in you.

Secondly, music therapy, involves a process of individuation and personalization, which is a creative, innovative and empowering process (Daykin 352) just like art therapy. As a part of a complementary medicine program in supportive cancer care, music therapy might accompany medical treatment. Some of the music therapy techniques include instrumental improvisation and singing as interactive exercises and receptive ones such as listening to recorded or live music (Stanczyk 2011). In short, music therapy in oncology uses music in preventive, curative and palliative cancer care, in Stanczyk’s words.

What should we be mindful of in Pink October?

15 products such as chips, jello, paper towel, fish filletos whose cover is pinkish all grouped together on white background
Credit: globalnews.ca

First of all, why is October called pink? Where does pinkwashing come from? In October, as a sign of acknowledgement of Breast Cancer Awareness Month, everything is coded in pink. In sporting events such as runs and walks, people wear pink. Many symbolic buildings, such as the Sydney Opera House, the Empire State Building, the Taipei 101 building, and the Tower of London shine with pink lights. But does wearing pink and buying pink things really help?

Capitalism manages to play a trick again. According to thinkbeforeyoupink.org, pinkwasher is a company or organisation that claims to care about breast cancer by promoting a pink ribbon product. But at the same time, it is the same organization that produces, manufactures and/or sells products that lead to the disease. Additionally, as Businesinsider article states, what is more concerning is the “environmental inequalities behind the illness, like toxic chemicals, a lack of chemical regulation policies, and exposure to carcinogens. By putting the onus on the individual: you must get a mammogram, you must buy this pink ribbon to help, you are a fighter, you are a survivor.”

Cancer as a metaphor

Known for her criticism of modern culture, American writer and political activist Susan Sontag was diagnosed with breast cancer in 1975. She resented the perception of the diseases and the language applied to them. In her book, Illness as Metaphor, she explores this issue. Also, she portrays the contrasting characteristics of diseases such as tuberculosis, cancer, and leprosy, but mainly the first two. She emphasizes how people have associated diseases with certain character traits, using a metaphoric language. For instance, tuberculosis was a more poetic disease for the Romantics, while “cancer is a rare and still scandalous subject for poetry, and it seems unimaginable to aestheticize the disease” (20).

Furthermore, in relation to cancer, Sontag stated that cancer was seen as an outcome of an overemotional state. In other words, cancer was the repression of feelings. In accordance to this, the problem was the individual. For instance, nineteenth-century cancer patients were thought to get the disease as the result of hyperactivity and hyperintensity (30). Sontag isn’t the only one who refers to language fail. Stolberg, likewise, criticizes the metaphorical references to cancer in political contexts. For instance, “the Nazi’s metaphorical reference to the “inferior race” as cancer” (Stolberg 54), integrates cancer into a political context, legalizing the act of killing.

Significance of Breast Cancer Awareness Month

a group of people wearing pink shirts while running for Breast Cancer Awareness Month, as they run and raise their hands up
Credit: businessinsider

Health is one of the biggest concerns in the worldwide. Therefore, one of our main goals should be to raise awareness about public health. During Covid-19, we have probably understood that one more time. October, as Breast Cancer Awareness Month, is a time to remind us of complicated medical conditions that we go through and witness others go through. This monthlong program aims to leave some messages. However, there are a few things to keep in mind.

First of all, pink-coded products can be misleading. Buying pink products doesn’t guarantee that we are actively supporting women with breast cancer. Just like how capitalism leads us to illogical consumerism, it might still be doing the same dressed in pink. In a sense, it is a bit like poisoning, which blurs our rational thinking. Hence, it is very important to support the charity organizations whose main concern is to contribute to breast-cancer research.

Lastly, cancer as an ancient disease had different lives, names and connotations. It has been a metaphor and an excuse to cut off not only the different parts of the body but also individuals, society and race. However, none of this changes the fact that cancer is a serious medical condition and a physical disease.

References:

Mukherje, Siddharte. The Emperor of All Maladies: The Biography of Cancer. New York: Schibner, 2010.

Malgorzata Monika Stanczyk- Music therapy in supportive cancer care

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