Next Step For Komen Should Be Break From NBCAM


Susan G. Komen for the Cure announced yesterday that the foundation's president, Liz Thompson, will be leaving her position in September, and that two board members will also be leaving. They further announced that founder and CEO Nancy Brinker will move to another role as Chairperson of the Board.

A difficult year for Komen Foundation

Admittedly Komen has had a difficult year. The controversy over cutting breast cancer screening grants to Planned Parenthood, followed by the PR disaster in part conducted by Brinker herself, and the subsequent reversal of the grant decision, put Komen on their heels. Participation in the 5k fundraisers, as well as the amount of donations, have gone down, so this move is very likely designed to mollify those who are now distrustful of the longtime leading advocate against breast cancer.

While for some people the move is seen as too little, too late, and for others it is seen as merely window dressing, it seems a bit unfair to attack the organization for shaking things up at the top. Board changes typically occur in big (some might say oversized) organizations like Komen in the wake of a bad fiscal year and in leading up to the most important time of the year for the organization--the month of October, and National Breast Cancer Awareness Month (NBCAM).

The next step: October independence

If Komen hopes to regain its footing in the campaign against breast cancer, the executive shake-up is not enough. They should take another big step and cut ties with NBCAM.

National Breast Cancer Awareness Month is federally recognized, but this does not mean that it is a program driven or directed by the government. Rather, it is a collection of several anti-cancer fundraising and awareness organizations, with Komen being one of them.

The problem that I have regarding NBCAM is a familiar one, but it speaks directly to the credibility of organizations like Komen and their ability to regain some of the trust they have lost in the past year.

The credibility gap

In principle, it is appalling to have the founding entity of NBCAM be a chemical company (Imperial Chemical Industries, or ICI) responsible for creating the kinds of substances that have been so strongly linked, if only epidemiologically, to cancer.

In practice, I find it less appalling.

I mean really, at least they did something, as pathetic as that sounds. And it's not as though we haven't all benefitted from their products and likely use some variation on them every day. To actively exclude every industry that in some way produces a carcinogenic product or by-product is not realistic.

The problem is that ICI was split up and sold and now its pharmaceutical division is part of AstraZeneca. And despite the fact that NBCAM extols the claim that it is made up of some 25 organizations including the American Cancer Society, Komen, the American Society of Clinical Oncology and the Oncology Nursing Society, it also includes the not-for-profit AstraZeneca HealthCare Foundation.

This makes AstraZeneca the sole pharmaceutical representative included in NBCAM.

Which puts center-stage the oncology products manufactured by AstraZeneca. They happen to have at least three in their current portfolio that are FDA approved for various indications against breast cancer:

- Faslodex (fulvestrant), an estrogen receptor antagonist
- Arimidex (anastrozole), a nonsteroidal aromatase inhibitor, which is indicated for, among other things, breast cancer treatment for patients whose disease worsened after taking tamoxifen.
- Zoladex (goserelin acetate implant), a gonaotropin releasing hormone agonist.

Until recently, they also made the selective estrogen receptor modulator tamoxifen, which was and is one of the great anti-cancer breakthroughs of the last fifty years. I can only speculate on why they dropped it, but it's hardly cynical to think that they only have in their portfolio drugs that they retain the patents on.

More to the point, NBCAM fervently pushes early detection. Early detection of course has great clinical value because in most cases the sooner the cancer is caught, the better the prognosis. However, emerging evidence has become difficult to ignore: some breast cancers caught early by mammograms require no treatment; women are not only being overtreated but in some cases unnecessarily treated; some are being unnecessarily exposed to potentially carcinogenic radiation levels by early mammograms.

These are evidence-based problems that NBCAM fails to acknowledge.

Komen is the biggest name among the many organizations within NBCAM. Their name is Susan G. Komen For The Cure (my emphasis). Early detection is no cure. Early detection could mean, to the more cynical among us, more patients. More patients, for AstraZeneca, means more sales.

This conflict of interest, as I stated earlier, is hardly a novel discovery on my part. It's even part of the Wikipedia entry on NBCAM.

But it is a blatant conflict of interest. A frightening one. And it leads one to question why, for example, Komen has rejected three grant applications from researchers investigating the Human Mammary Tumor Virus, suspected as the cause of anywhere between 40 to 75 percent of all breast cancers, including the highly aggressive subtype of inflammatory breast cancer.

Let's face it: Komen is far and away the most influential and recognizable member of NBCAM. You hear Komen, you think pink and October.

But thinking pink has produced some strange and scary bedfellows (KFC's pink bucket taking the cake). With the additional problem of pinkwashing, it's possible that pink is becoming a liability. And with the executive shake-up at Komen, it might also be time to break with some old associations and begin anew, with a more broad view of the causes of and responses to breast cancer. Komen would emerge from such a break as a freshly independent and dynamic organization.

In short, it might cause some growing pains, but there's nothing worthwhile to lose in ditching a campaign whose principle promoter is seeing direct-to-pocket profits from your participation.

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