Compromised? 

"What's missing is the truth," says Judy Brady of the Toxic Links Coalition in San Francisco. She wants to see a cure for breast cancer as much as anyone, but she and her group, along with several other activist breast cancer groups, have something to point out about the Susan G. Komen Foundation's activities: "There's no talk about prevention except, in terms of lifestyle, your diet for instance. No talk about ways to grow food more safely. No talk about how to curb industrial carcinogens. No talk about contaminated water."

"I really don't think environmental causes of cancer are acknowledged enough," said Dr. C.W. Jameson of the US National Institutes of Health. "It warrants attention so people can make better, more informed choices, as to where they live or what professions they work in." said Jameson, the director of a biennial report on cancer-causing agents published by the Institute of Environmental Sciences.

"Measuring levels of contaminants in the environment is getting better," says Dr. Michael McGeehin, director of the CDC National Center for Environmental Health. But proving the correlation between toxins and cancer can take decades from the time of exposure to the time a tumor might develop, he said.

Several breast cancer activist groups are persistent in their message, yet the circle it travels in remains small, especially when compared with that of the Komen Foundation and its founder, Nancy G. Brinker. Now the US Ambassador to Hungary, Brinker is the E.F. Hutton of the breast cancer world -- when she speaks, anyone who's anyone listens.

Brinker relies on the blockbuster PR value of the 5K Race for the Cure. The year-round calendar of cancer walks that draw grief-stricken yet hopeful patients and their loved ones, along with a fawning media, preserve Brinker and her group's image as being on the side of the average American woman tragically afflicted with breast cancer.

So most people would be shocked to find that the Komen Foundation helped block a meaningful Patients' Bill of Rights for the women it has purported to serve since the group began in 1982.

Despite proclaiming herself before a 2001 Congressional panel as a "patient advocate for the past 20 years," demanding access to the best possible medical care for all breast cancer patients, Federal Election Commission records show the Komen Foundation and its allies lobbied against the consumer-friendly version of the Patients' Bill of Rights in 1999, 2000 and 2001. Brinker then trumpeted old friend George W. Bush in August 2001 for backing a "strong" Patients' Bill of Rights, while almost all other patient advocates felt betrayed.

Brinker's support of Bush's position should come as no surprise, since the President had nominated Brinker for the Hungary ambassador post less than one business quarter earlier, at the end of May 2001. The President also no doubt helped toast Brinker's Congressional approval on August 3, 2001, less than 24 hours after the House version of the Patients' Bill of Rights, dubbed "the HMO bill of rights" by critics, passed on August 2, 2001.

In 1999, 2000 and 2001, dramatically different versions of the Patients' Bill of Rights were introduced. Critics say that both versions would have done little to provide universal coverage for the tens of millions of uninsured.

Patient protections proposed in the 2001 Democrat-dominated Senate bill, and the Republican-dominated House bill are nearly identical, but the means of enforcing those rights were a sore spot for both parties. Backers of the Democrat version said a patient's right to appeal an HMO decision was weakened under the House bill because the HMOs control who does the review. Republicans also insist that patients, after exhausting all appeals, head to federal court instead of state court where damage awards tend to be higher. The GOP-backed bill would have capped damages at $1.5 million, compared to a $5 million cap on the Democrat side. The legislation also blocks class action lawsuits. That's the bill Brinker supported.

It's no surprise that the Komen side favored the Republican position. A July 12, 2001, agreement between the President and five companies to run a Medicare prescription discount card program for Medicare patients, included a company called Caremark Rx where Nancy Brinker was on the board of directors. Another vendor, Merck-Medco, is one of the many drug companies found in the Komen investment portfolio. (Brinker resigned all board seats, including Komen, when she was appointed to be ambassador).

Cozy Relationships
The Komen group relies on longtime Washington lobbyist, Rae F. Evans, a self-described "corporate strategist" with little experience or interest in grassroots advocacy, who also doubles as lobbyist for Nancy Brinker's husband, restaurant magnate and polo champion Norman Brinker, of Brinker International. Norman Brinker made his fortune off restaurants such as Steak & Ale, Chili's, and Bennigan's.

Also on board for Komen's Patients' Bill of Rights efforts was Akin-Gump, the fourth largest lobbying firm in the country, whose roster reads like a who's who of anti-health care reformers. Akin-Gump has direct links to the 30-member Health Benefits Coalition, industry's leading PAC in the fight to stop a Patients' Bill of Rights that would boost patients' rights over their health plans.

For his part, Norman Brinker, a longtime Komen board member, was a bitter foe of a meaningful Patients' Bill of Rights, through the efforts of both Evans and the National Restaurant Association.

Through the years, the Brinkers helped deliver the state of Texas to George W. Bush, for the governor's seat and then the Presidency. Their phenomenal fund-raising skills earned them the moniker of "Bush Pioneers," followed up with committee positions for the Bush Inaugural Ball, which requires a minimum $25,000 donation. On her own steam, Nancy Brinker lists nearly $256,000 in Bush and Republican Party donations, from Bush gubernatorial races, GOP hard and soft money, and federal PAC hard money, according to FEC records.

Not surprisingly, the Komen Foundation has owned $162,843 in Brinker International stock during 2000, the only year for which records are available. The Foundation also owns stock in several pharmaceutical companies and in General Electric, one of the largest makers of mammogram machines in the world.

At 1998 Food and Drug Administration hearings, the Komen Foundation was the only national breast cancer group to endorse the cancer treatment drug tamoxifen as a prevention device for healthy but high-risk women, despite vehement opposition by most other breast cancer groups because of its links to uterine cancer. Its maker, AstraZeneca, which in essence founded Breast Cancer Awareness Month, has long been a Komen booster, making educational grants to Komen and having a visible presence at the Race For the Cure. Until a corporate reorganization in 2000, the company was a leading producer of pesticides, including acetochlor, classified by the EPA as a "probable human carcinogen."

Nancy Brinker also owns a half-million dollars' worth of stock in US Oncology, a chain of for-profit treatment centers (on whose board she sat at least from 1999 through 2001, according to company records). One of US Oncology's lobbyists in 2000, Alison McSlarrow of McSlarrow Consulting, is former Deputy Chief of Staff to US Senate Majority Leader Trent Lott (R-Miss.) -- a chief architect of the pro-HMO version of the Patients' Bill of Rights.

The Komen group's stock portfolios and cozy relationships with Republican leadership set them apart from most breast cancer patient groups. Even the Beltway insiders at the National Breast Cancer Coalition (NBCC), who played a major role in creating the national research and early screening agenda that sprung up nearly overnight beginning in the early 1990s, are austere in comparison. So when the Patients' Bill of Rights compromise bill was announced, the NBCC, among many others, was appalled.

"Late at night, and behind closed doors," read the Coalition's August 2001 press release, "members of Congress rewrote what would have been a strong and enforceable Patients' Bill of Rights, turning it into a sham for patients while continuing to protect HMOs."

"Any corporate ties to a cancer-related industry raises huge credibility issues for a group that is trying to influence public policy," says Sharon Batt, author of a seminal book on the movement, Patient No More: The Politics of Breast Cancer, and current Chair of Women's Health and the Environment at Canada's Dalhousie University.

"Sitting on corporate boards and organizations that have vested interests in cancer policies is an even higher level of conflict than taking funds: a board member is expected to promote the interests of that corporation," said Batt.

"Even the NBCC takes money from the pharmaceutical industry, but I doubt (its leaders) sit on corporate boards," a fact confirmed by an NBCC spokeswoman in a recent interview.

San Francisco-based Breast Cancer Action goes one step farther, refusing all donations from corporations that make money off breast cancer such as pharmaceutical companies, tobacco and pesticide manufacturers, and cancer treatment facilities.

Explained BCA's executive director Barbara Brenner, "With the growing effort by corporations to look like "good guys' by supporting cancer organizations, it is difficult, if not impossible, to know whether an advocacy organization's positions are based on well thought out policies or on who's paying the bills."

Batt said that one of the dangers of Komen's success is that only messages that don't threaten or embarrass corporations or the Republican Party get through to the media and Congress.

During the 1990s for example, she said, the NBCC and smaller organizations worked to try to convince the National Cancer Institute and other government policy makers to begin addressing the health concerns of a more diverse group of women: ethnic minorities, the poor, and lesbians. But the power brokers in government and the corporate world still listen most readily to the messages publicized by the high-profile Race for the Cure.

It's an uphill battle, Batt said. "For one thing, the Komen Foundation has had more money. For another they carry friendly, reassuring messages through the media and their own programs, a phenomenon I like to term the "Rosy Filter,' meaning the public is spoon-fed through a pink-colored lens stories of women waging a heroic battle against the disease, or the newest "magic bullet.' Yet little light is shed on insurance costs, the environmental causes of breast cancer, or conflicts of interest."

The Environmental Disconnect
One topic you'll never catch either of the Brinkers mentioning is the need for a cleaner environment. That might be because the international petrochemical giant Occidental Corp., big Komen boosters and the same folks who brought us Love Canal, donates 4,000 square feet of "glass and marble offices" to Komen on the premises of Occidental's Dallas headquarters.

The petrochemical industry, including Occidental, successfully lobbied in 2000 and 2001 for looser EPA air, water and chemical regulations at the same time government researchers reported auto and industrial emissions caused cancer.

Recently, the Bush administration essentially gutted the Clean Air Act, pleasing the President's oil industry friends including Occidental.

Officially, the Komen group is pro-environment, and joined with a national coalition of cancer and women's groups in late 1999 to demand research on the links between breast cancer and environmental toxins. However, a subsequent Congressional bill, the Breast Cancer and Environmental Research Act, went nowhere fast when it was introduced in May 2001. Komen's lobbyists made little or no effort to fight for the bill or the concepts behind it, according to mid-year 2001 lobbying records filed by Evans & Black and Akin & Gump. Black, along with many Occidental officals, sat in with Brinker on the Bush Inaugural Committee. And coincidentally, Occidental lobbyists also spent time in 2001 on the House version of the Patients' Bill of Rights.

Bennett Weiner, Chief Operating Officer of the Better Business Bureau Wise Giving Alliance, a national charity rating organization, says it's wrong for Komen's literature, website, and public statements to feature a central figure like Nancy Brinker -- or Norman Brinker for that matter -- while omitting relevant parts of their lives such as seats on boards of private cancer treatment corporations, stock interests, lobbying ties or their political activism as GOP favorites. Weiner said, "If a charity is making recommendations to the public regarding health care among other things, and if they have ties to the industry, then the public needs to be able to objectively use that information."

The Foundation denies that it spends money to lobby, and denies that it is solely aligned with the Republican health care and environmental agendas. In a letter in response to questions for this article, a Komen spokeswoman defends Norman Brinker as a devoted "volunteer." The Foundation even seemed to distance itself from Nancy Brinker by citing her new post overseas.

As Judy Brady points out, the Komen Foundation, and the Brinkers in particular, represent the systemic corruption of business as usual in a corporate-dominated society. "It would be a mistake to demonize the Komen Foundation," Brady says. "They have the best of intentions and I truly believe that they think they are doing good -- with a capital G. What they don't see is that "business as usual' is why we have cancer."

Mary Ann Swissler is a writer based in New Jersey. This article was made possible through financial support of the Fund for Investigative Journalism in Washington, DC.

Editor's Note: In downtown Charlotte this Saturday, an estimated 12,000 runners and walkers will participate in the Susan G. Komen Race for the Cure events. The Komen Foundation is the most well-known national breast cancer organization, providing funds for research, education, screening and, to some extent, treatment. Their trademark pink ribbons and pink balloons have become one of the country's most recognizable symbols, and the organization has won deserved praise for its dedication.

In the past couple of years, however, dissenting voices have begun to be heard about Komen. For some writers, like Barbara Ehrenreich (Nickel and Dimed, "Welcome To Cancerland" [Harper's magazine]), the "pink kitsch" and sentimental aspects of the "breast cancer industry," as she calls it, are hard to take. Others, like Sharon Batt (Patient No More: The Politics of Breast Cancer) or various feminist breast cancer organizations, say that Komen's many corporate ties have led to a focus that is heavily weighted toward finding a medical cure for breast cancer, and away from environmental conditions causing it. The following story examines Komen's corporate and political ties and their influence both on the Komen Foundation's direction. -- John Grooms