On losing Evelyn Lauder to cancer

The news of the passing of Evelyn Lauder, crusader for breast cancer awareness, on November 12 brought feelings of sadness for me and many in my family. Indeed, any family member of a survivor of cancer was probably affected by the news of Lauder’s death. Her pink ribbon campaign is as ubiquitous as air itself. Her tireless efforts to raise cancer awareness is admirable and appreciated.

Below Dr. Lauren Pecorino, author of Why Millions Survive Cancer, comments on Lauder’s influence and offers some hope for those diagnosed, or know someone close who has been diagnosed with cancer. – Purdy, Publicity

By  Lauren Pecorino

Cancer is managed throughout the world by teams of people, most notably those made up of doctors, nurses, hospice workers and scientists. But it took one powerful and astute businesswoman to use a successful marketing campaign to raise awareness of breast health around the world.

In 1992, Evelyn Lauder, daughter-in-law of Estee Lauder, along with Alexandra Penny, former Editor of SELF magazine, created the pink ribbon as a symbol of breast health. To date, the Estee Lauder Companies’ Breast Cancer Awareness (BCA) Campaign has given away more than 100 million pink ribbons and millions of informational brochures at its cosmetic counters around the world. The designation of October as Breast Cancer Awareness Month by politicians was a tribute to the success of her campaign.

In 2000, the BCA broadened its ‘Pink’ awareness campaign and began illuminating historic landmarks such as the Empire State Building, Niagara Falls, the Tower of London, the Leaning Tower of Pisa, and the Tokyo Tower with pink lights to raise awareness on a highly visible scale. English actress and Estee’ Lauder spokeswoman Elizabeth Hurley worked with Evelyn Lauder on breast cancer awareness since the mid-1990s. Together they traveled the world to raise awareness of the importance of breast health and early cancer detection.

Back in 1993, Evelyn Lauder founded the Breast Cancer Research Foundation (BCRF) as an independent, not-for-profit organization dedicated to funding innovative clinical and translational research. The BCRF has raised hundreds of millions of dollars and supports scientists across the USA, Canada, Europe, the Middle East, and Australia.

And as recently as 2009, the money raised from the sale of ribbons and related items helped Lauder establish the Evelyn H. Lauder Breast Center at the Memorial Sloan-Kettering Cancer Center in New York City. In so many ways, Evelyn Lauder contributed greatly to the progress we have seen in our fight against breast cancer.

The progress in our fight against breast cancer has been impressive over the last few decades and has resulted in a decreasing trend in mortality. In addition to better awareness, advances have been seen in screening participation, methods of surgery, new treatments, and quality of life. Participation of women in the USA over 40 years old in having a mammogram within the last two years is about 67%. Although different individual studies have reported different values, a re-examination of a mass of previous trials by experts commissioned by the World Health Organization has estimated that the reduction in mortality from breast cancer due to screening is about 35%. Advances in surgery include lumpectomy versus mastectomy and the use of robotics for more precise removal of tumor tissue.

Although has been a successful drug used for decades, newer alternatives such as aromatase inhibitors have been developed and have fewer side-effects. Also, new targeted therapies such as Herceptin that block specific tumor molecules have been added to the drug arsenal for breast cancer. And it is the genetic profiling of tumors that allow doctors to match a specific targeted drug to an individual patient: breast cancer has initiated the path for personalized medicine. Important advances in genetic profiling such as the Oncotype DX21, that examines 21 different genes, can help to calculate the risk of a cancer returning. A low score can spare a patient from receiving chemotherapy and a high score can help select those who would benefit from it. Many of the improvements seen for breast cancer arise from our molecular knowledge of the disease. It is likely that similar improvements will be developed for other cancers as we learn more about their molecular characteristics.

It is both sad and ironic that Evelyn Lauder died of ovarian cancer on the 12th November, 2012. Although I know nothing about Evelyn’s genetic profile, it is curious that a genetic link exists between some cases of breast and ovarian cancer. Inherited mutations in the BRCA1 and BRCA2 genes, although rare, are linked to increase risk of breast and ovarian cancer.

These genes code for protein products that plays a role in DNA repair. Since DNA damage can lead to mutations, and because mutations are an underlying cause of cancer, one can easily see why patients with defects in BRCA1/2 genes have an increased risk of cancer.

The American Cancer Society recommends that women with BRCA gene mutations should begin breast screening at age 25. There is new hope for these patients who develop tumors as a new drug strategy that uses molecular combinations to target their breast cancer cells has shown promising results in early clinical trials (Fong et al., New England Journal of Medicine, 2009).

Evelyn Lauder leaves behind a legacy of breast health awareness for all women. I suggest that the meaning of the pink ribbon be extended for both Breast and Ovarian Cancer Awareness in honor of Evelyn Lauder.

Lauren Pecorino is Principal Lecturer in Cancer Biology at the University of Greenwich and author of Why Millions Survive Cancer. She has presented guest lectures in Rome and Palermo, Italy; Istanbul, Turkey; Cairo, Egypt and the United States. She has previously written this post for OUPblog.

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