(The New York Times News Service) -- Catherine Guthrie remembers being inundated with pink after her breast cancer diagnosis in January. She left her oncologist's office with a pink satchel, a pink water bottle and other pink items, and found it "disturbing."

"I had breast cancer, a deadly disease, and I felt like I was being treated like a little girl," says the 38-year-old Bloomington, Ind., freelance writer who started a blog protesting pink during October. "I wanted to be treated like an adult with a serious illness and a pink water bottle is not going to make it better."

On the other hand, Darlene Dickson said seeing pink everywhere makes her feel like people care about those who have cancer.

"I like the pink," says the 52-year-old Southfield resident, who was diagnosed with breast cancer in June. "When you see it you know what the cause is."

When National Breast Cancer Awareness Month was founded 25 years ago, it was intended to nudge women to get screened for breast cancer and to promote education. Today, it is a machine arguably more successful than any other disease campaign, with hundreds of items washed in pink hitting the shelves every October, billions of dollars raised for cancer research and advocates saying the campaign has helped reduce the annual number of breast cancer deaths.

But the ubiquitous movement also has led to campaigns and blogs against pink products, researchers of diseases that receive less attention crying foul, and studies finding companies can make higher profits on cause-related products, introducing some skepticism about campaign participation.

How pink was born

In 1985, when members of groups such as the American Academy of Family Physicians, AstraZeneca Healthcare Foundation and Cancer Care created National Breast Cancer Awareness Month, there were no pink ribbons or products in the annual observance's campaign to promote education and awareness about the disease.

Pink was first linked to breast cancer in 1982, when nonprofit Dallas-based Susan G. Komen for the Cure created a logo with a pink ribbon. A decade later, the idea really got going when Alexandra Penney, Self magazine's editor-in-chief, created a ribbon for the second breast cancer awareness issue and worked with cosmetics companies to get it distributed in New York City stores.

Avon and Estee Lauder were among the first companies to use the pink ribbon on products in 1993, and other companies quickly followed suit.

Eventually, the campaign expanded from pink ribbons to the color pink itself, with pink-themed fundraisers and community awareness efforts like Think Pink Day or NFL players sporting pink gloves, hats and towels, and companies latching onto slogans like Shop Pink as they committed funds to be linked to the awareness campaign.

From Hungry Howie's pizza boxes and Swiffer dusters to KitchenAid mixers, companies donate money to benefit cancer organizations. Some companies, such as Yoplait , donate a nickel to cancer research for every lid sent to them. Other companies, such as Proctor & Gamble , commit to donating an amount (in its case, $250,000 minimum depending on how well products sell during October).

Today, pink-product fundraising is a juggernaut. For example, Susan G. Komen for the Cure, the giant of all breast cancer organizations, has more than 200 corporate partners slapping pink on products.

Corporate donors help

Karen White, Komen's director of corporate relations, said corporate partners donated nearly $50 million to the organization last year, and contributions from pink products have enabled Komen to donate $1.3 billion for cancer research.

"It allows us to do a lot of what we do," White says.

"Eighty-seven cents of every dollar is spent on our mission."

Some of that money comes back to Metro Detroit. For example, in September Komen donated grants, including $784,731 to Michigan's Breast and Cervical Cancer Control Program, which is administered in Wayne County by the Barbara Ann Karmanos Cancer Institute and Wayne State University, and $115,000 to the Breast Cancer Outreach Project in Dearborn administered by the Arab Community Center for Economic and Social Services (ACCESS).

Dr. Zeina Nahleh, co-director of Karmanos' Breast Oncology Multidisciplinary Team, said researchers have come closer to finding a cure for breast cancer because of "pink" funding. That funding comes from various sources, such as proceeds of products going pink in October, the Recipes of Hope cookbook on sale in October at local Kroger stores, and the Oct. 30 Pistons game where $5 of specially priced $15 upper level seats goes to Karmanos.

Nahleh said 98 percent of breast cancer detected early is curable. "We don't have a cure yet for advanced stages, but we have a cure for early stages," she said.

The breast cancer mortality rate also has dropped about 2 percent per year since the early 1990s, she said.

"This is the impact of screening, and the most recent decrease is related to newer development, newer treatment and novel therapies," Nahleh said.

Pink outperforms others

The success of National Breast Cancer Awareness Month and the pink products aren't without controversy. Some researchers say the focus on breast cancer overshadows the fight against other cancers and diseases that claim more women's lives.

According to the National Heart, Lung and Blood Institute, breast cancer is the No. 5 killer of women, ranking lower than heart disease, stroke, lung cancer and chronic obstructive pulmonary disease.

Dr. Douglas Arenberg, a lung cancer researcher and associate professor of pulmonary and critical care medicine at the University of Michigan, said he wishes there were more equity in cancer research funding.

"I'm a doctor who has patients with lung cancer, and they look for me to help them, and I don't have much to offer them compared to my colleagues who treat breast cancer," he said.

Because breast cancer gets so much more funding, there are more tailored treatment regimens, clinical trials, specialized drugs and alternative forms of treatment than are available for other diseases.

For every person who dies of breast cancer each year in the United States, Arenberg pointed out, four will die of lung cancer.

Yet, "the resources to treat lung cancer are much less than breast cancer," he said.

Adding to the controversy is the fact that companies can increase profits by simply adding the color pink to a product.

Those profits can be substantial. For instance, a shampoo aligned with a good cause increased its sales by 74 percent over the same brand without a cause, according to a test Duke University conducted with Cone Communications, a Boston consultancy group that helped pioneer the widespread use of so-called "cause marketing."

A recent University of Michigan study on cause-related marketing found companies can experience such "spillover" increase that it compensates for the money donated to charity.

The study's researchers concluded, "Our results suggest that actions of (cause marketing) firms should be looked on with some skepticism by consumers and government officials -- while the firms may be helping with charitable causes, they are also using (cause marketing) to increase their own prices and profits."

Though she does like the pink everywhere, Dickson of Southfield did recently cringe when she saw a pink bag of potato chips, called it "pimping the cause."

However, she said, she thinks the pink campaign is a good way to focus on breast cancer.

"Everybody has a mother, an aunt or somebody that they know has been affected," she said.

Karmanos' Nahleh said she lauds advocacy groups for campaigning for early detection.

"The increased voices for breast cancer research and the demand for breast cancer research have definitely had an impact," she said.

Copyright 2009 The New York Times News Service. All rights reserved.