When Janet McNeill's sister was diagnosed with breast cancer in the early 1990s, the signature pink awareness ribbons only came with a cosmetic product or two.
Now one can buy a week's worth of groceries, feed a cat, cure a yeast infection and catch a flight all while using pink ribbon-endorsed products and transportation. For McNeill, watching images of the National Football League players with pink gloves, pink cleats and pink towels this week pushed her cynicism over the edge.
"At first, I got excited about all the pink. It makes you really feel good, and then seeing everyone come together at the Avon walks, it was just so exciting," said McNeill, 50, whose sister died of breast cancer in 2000. McNeil was diagnosed with the disease last June.
"As the years go on … you begin to question," said McNeill. "It's sort of like pink is green for people. It means money for them, or it means attention … but where is the money going, what are they actually doing to eradicate this?"
Many agree with McNeill. Despite the multi-millions funneled to nonprofits each year through pink campaigns, some leading breast cancer activists, doctors and organizations have begun to grow wary, and wearier, of pink labels.
Stories about who originated the pink ribbon vary from organization to organization. San Francisco's Breast Cancer Action claims the infamous pink ribbons originated with Charlotte Haley, a 68-year-old woman in the 1980s, who started a grass roots peach ribbon campaign in her kitchen.
Other organizations say the pink ribbon was inspired by the red HIV/AIDS awareness ribbons and was adapted to a feminine color.
Whoever started it, no single organization can lay claim to pink or pink ribbons as a symbol for breast cancer today. As a result, hundreds of products may be bathed in pink in October to mark breast cancer awareness month.
"As a whole, the marketing of breast cancer has gone too far. I saw last year a yeast infection treatment sold to promote breast cancer; there are fishing rods and riding saddles," said Samantha King, author of "Pink Ribbons Inc.," and an associate professor at Queen's University, in Kingston, Ontario.
"I have to say, I'm little flummoxed. Marketing 101 suggests that you need to try to distinguish your product from its competitors, and with breast cancer, it seems to turn that on its head," she said.
King said she received a surprising response from frustrated breast cancer survivors after she published her book. "Pink Ribbons Inc.," examined the psychological effect of seeing cancer reminders everywhere when you're fighting the disease. Her book also tried to highlight the exchange of funds between pink products and philanthropic organizations.
While some products clearly stated how much money was going toward research, King said other companies simply put pink on their products to "raise awareness" without donating any proceeds toward research.
"I agree that the proliferation of pink is no longer effective. Women need to ask how much money is actually being contributed and where. The answer is not necessarily just more research but research that will find the cause of the disease," said Dr. Susan Love, president of the Dr. Susan Love Research Foundation.
"We need to look critically at what research is being funded. We still have no idea of the cause of breast cancer," she said. "Look at cancer of the cervix. We now have a vaccine ... no pink ribbons, runs, walks or products."
It's unclear, however, whether the multi-million dollar pink campaigns will ever lose steam, and many would argue that they shouldn't.
"Cause marketing partnerships, especially in these difficult times, are a way for people to purchase things they would purchase anyway and support their favorite charity," said Carrie Glasscock, manager of corporate relations for Susan G. Komen for the Cure organization.
The Susan G. Komen for the Cure organization, which brings in $50 million annually from its pink ribbon campaigns, has some words of caution for those purchasing products with cause-related marketing.
The organization recommends that before purchasing a ribbon-linked product people ask themselves, "Is this company committed? How is the program structured? Who does the program benefit? How will the organization that benefits use my money? Is the program meaningful to me?"
The Komen group also uses its patented "running ribbon" shape for its 200 officially approved corporate sponsors each year.
"I've been at Komen for four years, and the number of corporate partners has nearly doubled," said Glasscock. "We don't see any sign of it slowing."
This year, the sponsors run the gamut from Purina cat food to American Airlines, which decorated eight planes with the Komen pink ribbons. Glasscock said the airline promised $1 million for the next eight years to study a specific form of breast cancer.
"I can tell you, of course, every one's entitled to their own opinions," said Glasscock. "But Komen would not choose to partner with a corporation that was not making a commitment to the cause."
Lillie Shockney, a breast cancer survivor and administrative director at the Johns Hopkins Avon Foundation Breast Center, said she supports the pink campaign, even with the bad apples.
"I don't feel exploited at all. I am pleased to see that companies are supporting these research efforts," said Shockney. "It seems to me like a win-win -- a company makes money, and research benefits as well.
"But having a reporting system that shows where the money goes would be well received," she said.