TORONTO - "Pink Ribbons Inc." takes a less-than-rosy look at the business of breast cancer fundraising campaigns, but its Montreal-based filmmaker insists she's not out to condemn the global movement.

Lea Pool says her provocative documentary simply strives to get to the bottom of how those millions of dollars are spent — and whether a plethora of pinked-themed products — ranging from teddy bears to kitchen appliances and power tools — actually make a difference.

If that leaves some people seeing red, so be it.

"I myself was very angry about what's happened with breast cancer and how it was hijacked by big corporations," Pool said by phone last September before debuting the doc at the Toronto International Film Festival.

"I hope that people will be angry, too."

The Swiss-born director admits she certainly didn't start out that way.

When she was first pitched the project by National Film Board of Canada producer Ravida Din, she says she had little knowledge of the pink ribbon beyond its role as a fundraising and awareness tool.

Pool had given money to friends who embarked on walks for the cure and had seen the annual influx of pink-hued products take over store shelves each October.

Din encouraged her to read Samantha King's book "Pink Ribbons Inc.: Breast Cancer and the Politics of Philanthropy" and Barbara Ehrenreich's searing 2001 Harper Magazine article "Welcome to Cancerland," each of which question the motives of corporate-backed campaigns.

The material served as a wake-up call for Din, who discovered them as she emerged from breast cancer treatments six years ago.

"My own experience with the disease was one of a lot of terror around it and I couldn't reconcile that feeling with the eternally optimistic and cheerfulness and hope (of the pink ribbon) and being told frankly — even by people in the medical community — that I could see this as something of a gift," says Din, who underwent surgery, radiation and drugs to fight the disease.

"Pink Ribbons Inc." draws heavily from King's book as it accuses some companies of using fundraising efforts to boost sales while contributing only a tiny fraction of proceeds to the cause.

It lists dubious fundraising efforts including a 2002 American Express campaign in which the fine print promised one penny would be donated for every purchase made between certain months at certain stores.

It goes on to allege alarming incidents of "pink-washing," in which a company aligns itself with breast-cancer fundraising but manufactures products that may be linked to the disease.

"It's like they're using our disease to profit and that's not OK," one woman with stage 4 breast cancer says in the film.

Amid the critics, outspoken researchers and disaffected cancer-sufferers, the film also turns to the cause's biggest fundraisers to state their case.

They include Nancy G. Brinker, head of the group Susan G. Komen for the Cure, which has raised more than $1.9 billion since forming in 1982; and Evelyn Lauder of Estee Lauder, the first cosmetics company to use the pink ribbon. Evelyn Lauder died of ovarian cancer in November.

"It was important for us to get as many of the major players and talk to them," says Din, currently producing the documentaries "Payback: Debt and the Shadow Side of Wealth," based on the book by Margaret Atwood and "The Feminist Project," which chronicles the Canadian women's movement.

"Our approach to them was: You do actually have something to say, you're an important player in the breast cancer cause, we'd like you to actually explain to audiences in your own words why you think the work that you're doing is important and why you think it's making an impact."

A large part of "Pink Ribbons Inc." takes aim at what King calls "the tyranny of cheerfulness."

It traces the origins of the pink ribbon itself to focus groups commissioned by Estee Lauder and Self magazine. They were tasked with finding a colour that seemed comforting, reassuring and non-threatening.

Din argues it's this kind of approach that has marginalized the very people the cause was meant to help.

"I think sometimes people are just afraid to say it — they don't know what to say because you don't ever want to be perceived as being against speaking out for hope, you know?" says Din.

"But that's not what it is.... You've also got to allow yourself to feel sad and to feel angry and to work for change in other ways."

There's no question that the pink ribbon movement has galvanized people in impressive ways, allows Pool.

And by no means does she suggest donations are not worthwhile, she adds.

But Pool does urge people to be more critical about how donations are spent and where research is directed.

"It's easy to give some money or to go on walks or... to buy toilet paper for the cause and things like that but (no one is) asking people, 'Why you are doing this? Where is the money going? What do you know about this company? Is this company doing things that help to prevent cancer or are they part of causing the cancer?'" Pool says.

"To do this film for me was really an opportunity to start another conversation."

While a large percentage of money does go to research, not enough goes to prevention or looking at possible environmental factors, says Din.

Meanwhile, uncoordinated spending means overlapping studies and huge gaps in research, according to the film.

Big questions remain about the causes of breast cancer — a California researcher states that more than half of the women diagnosed don't have any of the major risk factors.

The statistics in "Pink Ribbons Inc." are sobering: 59,000 women in North America die from breast cancer each year, U.S. women have a one in eight chance of developing the disease, mortality rates haven't changed much in 60 years and women diagnosed today face the same treatment options they did 40 years ago.

"I think we're all aware enough," Din says of the ribbon's promotional power.

"It's great when women come together, there's solidarity and obviously there are women who really benefit from participating at these events but we have to do more.

"I hope people will ask questions about whether this really is the best way towards societal change around truly making a difference in women's lives, around our health."

"Pink Ribbons Inc." opens Friday.

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