LitSite Alaska | Perspectives

Native American Cancer Research (NACR) is a community-based, American Indian-operated, non-profit corporation. NACR staff have worked with Native American cancer patients for almost twenty years. The "National Native American Cancer Survivors' Support Network" (1-800-537-8295; www.NatAmCancer.org) has been collecting information about survivors from our communities to determine unmet needs, interests, to document variations in cancer patterns (e.g., earlier age at diagnosis in comparison with non-Natives), and document differences in the quality of care received. These findings have been published elsewhere. Their web site, designed with input from cancer survivors contains four interactive, personalized education modules. One section called "Storytellers" continues Native traditions of using stories and legends to teach lessons and heal by providing stories about surviving cancer.

The purpose of this commentary is to describe a brief overview of the cancer experience and its positive relationship to Traditional Indian Medicine. As is true with any person of any ethnicity, spiritual and cultural beliefs may vary greatly from one tribal Nation in comparison to another. Obviously, all patients need to be assessed for their spiritual beliefs (see Dr. Walt Hollow's Spiritual Model ) and supported as much as possible. A common foundation among almost all cancer patients (regardless of race) is strong spiritual beliefs in a higher power, Creator, God. Spirituality is evident in many forms. The individual cancer patient may choose to use organized religion (Native American Church, Shaker, Baptist, Catholics) or combine organized religion with Traditional Indian Medicine, or use Traditional Indian Medicine as the sole form of spiritual guidance. The emphasis in this commentary is on the inclusion of Traditional Indian Medicine for cancer treatment, recovery and healing by the Native cancer patient.

Acculturation, Traditionalism has little impact on the Use of Western Medicine for Cancer Care

For several years, NACR included spirituality belief measures on our surveys and intakes to see how we needed to modify our support programs to better meet the needs and interests of the patients. We found no significant differences in ones' spiritual beliefs, traditionalism, acculturation, and use of western healthcare systems. When we asked traditional Indian healers about this, the most common type of a response was, "cancer is a white man's disease and so it needs Western Medicine to help treat it."

NACR staff strongly encourages all patients to include some form of spirituality within their cancer care. This is due to the staff's observations of the impact of combining Western Medicine with Traditional Indian Medicine to greatly improve the patients' (1) prognosis; (2) reactions and recovery from invasive cancer treatments; and, (3) overall quality of life. Tobias Martinez, Mescalero Apache and head and neck cancer survivor, described his ordeal with cancer treatment as the Western Medicine helped to cure his cancer but he needed Traditional Indian Medicine to heal the "spiritual holes" caused by the cancer and the Western Medicine treatments (See My Red Road).

Traditional Indian Medicine uses many different products, several of which comprise commonly used over-the-counter medications. These medicines are frequently prepared specifically for the individual cancer patient and may include teas, soups, or poultices, as well as prayer and other ceremonies for the patient with and without the family. Since so many of these traditional medicines may include potent herbs and other ingredients, the traditional Indian healer and the western medical provider need to talk with one another to discuss the combinations of these treatments. For example, one tea that a colon patient was given to drink three times a day included products that were interfering with her chemotherapy. After the traditional Indian healer and western provider talked, they came to an agreement about what should go into her tea while she was in chemotherapy and what can be included in between her chemotherapy treatments. Over the years, NACR staff have rarely experienced problems by bringing both the traditional Indian healer and western medical provider to collaborate on their treatment.

NACR is frequently asked for "the tea" to help with one's cancer. We cannot do this for a few reasons. One is that the healer individualizes the treatment for the specific patient. Even if two men with prostate cancer and living in the same village came to the local Medicine Man for help, the tea, soups, poultices are different for both men. The second reason why NACR cannot comply with this request is that we do not have the training of traditional Indian healers. They know what they are doing. We would do something wrong. Thus, our response to these requests is, "you need to meet with your traditional Indian healer". If they are living away from home and need help finding a healer, NACR staff attempt to find someone acceptable to the patient in their current location.

A very serious problem throughout Indian Country is the difficulty obtaining and taking pain medication. When dealing with unmanaged cancer pain, the patient is frequently prescribed a narcotic medication; however, that drug may not be available from the local tribal, IHS, or urban pharmacy. Efforts are underway in some regions of Indian Country to do a better job managing pain. However, in the meantime, a very common reason for a cancer survivor to go to a traditional Indian healer for reasons other than prayers and ceremonial guidance is for pain management. Patients may run out of narcotic medications, don't have the money to travel to the clinic for a refill of their medication (in most settings, the patient must appear in person to be evaluated by the provider), or lose the medication (or it was stolen). The preparations the traditional Indian healer typically provides to these patients have been very effective for most of the cancer patients. These soups, teas, and poultices relieve the pain sufficiently to allow the patient to travel to the clinic for the refill (See NACR's web site for unmanaged cancer pain education).

It has been observed that Native cancer patients tend to be more sensitive to radiation and experience side effects, like skin burns, irritation, tenderness and swelling . Several traditional Indian healers prepare poultices to lay on top of the irritated skin area. Before this is done, it is important for the healer and the western provider to talk with one another. Some radiation skin irritation reacts very differently to poultices that would typically be appropriate for use.

Excellent drugs exist to prevent nausea and vomiting, usually from chemotherapy; however, many of the Native cancer patients who experienced these symptoms stated that these drugs were not offered to them or were unavailable. In those instances, once again traditional Indian healers have helped fill the gap by preparing teas or soups that help reduce the nausea and vomiting. While it is unacceptable that our community does not have access to these medications, we are lucky to have Traditional Indian Medicine to care for us.

In closing, we'd like to share some of the comments from Native cancer survivors:

"After I prayed with the healer and he gave me my medicine, I felt more at peace. I knew I could beat this disease. I wasn't afraid anymore. I felt strong – like I could do anything!"
"The healer did ceremony with my whole family. He said that cancer affected all of us and that all of us had to help get back in balance so that I could get rid of the cancer. And we did. It feels good. I think the cancer and working with the healer really helped me to get back into my spiritual beliefs. Now, I pray morning and night like I was taught as a child. But, you know, you get bigger and you think you understand stuff, but you really don't. All of us do ceremony now. We all sing a morning song and an evening song together. It feels good."
"I couldn't deal with the pain. I was afraid to take the narcotic drug because I thought it would make me an addict. But the local healer, he told me I needed something because I was in pain and I was being really mean to my family. So he told me that I had to stop it. He gave me a soup and it really tasted bad. But after a while, I really started to like it because I wasn't in such pain anymore. So, I told my family I was sorry for how I had acted. Then the healer came over and prayed with all of us. That was good. I really felt better and I've felt good ever since he did that with us."

These are only a few examples of how Traditional Indian Medicine has contributed greatly to the quality of life of the Native cancer patients. In short, we see it greatly helping our patients.

For more information on how to deal with unmanaged cancer pain, please visit www.NatAmCancer.org. A spirituality quality of life education module will be available on our Web site late 2005. Be well.