Cancer Education Brings Hope to Navajo Communities

The Uni­ver­sity of New Mex­ico Can­cer Cen­ter con­tin­ues to col­lab­o­rate with com­mu­ni­ties to bet­ter under­stand can­cer pre­ven­tion bar­ri­ers and facil­i­ta­tors in the state. Kristina Flo­res, research assis­tant pro­fes­sor of Epi­demi­ol­ogy at the UNM Can­cer Cen­ter, has been col­lab­o­rat­ing with the Navajo com­mu­ni­ties To’ Haji­ilee and Alamo in a com­mu­nity based par­tic­i­pa­tory research project that aims to pin­point and over­come bar­ri­ers impact­ing can­cer edu­ca­tion, research and pre­ven­tion within New Mexico’s Native Amer­i­can communities.

“Native Amer­i­can com­mu­ni­ties have higher mor­tal­ity rates com­pared to the gen­eral U.S. pop­u­la­tion for some types of can­cers,” Flo­res said.

Flo­res says that sev­eral fac­tors may be con­tribut­ing to lower can­cer screen­ing rates in Native Amer­i­can com­mu­ni­ties includ­ing issues related to pri­vacy, health­care access, fear about can­cer, and lan­guage bar­ri­ers. One issue that Flo­res and her team tried to address was the stigma around the trans­la­tion of the word can­cer. In Navajo, the word can­cer trans­lates to the “sore that does not heal.”

This trans­la­tion has tra­di­tion­ally made talk­ing about can­cer taboo among Native Amer­i­can com­mu­ni­ties. Hav­ing a stigma and taboo around can­cer makes it less likely that indi­vid­u­als will get early screen­ing for can­cer. Higher mor­tal­ity rates have been asso­ci­ated with later stage dis­ease, which Flo­res sug­gests can be pre­vented with ear­lier screen­ing. Flo­res advises that break­ing down the taboo around can­cer may lead to ear­lier screen­ing and pre­ven­tive mea­sures for can­cer in Native Amer­i­can communities.

Flo­res said that the pri­mary con­cern for the Navajo com­mu­ni­ties par­tic­i­pat­ing in the pro­gram was to under­stand what can­cer is.

“An impor­tant goal for us was also to learn from com­mu­ni­ties and develop ways to address their pri­or­i­ties about can­cer,” Flo­res said.

From the start, can­cer edu­ca­tion was the pri­mary focus of the program.

Edu­ca­tion about what can­cer is will hope­fully break down taboo bar­ri­ers and bring more aware­ness to com­mu­ni­ties. Flo­res’ efforts focus on increas­ing under­stand­ing of what can­cer is and gen­er­at­ing more con­ver­sa­tion about the topic. Fur­ther­more, Flo­res dis­cov­ered that most peo­ple liv­ing in these Navajo com­mu­ni­ties have an inter­est in com­bin­ing West­ern med­i­cine and tra­di­tional med­i­cine in their approach to being healthy and under­stand­ing what can­cer means to them.

Ophe­lia Spencer, one of the com­mu­nity coor­di­na­tors for the pro­gram, led the effort to trans­late a can­cer edu­ca­tion video into the Navajo lan­guage. Spencer, Flo­res, and sev­eral com­mu­nity mem­bers worked to mod­ify an edu­ca­tional mod­ule from the orig­i­nal “Can­cer 101” cur­ricu­lum orig­i­nally devel­oped by the Spirit of EAGLES pro­gram and the North­west Port­land Area Indian Health Board.
The Can­cer 101 cur­ricu­lum is designed to pro­vide basic can­cer pre­ven­tion, screen­ing and treat­ment infor­ma­tion and has been mod­i­fied for sev­eral pop­u­la­tions in the state of New Mexico.

The mod­i­fied video for Navajo com­mu­ni­ties was devel­oped to address the topic of can­cer in a more hope­ful way. The video, “Being Aware of Your Body: Can­cer Edu­ca­tion,” was trans­lated into Navajo to address the con­fu­sion that can arise from can­cer with lan­guage trans­la­tions. It also pro­vides more aware­ness and screen­ing infor­ma­tion for Navajo com­mu­ni­ties in their own lan­guage. Part of the goal of this edu­ca­tional video was to break down the taboo about can­cer among com­mu­ni­ties and start a hope­ful con­ver­sa­tion about can­cer with cul­tur­ally appro­pri­ate edu­ca­tion and com­mu­nity outreach.

“Many dif­fer­ent groups across the coun­try are try­ing to change the trans­la­tion of the word so that it describes can­cer in a more hope­ful way,” Flo­res said. The trans­la­tion of the words “can­cer screen­ing” in Navajo makes it sound like can­cer screen­ing is only look­ing to find can­cer in the body. The video tried to empha­size that can­cer screen­ing is also a way to stay healthy by rec­og­niz­ing changes in the body and relat­ing them to your physi­cian. The great­est demand Flo­res found in her research was to pro­vide more edu­ca­tional options for Native Amer­i­can communities.

Flo­res said focus groups showed that before the com­mu­ni­ties could start talk­ing about can­cer they wanted to know what it was. This drive for more can­cer edu­ca­tion pushed Flo­res to develop and cre­ate edu­ca­tion mod­ules and activ­i­ties that were pre­sented through­out the years of the program.

Flo­res has been involved with this project since 2005, and took the lead in 2007. Her goal is to spread the idea that there is hope with can­cer, and that if you catch it early there are many options for Native Amer­i­can com­mu­ni­ties. “It’s really impor­tant that these com­mu­ni­ties have access to and aware­ness of can­cer screen­ing to pre­vent can­cer or iden­tify can­cer early so that it can be treated,” Flo­res said.

With the sup­port of the UNM Can­cer Cen­ter, Flo­res is cur­rently look­ing for ways to get more fund­ing. She envi­sions the future of the pro­gram to include com­mu­nity sup­port groups and keep­ing multi-directional com­mu­ni­ca­tion out­lets open among Native Amer­i­can com­mu­ni­ties, can­cer researchers, clin­i­cians, and edu­ca­tors of diverse backgrounds.