American Indian Culture and Research Journal

INTRODUCTION TO CANCER AS AN ISSUE AMONG AMERICAN INDIANS AND ALASKA NATIVES Cancer is a growing problem among American Indians and Alaska Natives. Unfortunately, both non-Native and First Nations peoples are less aware of the growing cancer dilemma than they are of alcohol, violence, diabetes, and other well-promoted and widely dispersed conditions within Native communities. In the second half of the twentieth century, cancer has become the leading cause of death for Alaska Native women and is the second leading cause of death among Alaska Native men. In fact, cancer is currently the third leading cause of death for all North American Natives5 and is the second leading cause of death among American Indians (both sexes) over age 45. The disease is the third most cited reason for hospital stays among Indian Health Service beneficiaries served by the Alaska Area Native Indian Health Service. Cancer rates, previously reported as less frequent in American Indian and Alaska Natives, have been increasing throughout the last twenty years. Incidence rates among Alaska Natives have exceeded “U.S. All Races” rates for most cancer sites. Rates are increasing similarly for Canadian bands. Within Native American communities, health programs continue to focus on alcoholism and diabetes, although cancer is responsible for more deaths than either of these conditions. Because the word cancer is not indigenous, it translates into some Native languages as “the disease for which there is no cure” or “the disease that eats the body.” Many tribes regard cancer as a white man’s disease because of its rarity before European contact. For many Native cancer patients, the disease is not discussed and is considered a form of punishment, shame, and guilt. A few tribes consider the patient’s suffering necessary in order to ensure the health of the other tribal members (they wear the pain so that their community will be spared). Some tribal members living with cancer—infected with the cancer spirit—are considered contagious and are ostracized by their communities. Other tribal members refuse cancer treatment surgery for fear that their body and spirit will be incomplete, leaving them incapable of finding their ancestors when they move to the other side (death).