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Book offers cancer survivors guidance in traditional foods

By Carly Horton -- Alaska Journal of Commerce, Anchorage

ANCHORAGE, Alaska (MCT) - When she was diagnosed with acute myelocytic leukemia in 2004, Dr. Nora Nagaruk, originally from the Inupiat village of Unalakleet, thought of how she missed eating the fresh berries she gathered with her mother.

She was being treated in Seattle, so she didn't have access to the fresh, healthful foods to which she was accustomed.

''Leukemia is a cancer of the immune system, so I had a lot of restrictions with regard to what I could eat,'' Nagaruk said. ''I really missed dried fish, seal oil and muktuk [whale blubber]. I couldn't even eat berries the way I wanted to, frozen in a bowl with milk and sugar. In the hospital, I ate a lot of beef broth, noodles, macaroni and cheese and mashed potatoes. Being away [from Alaska] for so long, I have a much better appreciation for Native foods now.''

Nagaruk's story is not an uncommon one: According to Christine DeCourtney, cancer program planning and development manager for the Alaska Native Tribal Health Consortium, Native Alaskans who travel from rural villages to urban areas for cancer treatment are often forced to subsist on the pre-packaged, processed foods hospitals and medical centers serve to their patients.

''Most providers have not even heard of traditional Native foods,'' DeCourtney said.

In order to meet the needs of Alaska Natives undergoing or recovering from cancer treatment, the ANTHC cancer program published a full-color, 142-page nutrition guide for patients and their families in April. The ''Traditional Food Guide for Alaska Native Cancer Survivors'' highlights traditional foods that can and should be eaten by cancer patients. It includes nutrition information and recipes, as well as stories and anecdotes from a variety of Alaska Native cultures.

Porcupine, seal and whale meat, for example, aren't on the menu at most restaurants, but all three are low in sodium and are excellent sources of protein and iron - energy-boosting nutrients that can help mitigate the fatigue brought on by chemotherapy and other cancer treatments.

The inspiration for the guide came two and a half years ago during a cancer survivors workshop. According to DeCourtney, one woman had been advised to eat kale during her cancer treatment. The woman said that at the time, she didn't even know what kale was.

The woman told the group that she wanted sea asparagus, the Alaska equivalent to kale. It was at that moment DeCourtney decided to develop a comprehensive nutrition guide for Alaska Natives.

The book was funded primarily from a grant by the Lance Armstrong Foundation, with additional funding from local and national health care organizations. DeCourtney said the information contained within the guide draws heavily on research conducted by Dr. Elizabeth Nobmann, who in the late 1980s received a grant from the IHS to gather and analyze the nutrients in traditional Native foods.

In 1992, a document was completed that provided the nutrient information of more than 160 local Alaskan foods.

''But [Nobmann's] information wasn't something the lay public could access easily,'' DeCourtney said. ''We wanted to take that information and put it into a user-friendly format.''

The guide was published at a time when cancer rates among Alaska Natives are skyrocketing. Within the last 30 years, cancer has become the third leading cause of death for American Indians and Alaska Natives of all ages, according to the nonprofit Native American Cancer Research group.

Although cancer incidence is decreasing among whites, it continues to increase among American Indians and Alaska Natives. Within the last few generations, cancer has become the leading cause of death for Alaska Native women and is the second leading cause of death among American Indian women.

According to statistics supplied by the ANTHC, the rate of new cancer patients diagnosed each year increased 34 percent between the five-year period 1969 - 1973 to the period 1999 - 2003.

Calculations of cancer survival show that among Alaska Native patients diagnosed with cancer, 37 percent will still be living five years after diagnosis. About 300 Alaska Natives will be diagnosed with invasive cancer this year.

Karen Mitchell, program administrator for the Office of Native Health Research, said increased tobacco and alcohol use, sedentary lifestyles and poor nutrition are primarily to blame for rising cancer rates. Substituting fresh, vitamin-rich subsistence foods for Western staples like coffee, tea, soft drinks, bread, rice and potatoes has compromised the health of Alaska Natives in both the state's rural and urban areas.

''Getting away from the subsistence hunter-gatherer lifestyle has had [negative effects] on the overall health of Native Alaskans,'' Mitchell said.

The guide has been out just a few weeks, but DeCourtney said the response from patients and health care providers alike has been resoundingly positive. ''We're just overwhelmed by the success of it,'' she said.

DeCourtney said the last six months of the project were especially challenging as they tried to track down photos and compile stories. ''We were trying to pull it all together; so many hours went into it. And I had to crack the whip over all these poor people,'' she said.

Mitchell said getting people to share their stories and experiences was difficult at times.

''I talked to people over the phone, sent e-mails, met them in person, went to tribal gatherings - whatever I could do,'' she said.

But their efforts have paid off: DeCourtney said she visited a cancer ward where the patients had all been given copies of the book. Every single one of them was propped up in bed reading the guide.

The venture has been so successful, in fact, that the first order of 3,000 copies has already been depleted.

''We're stuck with a hit on our hands and we don't know what to do,'' DeCourtney said.

While the book will be provided free of charge to libraries, medical centers and to cancer patients, it retails for $24.95. All proceeds will help cover reprinting costs.

DeCourtney said they're already planning for a second edition of the guide to be released within the next few years.

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Copyright (c) 2008, Alaska Journal of Commerce, Anchorage. Distributed by McClatchy-Tribune Information Services.