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Native Navigators Program Takes Cultural Approach to Cancer Diagnosis and Treatment

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Negotiating the maze of modern cancer diagnosis and treatment is daunting to say the least, so it’s fortunate that some patients have a Native-oriented program to pave the way.

Native Navigator (Navigator) programs in Oklahoma and Colorado educate people about preventing illness, but if there’s a diagnosis of cancer they take patients through the stages of treatment and sometimes connect them with additional support systems.

The University of Oklahoma (OU) College of Nursing and partner Native American Cancer Research (NACR) in Denver have community-based programs, while the OU Health Sciences Cancer Center focuses on a clinic-based model.

“They (Navigators) guide patients through and around barriers in the complex cancer care system to help ensure timely diagnosis and treatment,” explained Valerie Eschiti, OU assistant professor of nursing and principal investigator of the federally funded project.

The Navigator program is beneficial, says Lisa Harjo, Choctaw, NACR project supervisor in Denver, because otherwise “people get a diagnosis (of cancer), and then may not come back in.”

The OU College of Nursing is collaborating with the Comanche Nation to study whether members trained as health educators can assist with cancer prevention, screening and treatment.

Two Comanche Nation members, Stacey Sanford, a licensed practical nurse, and Leslie Weryackwe, are Navigators who are leading workshops throughout the Lawton, Oklahoma area.

“Our Native people are more comfortable hearing from other Natives,” Sanford says. “It’s a cultural thing.” Weryackwe notes that “there is so much caring and love in our people. We’re all family and we just want to help each other.”

The Navigators ensure timely diagnosis and treatment, Eschiti said, and similar programs in other parts of the country have shown an increase in screening for certain cancers.

It’s none too soon, according to statistics at OU’s Health Sciences Cancer Center, which record high rates of gynecological cancers, primarily cervical cancer, among about 35 percent of the 300-plus Native patients seen in the last year from Oklahoma but also from as far away as Alaska and California.

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Lancer Stephens, Wichita, Ph.D., is director of the Special Populations Core at the Cancer Center. He explains that the Navigator program at the College of Nursing contacts his program and the Center’s Navigator, Rebecca Cravatt, Creek, “walks them through the system to receive their cancer care.”

Cravatt is a fluent speaker of her language and is culturally sensitive, which means “a lot of the patients would rather talk to her than the doctors” and “families rely on her strength so much,” he said.

Harjo said the use of Navigators is “kind of a new thing in medicine—kind of an old thing at the same time, connected to the Native way of using a Native sister who helps a person who gets medical care.”

The Navigator program “walks with them (patients) through their cancer journey” and can provide a number of benefits, including a reduction in the length of time between diagnosis and coming in for appointments, she said.

Navigators can also increase attendance for the total course of treatment, help to find financial and community sources of support and build on an existing spiritual and cultural connection with Native clients, who probably have “shared beliefs about life and history.”

Navigators advocate and articulate about medical concerns, but they also teach and translate information from the “purely medical,” she said.

Native Navigator programs are important because of increasing cancer rates among Natives—now the second leading cause of death among American Indian women and Natives older than 45—coupled with cultural beliefs that may delay needed treatment.

“Many older Native Peoples respect and prefer traditional medicine over medicine practiced by Western populations,” according to NACR. “There are numerous misconceptions related to cancer. For example, some American Indians believe that a cancer diagnosis is synonymous with a death sentence.

“The Native translation for ‘cancer’ in a few tongues is ‘the disease for which there is no cure’ or ‘the disease that eats the body.’ In other languages, the same word is used to describe epilepsy, leprosy, and cancer, and there is no way to distinguish among such disorders,” NACR notes.

The Native Navigators program hopes to clear misconceptions about cancer and spark early discussion to early detect the disease.

“Many Native cultures believe that one should not discuss a disease such as cancer because to discuss it is to invite the disease into one’s body.”