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Up close and personal

Cancer doesn’t discriminate. Each year, the disease affects people of every age, race, ethnicity and economic class. Unfortunately, some populations feel the effects of a cancer diagnosis more than others. That’s why during National Minority Cancer Awareness Week, April 18 – 24, the American Cancer Society and its newest Midwest Division Board member, Dr. Don Warne, would like to encourage everyone to keep fighting for equal cancer care and prevention across all populations.

As part of ACS, Warne has a vision: To increase awareness of American Indian cancer issues. He is an enrolled member of the Oglala Lakota Tribe in Pine Ridge, S.D., and ACS is proud and excited to have him as an advocate for American Indians dealing with cancer.

Warne has felt the impact of a cancer diagnosis within his family. When he was a young boy, his grandmother, who lived on the Pine Ridge Indian Reservation, died from lung cancer. He believes that if his grandmother had more cancer resources available to her at the time, her suffering could have been alleviated. Warne cites this experience as one of the main reasons he got into health care as a profession and started volunteering with ACS.

Between his positions serving as president/CEO of American Indian Health Management and Policy and the executive director of the Aberdeen Area Tribal Chairman’s Health Board, Warne’s schedule is more hectic than most. Still, he found time to answer some questions about cancer disparities and how ACS can better help Native Americans dealing with a cancer diagnosis:

Charlotte Hofer: Where do you feel Native Americans are being left behind in cancer care?

Don Warne: At every possible level. We have populations that live in a great deal of poverty, and one of the results of that is that our health systems are impoverished as well. We don’t have adequate prevention and education. We unfortunately have very high rates of cigarette smoke, and that is certainly leading to a lot of our cancer disparities. We have shortages in outreach and education to community levels. We have shortcomings in terms of the amount and types of screenings we are doing in our population. Once we get a diagnosis, again because of our funding, we don’t always have access to the most current technologies and treatments for cancer. I think that the shortfalls are the whole gamut – from prevention, screening, education, treatment, aftercare, research and data. We need improvement on all of those levels.

CH: How can we make health care materials more culturally appropriate for Native Americans?

DW: There has to be recognition that one size does not fit all when we’re talking about cancer education. Even within populations like American Indians, we have hundreds of tribes, so one size does not fit all even for American Indians because we have so many tribal groups and different beliefs about health. So in order to be as effective as possible with educational materials, there has to be culturally appropriate development of those materials. That’s why it’s important to have diversity in the makeup of the board of groups like ACS, in order to help to facilitate more cultural competency. In addition to that, we need to recognize as a health care system nationally that one size does not fit all, and we need to engage communities to help take the lead in the development of culturally appropriate materials.

CH: What do Native American youth need to know about preventing cancer and wellness?

DW: The truth is, it’s a big challenge, because anytime you have impoverished communities, we don’t have access to the healthiest foods or the healthiest lifestyles just due to poverty. One thing that can be done certainly is to reduce the amount of commercial tobacco use. This does need to be done in a culturally appropriate way because our tribes use tobacco ceremonially. And ceremonious use of tobacco really is not dangerous, it’s the commercial use of cigarettes and other forms of commercial tobacco that are the most dangerous.

There have been campaigns by other American Indian communities talking about using tobacco in a sacred way. Historically, when we used tobacco in our ceremonies, we didn’t see any chain smoking going on, and it certainly wasn’t in the form of cigarettes. Using cigarettes is not a traditional approach. I think that even though we have all of these challenges in terms of poverty and less resources, one of the things we can do for youth is to encourage them not to start smoking cigarettes.

CH: How important is collaboration between anyone involved with fighting cancer?

DW: We can’t connect resources to people if we don’t collaborate. Historically there’s been a desire to collaborate but not knowing the best way to do that. One of my roles [on the ACS Midwest Division Board of Directors] will be to facilitate those collaborations. Each entity has its own skill set and areas of expertise and types of programs and services that are available, and we need to link those together in order to provide the best services to all community members, especially ones who are suffering from terrible disparities. We absolutely cannot do that without collaboration.

CH: What has cancer taught you?

DW: It has taught me there is an incredible amount of suffering that individuals, families and communities endure that is preventable, and we need to focus as much effort as possible on prevention. But when someone is diagnosed, we need to access resources to alleviate suffering. The manner in which our current systems are set up for impoverished people unfortunately facilitate more suffering than healing. But what I learned from that is it doesn’t matter if you’re American Indian or non-Indian, these circumstances in a nation as great as ours should not be acceptable to anybody. With the resources we have in this country, we should not have to see this type of suffering continue in our populations.

CH: Why was it important to you to get involved with the American Cancer Society?

DW: American Indians in the Northern Plains have among the worst disparities in cancer incidence and cancer deaths in the nation, and the American Cancer Society is an outstanding advocate on behalf of people and families that are dealing with cancer. I wanted to be able to maximize American Indian connectivity to those resources. Native Americans are being left behind in cancer care. One of my goals is to link American Indian health priorities to the ACS legislative and advocacy agenda.

At ACS, our vision is a world with less cancer and more birthdays. As part of that vision, we are fighting cancer in every community, for every family, to help save lives. We recognize each community has different needs and we’re here to help everyone stay well and get well, to find cures, and to fight back against cancer. For cancer information, contact us at or (800) 227-2345.

Charlotte Hofer is public relations manager for the American Cancer Society in South Dakota. She is a member of the Native American Journalists Association, and her work for ACS focuses on cancer education to diverse populations through the media. Contact her at