Kristina Flores, PhD, UNM 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. Dr. Flores says, “Native American communities have higher mortality rates compared to the general U.S. population for some types of cancers.” The University of New Mexico Cancer Center continues to collaborate with communities to better understand cancer prevention barriers and facilitators in the state.
Dr. 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 Dr. 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 Dr. Flores suggests can be prevented with earlier screening. Dr. Flores advises that breaking down the taboo around cancer may lead to earlier screening and preventive measures for cancer in Native American communities.
Dr. 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,” says Dr. Flores. 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. Dr. Flores’ efforts focus on increasing understanding of what cancer is and generating more conversation about the topic. Furthermore, Dr. 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. Ms. Spencer, Dr. 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,” says Dr. Flores. 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 Dr. Flores found in her research was to provide more educational options for Native American communities. Dr. 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 Dr. Flores to develop and create education modules and activities that were presented throughout the years of the program.
Dr. 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,” says Dr. Flores.
With the support of the UNM Cancer Center, Dr. 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.
About the UNM Cancer Center
The UNM Cancer Center is the Official Cancer Center of New Mexico and the only National Cancer Institute-designated cancer center in the state. One of just 67 NCI-designated cancer centers nationwide, the UNM Cancer Center is recognized for its scientific excellence, contributions to cancer research and delivery of medical advances to patients and their families. Annual federal and private funding of over $65 million supports the UNM Cancer Center’s research programs. The UNM Cancer Center treats more than 65 percent of the adults and virtually all of the children in New Mexico affected by cancer, from every county in the state. It is home to New Mexico’s largest team of board-certified oncology physicians and research scientists, representing every cancer specialty and hailing from prestigious institutions such as MD Anderson, Johns Hopkins and the Mayo Clinic. Through its partnership with Memorial Medical Center in Las Cruces, the UNM Cancer Center brings world-class cancer care to the southern part of the state; its collaborative clinical programs in Santa Fe and Farmington serve northern New Mexico. The UNM Cancer Center also supports several community outreach programs to make cancer screening, diagnosis and treatment available to every New Mexican. Learn more at www.cancer.unm.edu.