Colorectal cancer affects American Indians at significantly higher rate
What you need to know
about prevention
By Mallory Black, Native Health News
Alliance; © Native Health News Alliance
SAN DIEGO – While colorectal can-
cer affects men and women of all racial and
ethnic groups, it’s the second most common
cancer among Northern Plains American
Indians – a population with rates 53 percent
higher than the general U.S. population.
About one in 20 Americans will
be diagnosed with colorectal cancer in
their lifetime.
Colorectal cancer, also known as colon
cancer, is a disease that develops in the
colon or rectum. Abnormal growths, or
polyps, can develop in these areas and can
potentially become cancerous over time.
March is National Colorectal Can-
cer Awareness Month and the American
Indian Cancer Foundation, located in
Minneapolis, Minn., promoted aware-
ness of colorectal cancer throughout the
month. The Colon Cancer Alliance even
designated March 6 as Dress in Blue Day
to raise awareness of the disease.
“Over the past 20 years, the U.S.
population as a whole has been celebrat-
ing decreases in cancer mortality. Unfor-
tunately, American Indian populations
have not had the same good news,” said
Kris Rhodes (Ojibwe), executive director
of the American Indian Cancer Founda-
tion (AICAF), a non-profit dedicated to
eliminating the cancer burdens on Ameri-
can Indian families. “This is largely the
result of cancer diagnoses that are too late.
AICAF sees opportunities to change that
story with the promotion of screening to
catch cancer early when it is easier to treat
and survive.”
Because there are often no symptoms
of early colorectal cancer, experts agree
that a colonoscopy screening is one of the
best forms of prevention as early-stage can-
cer can be removed during the screening.
Peter Lance, deputy director of the
University of Arizona Cancer Center,
says the whole idea of cancer screenings
is to prevent it.
“The reason we don’t want to wait until
there are symptoms is because the cancer
we can diagnose through screenings is
(found) much earlier in their development,”
Lance says. “Most colon cancers develop
from (non-cancerous) colon polyps.”
While some people in Indian Coun-
try are still largely unaware of the risk of
colorectal cancer, that’s changing every day,
says Joy Rivera (Haudenosaunee), a com-
munity health worker with AICAF and for-
mer colorectal cancer screening navigator.
Rivera helps increase awareness of
the importance of cancer screenings in
American Indian urban and reservation
communities. Her work includes dispel-
ling myths about cancer screenings, which
stem largely from past bad experiences.
Some of the most common concerns she
hears are whether the screenings hurt or
if it’s as bad as people say it is.
Rivera says bad news spreads fast in
the communities.
“A lot of times people are saying
they had a bad experience, painfulness,
so what I try to do is realize they (likely)
haven’t been apologized to. Things are
better now,” she said.
Rivera tries to help hesitant patients
by reminding them that because American
Indians make up such a small part of the
general population, each life is a big deal.
As soon as the walls come down, she says
she stresses the importance of regular
screenings and healthy living to be around
for generations to come.
“If you want to see your children or
your grandchildren grow up, this cannot
be ignored,” she added.
One of Rivera’s most memorable
moments happened when an American
Indian man rode up to the clinic on a
bicycle in the middle of winter, asking
for a colon cancer screening. He was
diagnosed with colon cancer soon after.
Curious to know what brought him in
that day, she asked and he said he wanted
to buy gifts for his children because the
holidays were coming up. The clinic was
offering a $25 gift card to anyone who
came in for a cancer screening.
The man underwent several opera-
tions to remove the cancer and the treat-
ment seems to be working.
Courtesy photo by the American Indian Cancer Foundation
“The last time I saw him, he was
doing well,” she said.
Individuals have options for screen-
ings, some of which are less invasive than
others, but for many American Indians, the
thought of ‘cancer’ or ‘cancer screenings’
can be intimidating. Fears about procedures,
complications or pain can be perpetuated
within small close-knit Native communities.
David Perdue (Chickasaw), a gastro-
enterologist in Minneapolis, says most
people just share a fear that the doctor
could find something. Perdue says what
many people don’t realize is when clini-
cians talk about cancer screenings, they’re
really talking about cancer prevention.
“Some people would rather not know,
which is something we’ve been really
trying to impress on people, that really
the intention of screening is not so much
finding cancer, it’s finding polyps and
getting those out before they turn into
cancer,” he said.
Perdue says sometimes genetics play
into the incidence of colon cancer and
polyps are bound to occur.
“But if you can get screened starting
at age 50 or earlier if there’s a family his-
tory, that’s the best way to find polyps. It’s
a lot easier to pull a weed when it’s small
than when it’s big and rooted,” he said.
Aside from colonoscopies, fecal
occult blood tests also can screen for signs
of cancer in stool samples. These tests
can be sensitive enough to detect bleed-
ing from a polyp that hasn’t otherwise
caused any symptoms or enough bleeding
to change the color of the stool. But the
tests are considered somewhat less effec-
tive than other screening methods.
The American Cancer Society rec-
ommends people receive screenings
beginning at age 50. Research shows
most colorectal cancers could have been
prevented if more people participated in
regular screenings. If colorectal cancer
is found early, nine out of 10 patients
survive, according to AICAF.
Still, colorectal cancer impacts many
people every year. The American Cancer
Society expected the disease to be diag-
nosed in nearly 72,000 men and 65,000
women in the U.S. in 2014 alone.
For some Native communities, the
struggle in seeking cancer care sometimes
involves another challenge – integrating
traditional healing and beliefs with West-
ern medicine.
Perdue understands traditional heal-
ers may have different feelings about
cancer, but says he knows a traditional
healer who reminds his own patients to get
screened for colorectal cancer. Otherwise,
he tells them, ‘‘It’ll take over.”
The Medicine Game traces life of top lacrosse players from Onondaga Nation
LINCOLN, Neb. – Tucked away in
central New York state is the Onondaga
Nation, a sovereign American Indian
community known to produce some of the
top lacrosse players in the world.
Yet, the fear of leaving their com-
munity, substance abuse and poverty have
kept far too many of these players from
venturing off the “rez” and into collegiate
or professional ranks.
Enter the Thompson brothers –
Jerome “Hiana” and Jeremy – who are
driven by a single goal of beating the
odds against them and playing lacrosse for
national powerhouse Syracuse University.
During the brothers’ freshman and
junior years of high school, they led their
school’s lacrosse team to state champion-
ships. Many people, including the film’s
director/producer Lukas Korver, assumed
they would compete for the state cham-
pionship again.
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“Lacrosse is more than just a game –
it’s a way of life, it’s a heritage. It’s being
Iroquois. It’s being Native American. It’s
a part of their culture, their religion, who
they are,” Korver said.
During the playoffs of their senior
year, the undeniably close brothers had
a shockingly out-of-character fight in the
school parking lot, leaving Hiana hospi-
talized and unable to play lacrosse during
his recovery from a broken jaw.
Without Hiana on the field in the
school’s next playoff game, Jeremy’s
play suffered. The team lost, ending its
chances of a third state championship. It
would take two years before the brothers’
relationship healed to what it had been.
“They started school late and they’ve
come from so far behind to catch up and
do as well as they’re doing now,” said
Jerome “Ji” Thompson, Hiana and Jer-
April 2015
emy’s father. “And, just to get that degree
to show everybody, because I know there
are people out there that actually know
them that don’t think they can do it.”
“A lot of people say that it’s bad
around here. But myself, I don’t know. I
think it’s just like any other child growing
up anywhere else,” said Jeremy.
With their now unfulfilled dream of
winning a third state championship, the
brothers heavily pursued their ongoing,
shared vision of playing lacrosse for
Syracuse University.
Athletically, the brothers were stand-
outs, but academically, they struggled.
But their love for the game, each other
and their family’s unyielding determina-
tion helped propel these youth against
the odds.
“The greatest gift you can give your
children is your time,” said Ji, who doesn’t
want his sons to be ironworkers like him-
self and generations before. “I taught my
boys to respect the game – the game of
lacrosse. Respect means to play as hard
as you can, you know. Go out there and
give it everything you can because you’re
playing for the Creator.”
“I titled the film The Medicine Game
because the game has helped not only the
Thompsons, but many families and com-
munities to stay healthy both physically
and mentally, to bond with one another
and to learn many powerful life lessons,”
said Korver.
To watch the film’s trailer, visit
visionmakermedia.org/medicine_game.
The Medicine Game is distributed by
American Public Television (APT) and
will be available to public television sta-
tions nationwide on April 28.
For broadcast information in your
area, visit pbs.org/stations.