During a celebration of the Fifth Annual NIH American Indian/Alaska Native (AI/AN) Heritage Month Program, sponsored by the American Indian/Alaska Native Employee Council and the NIH Office of Equal Opportunity and Diversity Management, a number of research scientists, clinicians, and program specialists gathered to reflect on the unique challenges of fighting cancer in these Native American groups. Lakota storyteller Dr. Joseph M. Marshall, III - author, historian, and cancer survivor - reminded the attendees that the struggles of the original Americans continue into the 21st century.

Cancer strikes different racial and ethnic groups in different ways. Health disparities often arise because culture, outlook, biology, and access to resources all influence the ways in which different people experience cancer.

"This country provides inadequate resources to Native Americans for cancer education, screening, prevention, and treatment," wrote Dr. Harold P. Freeman, on behalf of the President's Cancer Panel, in the 2002 Annual Report, Facing Cancer in Indian Country. Exacerbating these problems, he said, are "important but remediable cultural misunderstandings… Facing cancer in Indian Country should not be more arduous than it is elsewhere in our Nation."

Dr. Thomas Becker agrees, citing 2 basic lessons learned from nearly 20 years of work with Native communities. First, he says, bring your focus down to the local level - to individual tribes, groups, and regions. Second, "You need to reduce the barriers between Native communities that serve as study populations and the mainstream researchers who are usually from another racial group."

Dr. Becker is a medical epidemiologist. Each summer, he, Dr. Jennie Joe, and other colleagues invite Native researchers to their NCI-funded Native Researchers' Cancer Control Training Program. For 3 weeks, trainees get intensive hands-on training in the clinical and research skills they will need to make cancer control programs work better in the unique AI/AN community settings.

Dr. Joe, a Navajo, is one of the charter members of the Network for Cancer Control Research Among American Indian/Alaskan Natives Populations, which grew out of Dr. Becker's drive to create "a de facto think tank in the mid-1990s," says Judith Swan from NCI's Surveillance Research Program. She and Dr. Brenda Edwards, head of NCI's Cancer Statistics Branch, host the Network's annual meetings at NCI "where the crucial needs, cutting-edge ideas, and most-likely-to-succeed projects eventually rise to the surface. It's probably the most exciting meeting I attend each year," she says.

Currently, Dr. Judith Kaur chairs the Network, which also meets annually at the Mayo Clinic Cancer Center (a partner with NCI in supporting the Network). Dr. Kaur is a medical oncologist and a Choctaw/Cherokee, whose NCI-supported Native C.I.R.C.L.E. (Cancer Information Resource Center and Learning Exchange) is a national clearinghouse providing cancer-related materials to health care professionals and lay people engaged in the education, care, and treatment of AI/ANs with cancer.

NCI's Center to Reduce Cancer Health Disparities funds the Community Networks Program, which supports another Mayo partnership, Spirit of EAGLES, which is dedicated to building the infrastructure to support comprehensive cancer control. It also provides small community grants aimed at lowering incidence and increasing survival in communities in Indian Country, including Alaska. Both Mayo projects, said Dr. Kaur, "translate information and resources into ideas, concepts, and language to which Native peoples are more likely to respond."