To assess whether timing of initial post-diagnosis cancer care differs between American Indian and Alaska Native (AI/AN) and non-Hispanic White (NHW) patients, we accessed SEER-Medicare data for breast, colorectal, lung, and prostate cancers (2001-2007). Medicare claims data were examined for initiation of cancer-directed treatment. Overall, AI/ANs experienced longer median times to starting treatment than NHWs (45 and 39 days, p < .001) and lower rates of treatment initiation (HR[95%CI]: 0.86[0.79-0.93]). Differences were largest for prostate (HR: 0.80[0.71-0.89]) and smallest for breast cancer (HR: 0.96[0.83-1.11]). American Indians / Alaska Natives also had elevated odds of greater than 10 weeks between diagnosis and treatment compared with NHWs (OR[95% CI]: 1.37[1.16-1.63]), especially for prostate cancer (OR: 1.41[1.14-1.76]). Adjustment for comorbidity and socio-demographic factors attenuated associations except for prostate cancer. In this insured population, we observed evidence that AI/ANs start cancer therapy later than NHWs. The modest magnitude of delays suggests that they are unlikely to be a determinant of survival disparities.
Indigenous traditional healing is an ancient, deeply rooted, complex holistic health care system practiced by indigenous people worldwide. However, scant information exists to explain the phenomenon of indigenous medicine and indigenous health. Even less is known about how indigenous healing takes place. The purpose of this study is to describe the meaning and essence of the lived experience of 4 indigenous people who have been diagnosed with cancer and have used indigenous traditional healing during their healing journey. The researcher used a qualitative phenomenological methodology to collect and analyze interview data. Interviews were conducted with 4 self-identified indigenous people, ages 49 to 61, from diverse tribes. Time since cancer diagnosis varied from 2 to 20 years; types of cancer included lung, prostate, sarcoma of the leg, and breast. Four themes and 2 subthemes emerged (1) receiving the cancer diagnosis (with subthemes of knowing something was wrong and hearing something was wrong), (2) seeking healing, (3) connecting to indigenous culture, and (4) contemplating life's future. This study demonstrates that 4 individuals with cancer integrated Western medicine and traditional healing to treat their cancer. This knowledge provides necessary data about the phenomena of being healed by indigenous healers. Such data may serve as an initial guide for health care professionals while interacting with indigenous people diagnosed with cancer. Accordingly, traditional healing may be used to decrease health disparities.