Residential schools had a big impact on attitudes. Aboriginal people learned to repress their sexuality in the schools. They also lost respect for themselves, and this makes self-care difficult. So they often don’t get screened for cancer.
Be sure to read Part 1 before working on this unit. See these other units for more issues related to reproductive cancers:
Unit 6 – Women and Sexual Health
Unit 7 – Men and Sexual Health
Unit 17 – HIV/AIDS and Other Sexually
Cancer is a scary word in our communities. Cancers involving our sexual and reproductive organs can be especially hard to deal with because of the embarrassment we feel in talking about these parts of our bodies, and sometimes misinformation about why and how people get cancer. For women, however, breast and cervical cancer are important sexual health issues, just as prostate and testicular cancer are important for men to think about.
Residential schools had a big impact on attitudes. Aboriginal people learned to repress their sexuality in the schools. They also lost respect for themselves, and this makes self-care difficult.
So they often don’t get screened for cancer. Our Grandmothers and Grandfathers are the ones I worry about the most because they are a group that is not being targeted for health promotion. Many of our health care workers are embarrassed to ask an older woman if she understands or participates in annual cancer screening. Many of our older community members have not been told why annual cancer screening is so important.
Cree nurse living in British Columbia
Awareness campaigns can teach women and men of all ages how self-awareness and regular testing can help prevent serious health problems. Many Aboriginal people believe that their sexual health is a very private matter. This makes public education campaigns and discussions about reproductive cancers very difficult. Culturally sensitive written materials can be one effective way to overcome this barrier. Elders can set a positive example for the young, by participating in and talking about cancer prevention and early treatment in their communities. This teaches respect for the body as the sacred house of the spirit.
The long distances between most communities and properly equipped treatment centres often prevent Aboriginal people from getting the medical care they need. Better support programs for patients and their families who have to travel long distances for treatment may help them make the decision to go for cancer treatment in the early stages of the disease.
Reproductive Cancers of Concern to Aboriginal People
I would like to tell other women to be brave. I thought that people with cancer died right away, and I would have to leave my kids behind. I hope my daughters never get it. They know how to look for the lumps. I have three granddaughters.’
As recently as 20 years ago, breast cancer was uncommon among Aboriginal women. Now breast cancer rates are about the same as for non.Aboriginal women: one in nine women will develop breast cancer, and one in twenty-seven will die of the disease. Breast cancer that is detected early through breast self-exam and mammography screening can be successfully treated.
Some things that reduce the risk of getting breast cancer are eating less fat, keeping a healthy body weight and drinking less than two alcohol drinks a day. Aboriginal women need to learn how important it is to practise breast selfexamination and participate in breast cancer screening programs. Breast self-examination is something every woman can do for herself so cancer can be detected earlier and treated. She can learn what is normal for her breasts, and then be able to notice changes. The older a woman is, the more important this becomes. Mammography, or breast cancer screening, is an x-ray of the breast.
Old women should talk to their health care providers about getting a regular mammogram.
My advice to young women is don’t be afraid to ask anything. Ask exactly what the doctor is doing. Ask the doctor why they are doing it, what are PAP tests done for? Don’t be afraid to ask questions. It’s your body and you have to feel confident you know what’s going on. The more you learn, the more confident you can be.
Young Metis woman from British Columbia
Cervical cancer is more common among, Aboriginal than non-Aboriginal women. Cancer of the cervix (the neck of the womb or uterus) can result from abnormal changes in the cells in the cervix. Changes that can lead to cancer can be detected by a PAP test. All women who have ever been sexually active should have a regular PAP test. It is a simple test that is done in the doctor’s office or health centre.
Women can reduce their risk of developing cervical cancer by delaying their first sexual activity, limiting the number of sexual partners, using condoms and not smoking. However, poor access to health care services, embarrassment and a lack of understanding of the importance of screening for their overall health, prevent a majority of Aboriginal women from having regular cancer screening done.3
Prostate cancer is the most common form of cancer in Canadian men. Generally, it affects men over 50 years old. More than 65 percent of new cases are found in men over 70. One in eight men will get prostate cancer in his lifetime, and one in twenty-eight will die from this type of cancer. The prostate is a gland located just below the bladder and it produces the fluid that carries sperm. Since changes that are a normal part of aging (such as needing to urinate often, and pain or burning when we
urinate) can also be signs of prostate cancer, it is important that men report these changes to their doctors. Men over the age of 40 should have a regular medical examination that includes monitoring changes in the prostate gland. If you do have prostate cancer, your treatment will depend on your age, your health and how the cancer has developed. Unfortunately, it can be hard for older men to talk about these things.
When you’re raised to feel ashamed of yourself, you don’t want to drop your pants in front of anyone, much less a female doctor. Prostate cancer is just not something that I’ve ever heard anyone in my community talking about. The inhibitions themselves are one thing, and the other is – I don’t know what others are like, but my female doctor sends me to a male doctor [for prostate cancer screening]. She is uncomfortable. Nurses in nursing stations up north for example, maybe they don’t want to do it either. And what if they are the only health care providers around?
Older Metis man
Men at highest risk for testicular cancer are those between the ages of 20-45 years. Testicular cancer rates appear to be increasing, possibly because of environmental contaminants and less active lifestyles. Treatment is usually successful if it is detected early.
The testicles are male sex glands located behind your penis in a pouch of skin called the scrotum. The glands produce and store sperm and provide male hormones. Some first signs of testicular cancer are a lump on the testicle, a swelling, a feeling of heaviness or sudden collection of fluid in the scrotum, or pain in the area.
Monthly self-examination of the testicles in young men is important. If you find a lump, see your doctor right away. Any changes should be reported to a health care provider, because early detection is very important to successful treatment. Getting cancer of the testicles does not mean you will lose your “manhood.”
Living Through Cancer
For women who are diagnosed with breast or cervical cancer, it is important to talk with a doctor to discuss what type of treatment to choose that will be best for them. Some women find it very difficult to think about the surgical removal of a breast. They may want to take some time to think about their options. They may decide to come back with a husband or partner, friend or relative for support, and to help them remember everything the doctor says.
She discovered a lump in her left breast one night in 1991. She was scared and all sorts of horrible thoughts went through her mind.
Like many others, she denied she had found the lump and refused to touch that area. It was not until a week later that she went to the doctor, who told her “it was probably nothing to worry about. 11 Two months later she saw a specialist. She had a lumpectomy but was never told it was cancer. She didn’t realize it was cancer until she had to return for a sixweek checkup at the Cancer Treatment Centre. She decided to receive radiation treatments at the Cancer Treatment Centre, approximately 180 kilometers from her home community. She usually stayed with family and friends. They told her what she should do and who she should see. As a result, she was shuffled around all over the region, seeing many doctors and almost every Traditional healer around. She realized that they were all telling her the same thing – there was only one healer, God, the Creator.
She tried many traditional medicines, but they made her sick so she quit taking them. Prayer groups came to pray over her. She read Louise Hayes’ Heal Your Body three times.
Her sister has been very helpful around the house. Her mother, who lives next door, comes about six times a day and never goes very far from home. Her daughter refused to hear anything about her cancer for a long time. She would block her ears with her hands and rush out of the house. Now she is more accepting and asks her mother if there is anything she can do. She is in a lot of pain, and can’t sit up for too long as she tires easily. Sometimes she can’t keep her breakfast down, especially if she has milk with her cereal Every day she hopes she will feel better.4
Print and Web-Based Material
Breast Cancer in the NINT, The Voice of Survivors Summary Report, Status of Women Council of the NWT, Yellowknife, 1997.
Facts on Prostate Cancer, Canadian Cancer Society, Toronto, 1998. Available at: www.cancer.ca/english/ Cl_prostatecancer.asp
First Nations Women’s Self-Care Choices: Pap Test Results and Follow-Up Care, BC Cancer Agency, Canadian Cancer Society and the Native Brotherhood of British
Columbia, Vancouver, 1994.
Health Care Provider’s. Breast Health/Breast Cancer Handbook, Breast Cancer InfoLink,Prairies/NWT and The Hope Breast Cancer Information and Resource Centre, Winnipeg, 1998.
Quick Cancer Facts for Men, Canadian Cancer Society, Toronto, updated 2002. Available at: www.cancer.ca/english/ Cl-Gi-cancerfactsmen.asp
Take Time to Care for Yourself. Saskatchewan Native Women and Cancer, University of Saskatchewan’s Northern Medical Services Research and Development Committee, Saskatoon, 1994.
Through the Northern Looking Glass: Breast Cancer Stories Told by Northern Native Women, Lorelei Anne Lambert Colomeda, National League for Nursing, New York, 1996.
Your Health: Testicular Self-Exam, Calgary Health Region, Calgary, 2001. Available at: www.ca Igaryhea Ith region.ca/hlthcon nl
Audio-Visual Resources, Multimedia and Games
Circle of Hope: A Journey of Survival, Cancer Care Ontario (available from Za-gehdo-win Information Clearinghouse), 1999. Video documents the journeys of three First Nations women who have survived breast cancer. 20 minutes; available in English and Cree.
Echoes of the Sisters First Nations Women: Breast Cancer, First Nations Breast Cancer Society in Canada, 1999. Documentary with an all-Native cast raises awareness about breast cancer and encourages a good breast health program. 30 minutes; available in English.
First Nations Breast Self-Examination Video, First Nations Breast Cancer Society in Canada, 1999. Teaching video with an allNative cast helps women learn how to perform a breast self-exam. Intended for women and health care providers. Available in English.
Useful Internet Sites
Canadian Breast Cancer Network www.cbcn.ca
Canadian Cancer Society – www.cancer.ca Canadian Health Network, Cancer Section www.canadian-health-network.ca/ faq-faq/cancer-cancer/7e.html
First Nations Breast Cancer Society www.fnbreastcancer. bc.ca Native American Cancer Research http://members.aol.com/natamcan/
Prostate Cancer Research Foundation www.prostatecancer.on.ca
Visions Centre for Innovation (cancer information) – www.visions.ab.ca/health/ Health_Programs/Cancer_Information/ Cancer.html
Sample Tools from Existing Resources
The following pages in this unit are taken from existing resources. For a complete list of these and other materials, see Resource Information at the end of the Sourcebook.
A Yearly PAP Test Could Save Your Life, PAP Screening for Life, Nova Scotia Gynaecological Cancer Screening Programme – a pamphlet describing cervical cancer and PAP tests.
Take Time to Care for Yourself: Breast Cancer, University of Saskatchewan’s Northern Medical Services Research and Development Committee – a simple pamphlet on breast cancer and reducing your risk through self-examination and mammograms.
Testicular Cancer: What Every Man Should Know, Native American Women’s Health Education Center – a simple pamphlet that describes testicular cancer and discusses prevention and treatment.
1 Through the Northern Looking Glass: Breast Cancer Stories Told by Northern Native Women, Lorelei Anne Lambert Colomeda, National League for Nursing, New York, 1996.
2 Health Care Provider’s Breast Health/Breast Cancer Handbook, Breast Cancer InfoLink Prairies/NWT and The Hope Breast Cancer Information and Resource Centre, Winnipeg, 1998, p. 31,
3 “Cervical Cancer: Screening Hard-to-Reach Groups,” Eva Grunfield, Canadian Medical Association Journal, 157 (1997): 543-5. Available at: www.cma.ca/cmaj/ vol-157/issue-5/0543.htm
4 Health Care Provider’s Breast Health/Breast Cancer Handbook, pp. 21-2.
5 Cancers in the Aboriginal Female Population (Community Perspective), Rosella Kinoshemeg, Aboriginal Women’s Health Project, Native Physicians
Association in Canada, Ottawa, 1995.
Copyright Aboriginal Nurses Association of Canada 2002
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