FormalPara Key Points

  • Ancestral connections strengthen and support patients and families during life-challenging experiences.

  • Traditional medicines, along with Western medical interventions, extend and save lives.

  • Language considerations are important for culturally safe care.

  • Compassion facilitates good relations and the best outcomes.

  • Teaching cancer healthcare providers about traditional medicines is important.

  • Transferring traditional medicine knowledge to youth is important.

In Canada, cancer rates have increased among First Nations, Inuit, and Métis people in the past few decades and, in some populations and for some cancers, are now at or above the incidence rates in the general Canadian population [1]. This chapter shares four cancer care stories from knowledge holders who have had direct experience with cancer and the cancer care system. Their narratives offer real-life wisdom to learn from and influence positive change for improving the direct care of Indigenous cancer patients.

The first story speaks of the prevalence of cancer in one family and their utilization of both traditional medicines and Western approaches to treating cancer.

The second story speaks of the limitations of Western biomedical approaches to dealing with cancer and, in particular, the lack of knowledge, understanding, and sensitivity present when patients and families wish to use traditional approaches to treatment, including end-of-life transition management.

The third story reflects how life history and trauma are relevant when Indigenous patients are seeking services related to cancer care, including how a diagnosis is delivered and how language can leave a patient poorly prepared to make informed choices for cancer care and treatment.

The final story is about the power of traditional medicine and the importance of ensuring that the next generations are provided with medical knowledge to apply to their lives and wellbeing.

Story 1: Family, Traditional Medicine, and Faith in the Creator

We carry on our ancestors’ work. My Cree name is Kakaki Kaoskiikit (Forever-Young Man), and my English name is Victor Bruno from Samson Cree Nation. We have too many First Nations people stricken with cancer. As a Nehiyaw (Cree) family, we made a commitment to support Indigenous-led cancer research within Alberta and the work of the Alberta First Nations Information Governance Centre (AFNIGC). This story is to bring you back to what we are all here for and why we as Elders/knowledge holders are involved in this work.

My personal loss of so many sisters and brothers to cancer is part of the reason why my wife and I decided to work with AFNIGC. I had six sisters and eight brothers, and there are only five of us left now. My wife and I are thankful that we are on this journey together to work in this area. We want to connect our beliefs, our cultural ways, and our medicines to combine Western and traditional ways and to see how we can help our people who are suffering from cancer. I have learned about cancer through being involved with AFNIGC, and I was prepared when I got the shocking news in the fall of 2019 that I, too, was diagnosed with cancer.

Traditional medicine ways helped us as a family. We used both Western and traditional medicine, but I found that Western medicine did not stop the cancer. When I took our traditional medicine, it started working right away, and I continue to drink the medicine to stop the cancer.

Cancer has also affected our children. My wife, Sophie, shares our family cancer journey:

All my five daughters had cancer. I lost my oldest daughter to cancer. Also, two granddaughters went through cancer, including our newborn granddaughter who had a growth removed in her breast area. Our other daughters were diagnosed with breast cancer and after I lost my oldest daughter, a month later my other daughter was diagnosed with stomach cancer. Two weeks after that, my granddaughter who lives in Winnipeg was diagnosed with breast cancer. We used both ways, the native with Western medicine, but prayer played a major part [Personal conversation, Sophie Bruno, 2023 August 16].

When we lost our daughter to cancer, I thought maybe I should step away from the AFNIGC project. I had a long, serious thought about it. But I thought to myself that I would be giving up on my people. I had to continue. Whatever little I can do, whatever little knowledge I can share to help with this work, I need to share. Helping my people has helped me to continue, and my grandfather always said to never give up. You have to continue; you have to stand.

We use these cultural beliefs along with Western medicine. We combine them with the hope of achieving something that is going to help our people, especially the young people. When you want to follow and include our ways, it is important to do this meticulously. My mentor showed me and passed the pipe on to me. We had four sweat lodges for me to use the pipe; the ceremony was done very, very slowly and diligently, and we followed each ceremony according to the plan for four sweats. Our mothers, grandfathers, grandmothers, and lots of mosôms (grandfathers) and kokums (grandmothers) teach us these things.

I am hoping that this story will help along the way to give you a better understanding of why we have Elders involved in this research—the cultural aspect of traditional and Western medicine.

Time is of the essence for our people.

Hiy Hiy (Give thanks).

Story 2: Land-Based Medicine, Cultural Practices, and Respect

My name is Rose Richardson. I am Indigenous and have lived most of my life in the northern village of Green Lake, Saskatchewan. Knowledge of plant use was passed on through oral tradition and other forms of knowledge through dreams, visions, and kosapachkewin (the ability to see through dreams and visions). Kosapachkewin is a form of knowledge transfer to certain people, through a different way of knowing. In most cases, it is described as a spiritual insight from other dimensions, which is sometimes conducted through ceremony, fasting, or sweat lodges. Some people are born into this realm and see vision and are able to recognize plants and their uses.

Many of our cultural practices were banned and only practiced covertly. My mother often told me, as I explained to her my dreams, visions, and experiences, “one day you will be put in jail, we can only use White man medicine now.” I grew up supported and taught quietly by Elders, little people, and three beautiful, kind, and transparent ladies (spirits) who simply appeared and vanished into thin air. My mother cautioned me not to tell anyone because I would be ridiculed and maybe taken away.

The culture, lifestyles, values, language, and religious and spiritual beliefs of people must be taken into consideration in cancer care. As Indigenous Métis people, our environment has influenced our culture, lifestyle, and spirituality. For many, being Métis means appreciating and knowing how to survive in nature. Métis believe that every plant has the creator’s signature, with specific plant uses. There is general knowledge of plants, and then there is specific knowledge given to some people.

Many of our people are busy struggling to survive and are held back by a colonialized system, which stifles their cultural practices. Another factor influencing our traditional use of medicine is the limitations of not allowing us to take our own land-based medicine that we used traditionally for healing and health.

Medical services are not readily available in many areas, and people have resorted to land-based medicine. Many people in the remote areas of Canada and possibly the world rely on plants that grow within their traditional lands. Today, there is an effort to combine traditional and Western medicines wherever possible. Some headway with traditional medicine use is being made, especially since hearing about issues concerning medical system shortfalls.

On June 17, 2020, I lost my husband, Ric Richardson, due to cancer. Five years earlier, he had been informed about it. The oncologist said, “you have stage 4 cancer, it’s terminal and irreversible.” To make sure we understood, the oncologist further added, “and you’re going to die.” The oncologist’s language was crude and uncaring, but he said we could do chemo and radiation, which might add a couple more months.

Ric and I left the clinic and cried in each other’s arms. I promised we would go back to my spirit world and get the answer. We journeyed through dreams and visions, and Ric informed the oncologist that we planned to use traditional medicine. We asked for regular follow-up, even though we were using our traditional medicine. It was a challenge to get this care, but through our persistence, we successfully received subsequent care. Then COVID-19 came along and brought more challenges as we could not do our traditional methods and I was not allowed in the hospital. I waited all day in the hospital parking area so Ric would know I was close by. During Ric’s last few days, we continued to face additional challenges due to the disrespect and unkindness of the medical staff. That day, my spirit died too.

Education is very important in terms of the accessibility of food sources that are readily available in the specific areas or regions where people live. Métis people must be trained to return to their own communities and support the establishment of centers and services to offer traditional medicines. Healthcare professionals must also work alongside Métis people and acknowledge and respect our choices and traditional values.

Story 3: The Reality of Trauma and the Necessity for Trauma-Informed Care

My traditional name is Itsagha Dinisjosh (Bluebird). My English name is Jeannette Nancy Starlight. I am 74 years old, and I have two sons: my oldest son, Emil, whose wife is Kristin Starlight, and my younger son, Bernard, whose wife is Moriah Whitney Starlight. I have two grandsons, Suh Tsi’do and Nists’i Whitney Starlight. We live in the Tsuut’ina Nation in Alberta, Canada.

I am sharing my cancer journey of the last 15 years. During this journey, my daughter-in-law, Kristin Starlight, helped me understand the extent of this disease; I had stage 3 cancer. I deeply thank Kristin for her presence.

I think it is important that I share a story from my childhood for a little glimpse of context. When I was 8 years old, I had to get my tonsils removed. I remember waiting for my parents, by myself, in the examination room. The doctor walked in with several male interns (five or six), and I was lying down wearing just a hospital gown. The doctor disrobed me and said to the interns, “this is what an Indian looks like.” My mind went blank, and they all left before my parents arrived. I never told my parents—I did not know how to say it.

My first diagnosis with cancer was when I was 59 years old. Returning to the medical system for care was overwhelming, but I knew I had to take care of my body, which was no longer well. My experiences with the medical system for my cancer have left me feeling unsettled, disquieted, and traumatized.

First, I could not really comprehend the extent of the disease because of the medical terms used and the way medical personnel spoke to me. I could not visualize the words when they were talking to me since the words were all new to me, and I was not familiar with the medical language.

Second, racism was present—I sensed it in the tone of the doctors and their assistants. Their communication was demanding and pressuring rather than offering kindness and informed choices. The environment lacked cultural safety or connection, and I felt so vulnerable. As I looked around, I saw blood on the floor from previous patients. Seeing this blood increased my stress; my breath stopped, and I could no longer hear clearly.

Some medical staff advocated for me and supported me to make informed decisions. They engaged with me with humility and compassion. They could sense my fear. They met me in relational ways where I could feel their presence and their kindness; the way they took and held my hand supported me to experience safety and connection.

The healthcare system must listen to First Nations patients. Our relationships with our bodies are different. Medical professionals might learn about First Nations history, and I invite them to embrace with compassion these histories because our lived experiences are relevant today. It would be more support of medical professionals to learn about us as people and not just the disease.

Before I go to the hospital, I put down tobacco. I pray for the land, the place, the path, the surgeons, and the helpers. I pray that everything will be cared for, for strength, for guidance, and for everything to go well for all of us. I know I had to go through this. I have learned to deepen my understanding of what my body is sharing with me, and now I know how to share with you. Family love has been a critical aspect of support during my journey, and I would like to deeply thank them and all the people who sent prayers for me.

Guja (Good). Siyisgaas (Thank you).

Story 4: Cancer and Traditional Medicine Use

My name is Gordon Courtoreille from Swan River, Alberta, Canada. I am a Cree Elder and holder of knowledge. I am a survivor of cancer, and I believe my survival is due to listening to my Elders about traditional medicines. The cancer was pretty bad when I started using traditional medicines, but I soon started to feel better.

When I was diagnosed with prostate cancer, my PSA was one of the highest the specialist had seen. I had an appointment scheduled to discuss my treatment options, but nothing was explained. When I came home from the doctors, we had a family meeting to let them know about my diagnosis.

My wife Doris talks about breaking the news to the family:

I felt that all the family should know, not to keep them in the dark as to what their dad was going through. There was a lot of tears and sadness going on there and Gordon said, “don’t cry, I’m still here.” I remember him going downstairs and I kept trying to console the kids, not to cry. There was just no happiness in our house. After a while, Gordon came up from downstairs with this crate of medicines that he had picked over the years. Not only months or weeks, it was years, that he had gathered these things, and without saying anything or why, and he made himself a tea.

So, we went back to the specialist and we were told the PSA level had significantly dropped. The doctor questioned Gordon, “what are you doing?” And Gordon told him he was taking traditional medicine. He said, “whatever you’re doing, continue, and we’ll make another appointment.” So the discussion about chemo, radiation, or surgery treatment did not happen.

Gordon continued to use the tea he was making. And when he went back for follow-up, the specialist said there was no sign of cancer, and no sign of diabetes after 30 years; and to this day still there’s no sign of diabetes and the cancer is gone [Personal conversation, Doris Courtoreille, 2020 November 13].

When I was young, I always sat with the Elders, and that was where I got all the medicines. They told me what to use and to teach younger generations to gather medicines—to tell them what type of medicine to use and what kind of roots. I would sure like to have people know about our medicines to help themselves and help their children and their grandchildren. I have seen a lot of people having a hard time and not using our medicines because they do not know their power and how healing they are. I know it helps us. I know it helped me. Well, I am still here!

Thank you for hearing my story.