The Cancer Care Institute (CCI) in Rapid City, South Dakota, serves approximately 100,000 Native Americans from three reservations. Some patients live up to four hours from the cancer center. Identifying barriers which prevent Native Americans from presenting with earlier stages of cancer, or in some circumstances not at all, will be investigated. A culturally responsive questionnaire will be administered to randomly selected Native Americans on the reservation who do not have cancer. A second questionnaire will be given to cancer patients, and address similar issues, but concentrate on additional questions of oncologic relevance. It is hypothesized that a major barrier is geographic dislocation from cultural/community roots close to home. Traditional radiotherapy involves a 6 to 8 week course and daily treatments. This treatment approach may represent a major barrier. With the use of advanced technologies such as intensity modulated radiotherapy and brachytherapy, the treatment course can be shortened to 1 to 4 weeks. Therefore, to address this barrier, clinical trials have been developed which shorten treatment duration. A series of phase II studies are proposed for malignancies commonly seen among the Native Americans: metastatic disease, non-small cell lung (NSCLC), breast, prostate and head and neck (H and N) cancer. For patients with stage I and II breast cancer, high-dose-rate (HDR) brachytherapy will be substituted for a conventional course of external beam radiation. Patients with advanced prostate cancer will be treated with a 2 week course of conformal external beam radiation followed by an HDR implant in combination with androgen ablation. Pilot tomotherapy trials are proposed for patients with metastatic disease, locally advanced H&N, and NSCLC. The final pilot trial will investigate the use of HDR brachytherapy alone for early stage prostate cancer. A genetic milieu may exist which renders Native Americans more sensitive to radiation. Therefore, a laboratory study will be conducted to investigate whether Native Americans have a higher mutation rate of the AT (ataxia-telangiectasia) gene determined through HPLC of the peripheral blood lymphocytes. Through patient education, screening, assessing potential barriers to health care, and innovative treatment strategies, it is hoped that Native Americans will eventually present earlier in their disease process.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Exploratory Grants--Cooperative Agreements (U56)
Project #
5U56CA099010-05
Application #
7119977
Study Section
Special Emphasis Panel (ZCA1-SRRB-Y (O1))
Program Officer
Wong, Rosemary S
Project Start
2002-09-27
Project End
2008-02-28
Budget Start
2006-09-01
Budget End
2007-08-31
Support Year
5
Fiscal Year
2006
Total Cost
$1,182,097
Indirect Cost
Name
Rapid City Regional Hospital
Department
Type
DUNS #
068677160
City
Rapid City
State
SD
Country
United States
Zip Code
57701
Petereit, Daniel; Omidpanah, Adam; Boylan, Amy et al. (2016) A Multi-faceted Approach to Improving Breast Cancer Outcomes in a Rural Population, and the Potential Impact of Patient Navigation. S D Med 69:268-73
Petereit, Daniel G; Hahn, L Jennifer; Kanekar, Shalini et al. (2013) Prevalence of ATM Sequence Variants in Northern Plains American Indian Cancer Patients. Front Oncol 3:318
Kaur, Judith Salmon; Petereit, Daniel G (2012) Personalized medicine: challenge and promise. J Cancer Educ 27 Suppl 1:S12-7
Pandhi, Nancy; DeVoe, Jennifer E; Schumacher, Jessica R et al. (2012) Number of first-contact access components required to improve preventive service receipt in primary care homes. J Gen Intern Med 27:677-84
Guadagnolo, B Ashleigh; Boylan, Amy; Sargent, Michele et al. (2011) Patient navigation for American Indians undergoing cancer treatment: utilization and impact on care delivery in a regional healthcare center. Cancer 117:2754-61
Pandhi, Nancy; Guadagnolo, B Ashleigh; Kanekar, Shalini et al. (2011) Intention to receive cancer screening in Native Americans from the Northern Plains. Cancer Causes Control 22:199-206
Pandhi, Nancy; Guadagnolo, B Ashleigh; Kanekar, Shalini et al. (2010) Cancer screening in Native Americans from the Northern Plains. Am J Prev Med 38:389-95
Kanekar, Shalini; Petereit, Daniel (2009) Walking forward: a program designed to lower cancer mortality rates among American Indians in western South Dakota. S D Med 62:151-3, 155-7, 159
Guadagnolo, B Ashleigh; Cina, Kristin; Helbig, Petra et al. (2009) Medical mistrust and less satisfaction with health care among Native Americans presenting for cancer treatment. J Health Care Poor Underserved 20:210-26
Guadagnolo, B Ashleigh; Cina, Kristin; Helbig, Petra et al. (2009) Assessing cancer stage and screening disparities among Native American cancer patients. Public Health Rep 124:79-89

Showing the most recent 10 out of 15 publications