Study of Native American genes searches for way to reduce cancer

By Jennifer McBride / Leader Staff

The future of cancer on the Flathead Indian Reservation could be changed by a tablespoon of blood.

The Montana Cancer Institute Foundation (MCIF), in collaboration with the Confederated Salish and Kootenai Tribal Health Department, is sponsoring a new program looking at Native American genes. Researchers are hoping to find out whether Tribal people might have certain genetic traits that can help fight cancer, or identify barriers to recovery.

According to Dr. LeeAnna Muzquiz, a Tribal liaison coordinating the project, patients who come into Tribal Health for regular appointments will have the chance to give blood for research.

"It's a study that looks at cancer's genetics," she said.

Certain genes can determine a patient's reaction to any medical treatment. When it comes to life-threatening diseases like cancer, MCIF President Pat Beatty said, doctors don't want to leave anything to chance.

"Particularly with cancer drugs, there are certain genetic traits that people have which will determine if they react toxically to treatment, or if chemotherapy will have few side effects but no benefits, either," Beatty explained.

Specifically, Beatty wants to study a tablespoon to tablespoon-and-a-half of blood given by study participants. The samples will be sent to Missoula with dialysis patients in a van run by the Confederated Salish Kootenai Tribes. The blood will then travel to New York, where researchers at the University of Rochester will look at nine specific genetic markers to find out whether or not Indian populations share traits that could hamper chemotherapy, for example.

According to Beatty, similar genetic testing for the efficiency of cancer treatment has been conducted in other population groups, including whites, Asians and blacks.

"Nobody has ever studied this systematically in Native Americans," Beatty said, despite the fact that American Indians sometimes suffer from heavier concentrations of cancer fatalities than Caucasians. Cancer is the leading cause of death in Lake County.

Two hurdles, Beatty said, have prevented American Indian-specific medical research. First, most of the big pharmaceutical colleges are in urban areas with low Indian populations. The University of Montana is different because Missoula is so close to the Flathead Reservation. Though UM doesn't have all the necessary equipment to conduct the study, Beatty said the MCIF's partnership with the University of Rochester should make up for any deficit.

The second, more significant problem, Beatty said, stems from American Indian resistance to outsiders performing research experiments. The medical establishment's previous misuse of power has given some Tribal members a bad taste in their mouths when it comes to the word "research," Beatty said.

"Many Native Americans, for good reason, don't have a lot of trust in the medical system," Beatty explained. "So that means that it's almost impossible for some unknown research project to come out and do something like this."

To help earn Tribal members' trust, the project will be administered through the Tribal Department of Health. Muzquiz said she and others spoke to the Department about the research study. The Tribal council supported the project unanimously.

That reassurance will not necessarily satisfy everyone.

"Of course everyone's going to have their bias and their preconceived notions," Muzquiz said. "We'll take that as it comes."

Muzquiz, who volunteered to be the first test subject, said they've built safeguards into the project.

"We've tried to keep the study as transparent as possible," she explained.

The first protective measure is privacy. Only a handful of people will know whose blood belongs to whom. Second, Muzquiz emphasizes that the study is informational only.

"There's no hidden agenda," she said.

Even with these reassurances, Muzquiz isn't sure whether or not people will be enthusiastic about signing up to have their genes examined. Right now, the Tribal staff is only asking people who already come into health clinics for regular appointments to donate blood. They don't have to be suffering from cancer to participate, or meet a required blood quantum. The subjects will each receive $10 for participating in the study.

Muzquiz said she expected most of the volunteers would be people whose lives had been "touched by cancer."

Though Milissa Grandchamp, the clinic nurse in St. Ignatius in charge of handling logistics, hasn't completely worked the kinks out of the process, she said all the preparations have been going well.

"I think it will flow smoothly once we get going," she said. Since the program's official kick-off, however, Grandchamp said the clinic hasn't been receiving many volunteers.

Pat Beatty hopes this project will be just the beginning of a widespread effort to improve cancer treatments in Indian country.

"There's a lot of national interest in research and health care in Native Americans," Beatty said. "It's kind of dawning on people that that's one minority group that's been underrepresented in research."

At the end of the project, Beatty wants to have collected the blood of "1,000 rural Tribal members" — an important first step to improving health care.

"We want to find a way to bring better cancer treatment to Native Americans. That's the bottom line," he said.