title: Cancer Journey for American Indians and Alaska Natives in the Pacific Northwest .
abstract: To describe the experiences of American Indian and Alaska Native cancer survivors to improve understanding of the trajectory of cancer treatment.  .
  
  
  
  Qualitative focus group research. .
  
  
  
  Rural and geographically isolated American Indian and Alaska Native communities in the Pacific Northwest. .
  
  
  
  30 American Indian and Alaska Native cancer survivors or caregivers.  .
  
  
  
  The authors analyzed data from two focus groups with cancer survivors by using thematic analysis informed by indigenous methodologies. .
  
  
  
  Based on focus group findings, the authors developed a conceptual model of the cancer experience called Rough Waters. Participants described their cancer experience as a collective journey involving family and friends and requiring resources to offset challenges along the way. Dominant themes were delays, isolation, communication, money, advocacy, spirituality, and family involvement. .
  
  
  
  American Indians and Alaska Natives in the Pacific Northwest have special cultural needs during cancer care. The current study provides examples that can guide patient-provider interactions. .
  
  
  
  Using the metaphor of cancer as a journey, clinicians can begin a dialogue to identify what will impede or assist the cancer journey for their American Indian and Alaska Native patients.
authors.affiliation: University of New Mexico.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Haozous
authors.affiliation: University of Washington in Seattle.
authors.forename: Ardith
authors.initials: A
authors.lastname: Doorenbos
authors.affiliation: University of Arizona.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Alvord
authors.affiliation: University of Washington.
authors.forename: David R
authors.initials: DR
authors.lastname: Flum
authors.affiliation: Stanford University.
authors.forename: Arden M
authors.initials: AM
authors.lastname: Morris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000072957:Alaska Natives / Q000523:psychology*; D000073116:Cancer Survivors / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D015205:Northwestern United States; D036301:Qualitative Research
keywords: Alaska Native; American Indian; cancer survivorship; indigenous methodologies; qualitative