UICC World Cancer Congress 2006

My research explored the meaning of cancer to Australian Aboriginal women with the aim of understanding the cultural context influencing treatment decision-making. Culturally targeted cancer screening programs have improved Aboriginal women's participation, but have been less successful in attracting them beyond the investigative.

Methods: I used qualitative methods which involved fieldwork in two rural Aboriginal communities. Participants included health workers, and women with a history of cancer or others with experience of the disease.

Results: The Aboriginal women perceived cancer to be fatal and all treatment futile. They feared the disease because it threatened their integrity in all domains; physical social and cultural. Cancer was seen as an adversary of double proportion because it represented another form of colonisation. The disease invaded their body and makes them vulnerable to the old adversary of ‘whitemans' authority. However, rather than becoming a compliant patient, a cancer diagnosis inspired the Aboriginal women to position cultural values and aspirations central to their treatment decision-making.

I propose a culture-centred approach for supporting Aboriginal women with cancer, which is based on principles similar to those underpinning the ‘Witness Project', a cancer program for African American women. A culture-centred approach positions cultural values and beliefs as the matrix from which to appropriate cancer-palliative care services for the Aboriginal population are constructed.