Dr. Judith Kaur, Choctaw/Cherokee, is professor of oncology at the Mayo Clinic Cancer Center’s College of Medicine and medical director for both the Mayo Clinic Hospice and the cancer center’s Native American Program. She is one of only two American Indian medical oncologists in the country. Kaur took time out of her extremely busy schedule to talk with ICTMN about her background and her work.
What was your journey from your grandmother’s backyard through medical school to becoming an oncologist at one of the world’s foremost medical institutions?
My Grandmother Ada had no formal education but she was a very wise woman and a very keen observer, so she understood the natural world. She taught me to observe animals and their behavior and plants and what they could be used for either in poultices or teas or for spiritual ceremonies. She was not a healer, but she thought that I had the potential to be a healer and she was the first one that ever put that little seed in my brain.
Why did you choose education?
At that time if you were a woman who was interested in science, they said be a nurse or be a teacher. I always had an interest in the sciences and teachers were my role models. My science teachers encouraged me to get a K to 12 teaching certificate that they said would be useful the rest of my life and that’s been true. I’ve tried everything from Head Start through graduate school now.
How did you move from teaching to medicine?
I had my daughter and was a very traditional mom, supporting my husband in his career interests. My daughter got a little bit older and stopped nursing and my husband would come home and find me reading Scientific American or something. He would say, ‘You want to go back to school?’ and I’d say, ‘No. Well, maybe.’ And he’d say, ‘Well, I know your professors said that you were smart enough to go to medical school and I don’t want to hear 10 years from now ‘I could have done that.’ He said if you want to do that let’s go figure it out. So he kind of pushed me in that direction and one thing led to another.
What strategies and programs have you instituted at Mayo for Native American outreach that could serve as models for other hospitals and clinics?
There were three major outreach programs for American Indian cancer patients at Mayo. One of them, NativeWeb, has discontinued because the breast and cervical program in house became well-funded through the CDC, but that was an initial effort in education about breast and cervical cancer. The programs that I run now are Spirit of Eagles and Native CIRCLE.
What research programs are you working on?
We are focused on what’s called community-based participatory research, which means that the community identifies a priority and then we work together as partners to look for solutions. Our major research project, in Alaska, is working with Alaska Native pregnant women on smoking cessation and issues of carcinogen exposure. Other smaller projects are looking at everything from wellness approaches for youth to diabetes. We’ve also supported different programs that the tribes have developed, for example, for men’s health, to get men into screening. There was so much focus on breast and cervical cancer that men started to come to me and say, ‘Hey, I understand that men get cancer too. What are you doing for us?’ We sponsored a project with Standing Rock Reservation in North Dakota where they developed a community-wide screening approach—a sort of men’s night out—to educate men about everything from diabetes to colon cancer to prostate cancer.
What do you see as the unmet needs for cancer education/screening/treatment in American Indian communities?
Access to care issues. It’s one thing to have cancer awareness. It’s another to be able to get the timely screening and treatment that can make a big difference as far as survival. Our emphasis is everything from the prevention approach to early detection to treatment up to and including clinical trials and then of course end of life care. One of the issues is how to make sure tribes take advantage of the Affordable Care Act. [If the Affordable Care Act continues, it will] improve systems like colon screening, mammography and an annual physical exam—some of those things that are so crucial to picking up on health issues while they still can be fixed.
What else would you like people to know?
Sometimes you think things don’t change or they’re never going to change. Because I’ve got the long view, it’s been pretty amazing to see now that cancer is on the agenda, that prevention is on the agenda, that even tobacco issues, aside from their spiritual and traditional approaches to tobacco as a ceremonial agent, even that is being addressed by a large number of tribes who understand that that’s the most important preventable source of health issues, including emphysema and cancer. Having it be much more open to talk about cancer and how to prevent it, treat it and eventually cure it is exciting for me.
The other aspect for me is I see very bright students who really want to help their tribes now getting the education they need and they will be the next group that will take leadership. I am 69 [and some of my colleagues are older.] We need energetic, idealistic young people who are well-trained, who can do this work. And I’m hopeful.