Project emphasizes 'ohana
care for breast cancer

By Liza Simon / Ka Wai Ola

Mounting clinical evidence shows that Native Hawaiian women not only have high rates of breast cancer but are more likely than other groups to die from the disease. This was hardly news to Noreen Mokuau who has seen breast cancer claim the lives of many of her Native Hawaiian relatives – including her own mother.

Putting aside the medical questions of why the disease impacts some groups more than others, Mokuau and fellow researchers at the University of Hawai'i School of Social Work have begun a grant-funded two-year project that is aimed at helping Native Hawaiian women with breast cancer survive longer. “With the disproportionately high rates (of Native Hawaiian breast cancer deaths), it appears the health system is missing something, so our project is using a culturally tailored intervention to correct the situation,” says Mokuau.

Kū Me Ka 'Ohana – or “standing tall with family,” is the name of Mokuau's project. As the name implies, it involves 'ohana members in the care and recovery of a loved one who has been diagnosed with breast cancer. Project social workers will visit the homes of women who have the disease and provide them and at least one other relative with coping tools that have Hawaiian cultural appeal. “This may include doing a pule with family members before we even begin to discuss the disease,” says Mokuau.

Participating 'ohana members will learn how to tap into a cancer recovery network by phone; women with breast cancer will also get help in preparing for doctor visits where they may be in the habit of not asking key questions that help their own treatment.

Another important component of the project involves teaching family members to lighten the load of the loved one with breast cancer. “It can be a lot for a women who is undergoing (cancer) treatment to carry on as usual with chores at home, a career at work – and make it to crucial doctor appointments. So we support the re-negotiating of roles,” says Mokuau.

And the project offers support with perhaps the most sensitive issue of all – the emotional fallout of cancer. “We listen when someone gives us a word. So let's say a husband says that his wife no longer feels beautiful because she is losing her hair (following chemotherapy treatment). We prompt the discussion. This way, important mental-health issues are not just glossed over,” says Mokuau.

The project, which is receiving major funding from the Susan G. Komen Foundation, grew out of a pilot study which indicated that so-called psycho-social interventions may have a positive effect on Native Hawaiian women struggling to cope with breast cancer.

Kū Me Ka 'Ohana is looking to recruit 50 women along with 'ohana members. Participants must have received a breast cancer diagnosis within the last one to four years. Mokuau explains that a woman's choices during the four years following breast cancer diagnosis are critical in determining long-term survival. “No one can say for sure if you're in the clear after the four years, but we hope to find that an intervention tailored to the strengths of the Hawaiian family has the effect of saving lives.” Each participating 'ohana will receive a small monetary makana, Mokuau says. Anyone wishing to become a participant in Kū Me Ka 'Ohana may call the project at 956-6809.