If she wanted her fellow tribal members on the Flathead Indian Reservation to supply blood samples for a new study, the medical adviser at the Confederated Salish and Kootenai Tribal Health Clinic figured she'd better be willing to do so as well.
With the help of the nurse, Muzquiz delivered the first of what they hope become 1,000 blood samples for the Montana Cancer Institute Foundation.
“The concept is that people respond to cancer drugs, in large part, based on their genetic background,” says Dr. Patrick Beatty, president of the Montana Cancer Institute in Missoula.
Similar tests have been done on whites, blacks, Asians - on most races of people.
“The reason they've never been done on Native Americans,” Beatty says, “is that most medical schools are located in big cities.”
And most Indian reservations that provide a population base large enough for such a study are not.
But the cancer institute, a collaborative effort between the University of Montana and St. Patrick Hospital and Health Sciences Center, has the expertise and technology to help determine what cancer treatments would be most effective in any race. And the 1.3-million-acre Flathead Reservation sits just a few miles outside Missoula.
So was born this project.
The idea is fairly simple. A drug that may work well with one race of people may, due to genetics, break down quickly and be ineffective in another, Beatty says. Or it may break down too slowly, leading to toxicity.
The study will help Indians who have cancer rely on treatments based on the genetic characteristics of their own people, not someone else's.
“The direction of medicine is led by research and evidence,” says Muzquiz, a Ronan native who graduated from the University of Washington School of Medicine and did her residency in Seattle before returning home to practice 4 1/2 years ago. “But there is very little research and evidence that relates to the Native population.”
Muzquiz was approached by Beatty and Mark Pershouse, the associate professor of molecular genetics and toxicology at the University of Montana who will analyze the samples. They asked her to help them navigate the proper routes to set up the genotyping study, and serve as a liaison between the research group and patients, tribal health and tribal government.
“Historically, there has been research performed on Native peoples in a less-than-respective manner,” Muzquiz says. “They (the people at the cancer institute) have made an extra effort to respect our patients and our culture, and are very mindful of that. They've been very inclusive with the tribal health clinic and tribal government.”
They're rolling out the program slowly. An information booth at this weekend's Kyi-Yo Powwow at the University of Montana will explain the project - for instance, that the blood samples for the study can come from any Indian, not just those with cancer - and how it could benefit tribal members who do have the disease.
But no blood will be drawn at the powwow for the research. People can volunteer to give blood at the tribal health clinic or other locations later, and there will be other opportunities down the road to donate samples at other events, such as the Arlee Powwow this summer.
Muzquiz gave the first sample two months ago, and about 60 patients and employees at the tribal health clinic have followed suit since.
Just with that small sampling, Beatty says, “We're already starting to see that the Native American genetic makeup is quite different.”
“And it's looking different in a good way,” Pershouse says.
Trust us, the explanation of why delves into vocabulary only a scientist or doctor would understand. The bottom line, however, is that “it's already getting very exciting,” Pershouse says. “You hope your research keeps you encouraged to keep going, and it does in this case.”
Pershouse says he expects the data gleaned from the samples will differ from tribe to tribe as well, but all tribes are welcome to participate. In addition to Salish and Kootenai tribal members, already Blackfeet and Chippewa Indians have given samples.
It's all confidential, Beasley says. While information on tribal mixtures is important to the study, all samples are identified by a number, not a name, and there is no way to link them back to an individual.
To Muzquiz, the study represents a rare opportunity for Indians to help other Indians who have cancer.
“It can be frustrating” to practice medicine on people for whom too little research has been done, she says. This study, she adds, is an opportunity for her people “to rely on care based on evidence.”
Reporter Vince Devlin can be reached at 1-800-366-7186 or at vdevlin@missoulian.com.
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