University of Montana School of Pharmacy involves CSKT members in pharmacogenetic studies for cancer research

By B.L. Azure

Members of the Flathead Indian Reservation Community Pharmacogenetic Advisory Council tour the University of Montana School of Pharmacy last Thursday. From left are: UM Pharmacy professors Mark Pershouse and Erica Woodahl, CPAC member Cheryl Mathias, UM graduate student Chelsea Morales, CPAC member Tony Incashola, UM professor Liz Putnam and CPAC member Brenda Bodnar. (B.L. Azure photo)

MISSOULA — A couple of years ago the Confederated Salish and Kootenai Tribes Tribal Health and Human Services Department, the University of Montana and the Montana Cancer Institute Foundation at St. Patrick Hospital entered into a mutually beneficial agreement that focuses on cancer research on American Indians, in particular members of the CSKT.

One of the goals of the research is to find out how the tribal members respond to the various pharmaceuticals used to treat cancer and its collateral effects.

The field of research is called pharmacogenetics and the focus is on how a person’s genetic make-up affects an individual’s response to the prescribed medications.

It is a well-known scientific fact the people can respond in different ways to the same drug — genetic make-up is a determining factor. Response runs the gamut from no response to serious side effects. Somewhere along that continuum may be the perfect dose or there may be the need for a different pharmaceutical.

The end product of the research is to find the right drug at the right dosage that doctors can prescribe to cancer patients based on their genetic make-up and the types of cancer they have.

Vernon Finley was a featured speaker at the Northwest-Alaska Pharmacogenetics Research Network conference at the University of Montana last week. (B.L. Azure photo)

Last week members of the collaborative group as well as members of another component of the research effort based at the University of Washington that focuses on Northwest Indians and Alaska Natives gathered at the University of Montana for a two-day conference. The Northwest-Alaska Pharmacogenetics Research Network is the umbrella group of the Montana research effort.

The community based participatory groups’ research offers the potential to improve drug safety and efficacy by establishing bonds and partnerships with American Indian and Alaska Native communities.

Towards that relationship the research groups formed the Community Pharmaceutical Advisory Council. The Flathead Reservation CPAC members include Catherine Addison, Bernard Azure, Brenda Bodnar, Clara Charlo, Dib Espinoza, Patricia Hewankorn, Tony Incashola and Cheryl Mathias.

The mission of the CPAC is to: increase tribal input about pharmacogenetics research; work together to build trust and strengthen the partnership between researchers and the tribal community; provide advice about the cultural approaches to conduct pharmacogenetics research projects involving the Tribes; and discuss the tribal interest in the research.

University of Montana School of Pharmacy professors Erica Woodahl, Liz Putnam and Mark Pershouse discussed the pharmacogenetic research partnership with the CSKT Tribal Health and Human Services Department, the University of Washington and the St. Patrick Hospital Montana Cancer Institute Foundation. (B.L. Azure photo)

Dr. LeeAnna Muzquiz of the THHS told the conference attendees that she and THHS Director Kevin Howlett were very skeptical when first approached about the pharmacogenetics research project that would involve THHS and members of the CSKT. Howlett was in Billings on THHS business and could not attend the conference.

“But now we understand the small steps taken for the better health in the future and its impacts on future generations,” Muzquiz said. “Kevin and I have a vested interest in our professions and what happens to our people and our patients, many of whom are our family members. This is a way forward to something never done before. Most or all medical research is focused on the non-Indian groups. This is important research and it matters because treatments for one population group may not be applicable to another.

“Today cancer is about the worst enemy we have. We can’t seem to get a handle on it,” said CPAC member Tony Incashola. “What is being done here is very important. We need to try and understand how genetics affect efforts to find cures for ailments and diseases. We want to give our future generations a better chance in life.”

Muzquiz said the treaty-obligated healthcare provided to American Indians falls well short of the needs in Indian Country. She said many in the Indian community have resigned to the present reality of inadequate healthcare. “We need and deserve more and better healthcare,” she said. “We should be on equal health status as the rest of America. I see this partnership with the University of Montana and the Montana Cancer Institute as a way to elevate our status. This puts us in the forefront when we as Salish and Kootenai people can partner with the medical professionals in this type of research. We, Kevin and I want to do better for our people.”

Cancer oncologist Dr. Pat Beatty of the Montana Cancer Institute Foundation and Dr. LeeAnna Muzquiz both laud the importance on the cancer research partnership that includes THHS. (B.L. Azure photo)

Muzquiz said the Indian people involved in the project could help educate others about the unique tribal culture and the existing healthcare system. “The value of this participatory research is the realization that we really are the kind of unique population we have always thought we were,” she said.

Dr. Erica Woodahl of the UM School of Pharmacy said the CPAC members have taught the researchers a tremendous amount about the cultural proper ways to interact with the tribal population involved in the research project. “We have built trust upon that relationship,” she said, adding that oncologist Dr. Pat Beatty of the Montana Cancer Institute is the driving force behind the research effort.

“The relationship has bore fruit and we hope to build more upon it in the future,” said UM School of Pharmacy professor, Dr. Liz Putnam. “Our partners have told us a lot about communication with the tribal community.”

And both sides are the better informed because of the appropriate communication connection. Lives are dependent upon that openness and mutual understanding of the other.