Improving cancer care for Indigenous communities

Venturing into research

For most of his career, Dr Gary Groot, a general surgical oncologist, did not see himself as someone who did research, but rather, someone who consumed research.

However, after spending years as the department head of surgery for the Saskatoon Health Region, Dr Groot decided to begin an academic career in 2015, pursuing a PhD in community health epidemiology. Dr Groot’s transition into research has allowed him to contribute to changing the healthcare system.

When I treat a patient, I make a difference in one person’s life. But if I do research that changes the system, that has an impact on hundreds and thousands of people’s lives. The impact factor is so much greater when I’m involved with research.
Headshot of Dr Groot
Dr Gary Groot

Supporting Indigenous healing

After shifting into research, Dr Groot took an interest in improving the quality of cancer care in Indigenous communities.

Dr Groot worked with the Ministry of Health to co-lead their health quality improvement program for physicians, developing an understanding of how shared decision-making works and for whom. He used this as a starting point to work closer with Indigenous communities in Saskatchewan.

Through years of background work, which included interviews with Indigenous elders and people living with cancer, Dr Groot learned about their cultures and the challenges they faced during their cancer experiences. They told Dr Groot stories that centred on the strengths of their communities and how those strengths helped them during their cancer experiences.

“They wanted to focus on the things in their own communities that historically would have been strong for them but have been neglected over time,” Dr Groot says. “They’re a strong people who have lots of historical injustice that needs to be considered and often isn't. A strengths-based approach to the Indigenous cancer journey is definitely necessary.”

As Dr Groot connected with more members of Indigenous communities, he observed their different worldviews and as a result, different approaches to treatment.

“To work in those communities well and to understand their concerns well, you have to really be patient and you have to understand that a pan-Indigenous approach isn’t appropriate,” he says. “In terms of the scope of Indigenous worldviews, not everybody has the same approach. The worldview is not one worldview, but many worldviews. There are some people who want to use traditional medicine mostly or entirely, some that want to use Western medicine entirely, and a large percentage that straddle the two.”

When it comes to bringing traditional healing into everyday practice, Dr Groot notes that the current system is moving towards supporting Indigenous people trying to find ways to use their own traditional medicine when possible.

“The elders that I was working with told me not to think in terms of integration, so much as support,” he shares.

I think I learned a lot from them as to how they can live well. They have the answers for their own people about what living well means traditionally. They want to revitalize that culture where possible.

Today, Dr Groot’s research is almost entirely patient-engaged research, and increasingly guided by people living with cancer and elders. Dr Groot co-creates research with them and they provide their perspective and lived experiences.

“I don’t feel like it’s my research anymore. I think it’s mostly research that belongs to them and I help out where I can,” he says.

Cancer treatment and worldview

Dr Groot’s approach to cancer treatment emphasizes the importance of understanding different worldviews and needs.

“Is it important that they live 3 more months, or is it more important that they are in good relationships with their family and friends? There isn't a right answer, but I think the Indigenous people take that more holistic approach to their illness by and large,” he says. “We tend to compartmentalize a lot more and be more individualistic and very much focused on survival. And I think that we have a lot to learn from them. I think there's a lot of Western people that think the same way, it’s just that our system doesn't function that way.”

I think we have something to learn from the Indigenous community. We won't totally succeed until we recognize that we have things to learn too.

Dr Groot believes that when it comes to cancer research, the value isn’t just in the research itself, but change within the healthcare system.

“When we change the system, when we don’t do it the same way over and over again, that’s when we’re going to see results. And we do see results.”