Māori need culturally safe cancer research

Wed Mar 23 2016 13:00:00 GMT+1300 (New Zealand Daylight Time)

Māori need culturally safe cancer research

23 March 2016

Research Fellow, Dr Kimiora Henare, ACSRC.

Genomic sequencing looks set to transform healthcare and it is essential that Māori do not miss out on the benefits of these advances, according to cancer researcher, Dr Kimiora Henare.

Historic mishandling of samples and data, particularly from indigenous populations both in New Zealand and overseas, has contributed to mistrust between Māori and the biomedical community.

Some research groups are making a concerted effort to understand and incorporate key Māori values into their research, to ensure that their research is culturally safe and inclusive.

Dr Henare is looking at ways to build Māori research capability and to develop tikanga for cancer research, to ensure that it is not only scientifically robust, but is also culturally safe for Māori.

Once these things are in place, he expects more Māori will want to participate.

“If personalised medicine is the future for cancer therapy and Māori participation doesn’t increase in terms of getting their genomes sequenced for that treatment, the risk is many are going to miss out on access to cancer care and the discrepancies in health outcomes could get bigger,” he says. “This extends to the need for more Māori researchers driving this type of work as well”.

Dr Henare is a cancer research scientist at the Auckland Cancer Society Research Centre that is based at the University of Auckland. He comes from a background in biomedical science and has done all his post-graduate study at the University and Auckland Cancer Society Research Centre.

His affiliations are to Te Aupouri and Te Rarawa, with connections to Whangape, just north of the Hokianga Harbour and southwest of Kaitaia area on Northland’s west coast.

In 2014 he was awarded a four-year Eru Pomare Research Fellowship from the Health Research Council of New Zealand, and his lab work at the Centre focusses on investigating how to re-educate immune cells to combat cancer, working alongside Associate Professor Lai-Ming Ching and her research team.

He looks at macrophages, normal cells that carry out a wide range of tasks that include getting rid of debris, pathogens, and cancer cells, helping to repair wounds, or to shut down an immune response.

But in cancer, some of the tumours have learned to exploit the macrophages to help the tumours grow and survive.

“These tumours are pretty cunning, but we are developing ways to re-educate the macrophages to stop the tumours from growing instead,” says Dr Henare. “Looking into the future, these could work in tandem with some of the new exciting immune therapies, like Pembrolizumab for melanoma.”

“If we can nail a strategy like this and get it to work in humans, it could complement those drugs and help their activity,” he says. “It could potentially help more patients become suitable candidates for those drugs as well.”

In addition to his interests in immune-based therapies for cancer, another facet of his work was to develop a road-map of cultural engagement for scientists.

Kimiora is attending the World Indigenous Cancer Conference in Brisbane in early April to present this work developed with the NETwork project, led by Professors Cris Print and Michael Findlay, and Dr Ben Lawrence.

The project authors presented their work at the New Zealand Society for Oncology conference in November entitled, ‘PUKUmahi!: Kia whai te huarahi tika. NETwork! Roadmap for safe travel: Ensuring health benefits flow on to Māori’.

“I joined the research team to create the roadmap for cultural engagement for their nationwide genomic project looking at understanding neuroendocrine cancer in New Zealand,” he says. Developing a culturally safe research structure is an important aspect of their research goals, in order to ensure that the research benefits extend to all New Zealanders

The conference audience will include research scientists and clinicians talking about cancer in indigenous populations. Most will be clinicians, people who work in indigenous communities, indigenous advocacy groups, social scientists, population health scientists and biomedical scientists.

Kimiora is concerned that there are so few Māori biomedical scientists in Aotearoa. For many years, he was involved in the Tuakana programme at the University’s School of Biological Sciences that works to improve retention of Māori and Pacific Island students in their first year of science.

“If Māori science students can be retained in that first year they can go on to do great things – there’s a lot of evidence to show that,” he says. “Quite a few students then go into medicine which is great.”

“I’d like to see more Māori getting into biomedical sciences and to actively do the research,” says Kimiora. “My long term goal is to create a culturally safe research environment to facilitate capacity building for Māori within this space. Understanding how tikanga can be appropriately incorporated into the cancer research lab environment is essential for that”.

“Māori are disproportionately affected by cancer and their mortality is much higher,” says Dr Henare. “There are all sorts of reasons for that including some healthcare discrepancies that need addressing.”

“For culturally safe science to happen there needs to be a higher best practice standard adopted by all researchers doing this type of work,” he says.

“If we can increase the numbers of Maori biomedical scientists, then we can realistically have more Māori -centred and Māori controlled biomedical research,” says Dr Henare.

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