Purpose/Objectives: To describe the experiences of American Indian and Alaska Native cancer survivors to improve understanding of the trajectory of cancer treatment.
Research Approach: Qualitative focus group research.
Setting: Rural and geographically isolated American Indian and Alaska Native communities in the Pacific Northwest.
Participants: 30 American Indian and Alaska Native cancer survivors or caregivers.
Methodologic Approach: The authors analyzed data from two focus groups with cancer survivors by using thematic analysis informed by indigenous methodologies.
Findings: Based on focus group findings, the authors developed a conceptual model of the cancer experience called Rough Waters. Participants described their cancer experience as a collective journey involving family and friends and requiring resources to offset challenges along the way. Dominant themes were delays, isolation, communication, money, advocacy, spirituality, and family involvement.
Conclusions: American Indians and Alaska Natives in the Pacific Northwest have special cultural needs during cancer care. The current study provides examples that can guide patient–provider interactions.
Interpretation: Using the metaphor of cancer as a journey, clinicians can begin a dialogue to identify what will impede or assist the cancer journey for their American Indian and Alaska Native patients.