What started as a routine overnight trip to Edmonton in 2015 turned into a life-altering journey for Lianne Mantla-Look, a then 34-year-old nurse from Behchokǫ̀, N.W.T.
Mantla-Look, the first registered nurse from the Tłıcho region of the Northwest Territories, was in Edmonton with her husband gathering supplies for their new home when a call from her gastroenterologist shattered their plans.
“He asked, ‘Are you sitting down?'” Mantla-Look recalled in an interview with Yahoo News Canada. “He just said ‘You have cancer, my girl.’ That’s when I just broke down.”
Today, Mantla-Look has been cancer-free for nine years and dedicates her time to raising awareness about the barriers Indigenous Canadians in remote regions face in accessing health care.
Lianne Mantla-Look is a stomach cancer survivor and an Indigenous nurse from Behchokǫ̀, the largest First Nations community in Northwest Territories. (Image submitted by Lianne Mantla-Look)
‘I’m sorry, you have cancer’: Registered nurse becomes patient
In 2014, Mantla-Look began experiencing mild but persistent gastrointestinal issues. Despite dietary changes and increased exercise, the symptoms did not improve. Concerned, her doctor ordered tests that revealed traces of blood in stool — an unusual result for someone her age.
When her doctor referred her for a colonoscopy, the request was rejected. At 33, she was considered too young for colon cancer, and her symptoms were dismissed. Frustrated, Mantla-Look sought a second referral, this time to a gastroenterologist, which led to further testing.
I just had this horrible feeling in the pit of my stomach that this test was not going to be a good one.Lianne Mantla-Look, Indigenous nurse and cancer survivor
Mantla-Look knew the typical wait time for gastroscopy results was about two weeks, but given her understanding of the strained healthcare system and the shortage of doctors and nurses, she braced herself for a longer wait. When three weeks had passed after her last test, she was in Edmonton when the call came. The diagnosis: stomach cancer.
‘Everything happened really fast at that point,” she shares. “The doctor’s office was dealing with medical travel on my behalf because living in the Northwest Territories is a geographical nightmare when it comes to attending appointments down south.”
Photo of Lianne Mantla-Look following her admittance to hospital on the day of her cancer diagnosis. (Image supplied by Lianne Mantla-Look)
Mantla-Look shares the treatment required for her diagnosis would require the removal of her complete stomach, as well as surrounding lymph nodes and parts of her esophagus and intestines.
“My surgery took approximately 10 hours and the recovery following was the most pain I had ever felt,” she says. “Most of the time I had taken care of other people and this time it was me in the hospital bed. I didn’t know how to deal with it.”
In addition to recovering from major surgery, Mantla-Look found herself fighting another battle — one with the hospital. Despite her condition, she says staff repeatedly tried to discharge her, eager to free up her bed.
But Mantla-Look wasn’t giving up. Now, 43 and nine-years cancer-free, she has defied the odds in more ways than one. Not only did she survive, but she also welcomed a daughter into the world — something her surgeon once believed would be impossible after her stomach was removed.
“When it came to my own care, I’m not sure where I would be if I didn’t push my doctors for that colonoscopy referral when I knew there was something wrong with me. Probably dead,” shares Mantla-Look.
‘Strong like two people’: Bridging the gap between worlds
Mantla-Look believes it’s crucial for Indigenous patients to be empowered and informed so they can advocate for themselves.
Her own journey through cancer and the healthcare system has raised a troubling question: how often do Indigenous patients receive sub-par care, particularly when they’re too afraid or unable to speak up? She worries about how many are left to navigate unfamiliar southern hospitals, far from home and family, without the support they desperately need.
Indigenous communities in Canada have significantly higher rates of stomach cancer than non-Indigenous populations, according to the National Institute of Health. Research shows northern Indigenous men have rates 2.7 times higher, and Indigenous women in the Northwest Territories have rates 3.1 times higher than the national average.
Geographical distance poses a significant barrier to healthcare for many in the North and across Indigenous communities in Canada. In the Northwest Territories, residents must travel all the way to Alberta for essential services like cancer care or specialized surgeries, such as a total gastrectomy, leaving them far from home when they need support the most.
While Mantla-Look was fortunate to have travel benefits as a government employee, most patients don’t have that luxury. For those needing emergency treatment in Edmonton, a one-way flight can cost anywhere from $562 to $865, adding a significant financial burden on top of their health struggles.
Cost of short-notice one-way flight from Yellowknife, N.W.T., to Edmonton, Alta. (Screengrab Google Flights)
Mantla-Look says that building trust with Indigenous peoples in healthcare is a major element to creating a system that serves communities nationwide.
‘We just have a long history of being marginalized and long history of systemic discrimination,” says Mantla-Look. ‘It’s so key to building trust and a relationship.”
One of the key elements to building that trust is language, Mantla-Look says.
Language barriers create significant challenges in accessing healthcare. When patients can’t speak English, critical information may be miscommunicated to healthcare providers.
Mantla-Look says her ability to speak Tłı̨chǫ encourages patients to open up about their health concerns in ways they might not with non-Indigenous doctors and nurses. She notes that many healthcare providers in the North are transient, making patients hesitant to build trust. As a result, it can take months for them to share the full scope of their health issues.
“I called this elderly lady in from the waiting room and she seems a little bit nervous when she saw me,” Mantla-Look recalled. “I sat down and before I even had a chance to speak, she said to me in broken English asking about an interpreter. I looked at her and I said to her, why do you need an interpreter, I can understand you and I can speak to you just fine by myself.”
“Just this look of shock on her face,” said Mantla-Look. “She burst out laughing and said ‘I thought you were white.'”
She believes trust is fostered when healthcare providers embrace cultural understanding and create space for diverse identities within the system.
“We have this saying that’s called Strong Like Two People, and this refers to being both comfortable in the Western AKA ‘white world’ but still maintaining your own culture, language and identity,” shared Mantla-Look.
Mantla-Look recently became part of the My Gut Feeling — a volunteer-run Canadian non-profit organization founded by two stomach cancer survivors to provide support to patients, survivors and caregivers by providing peer-to-peer support, education, awareness and advocacy as they go through their cancer journey.