A patient

Note: This article is a sidebar to this issue's feature story, "On Cancer’s Trail."

Kathleen Tsosie sits in the waiting room of the San Juan Regional Cancer Center in Farmington. A one-year breast cancer survivor, she has just received devastating news: A new growth has been spotted in her remaining, healthy breast. Dressed in a turquoise blouse accented by silver jewelry, her hair growing back stylishly after chemotherapy, Tsosie now awaits an ultrasound. She looks worried.

She had hoped the cancer was behind her, even though she faces another five to seven years of treatment with tamoxifen, a drug given to prevent estrogen from binding to mammary cells. "In our community, cancer is a death sentence," says Tsosie, who was diagnosed a year ago, when she was 47. "People think you don't recover. Now I find out you survive. You want to live when that word cancer comes around. When I first heard I had cancer, I thought it was a mistake. Then I flipped out. I thought, "Oh my God, who is going to take care of my children and grandkids?' ... So many things go through your mind. I have to do this, accomplish this." She starts to cry quietly.

"Why? You always ask yourself, "Why?' " Tsosie says, fingering the silver bracelets on her left arm. Like many breast cancer patients, she is working through the emotional stages: shock, fear, anger and a desire to assign blame. Was it pesticide exposure in childhood? Not enough broccoli, or too many hormone-laced meats? There are many possible culprits, but for Tsosie, as for many Navajo women, one villain stands out above all others. "It's obvious the uranium is related to my cancer," says Tsosie. She grew up in the town of Cove, in the northeastern corner of Arizona, which was one of the Navajo Reservation's major uranium-producing areas.

"My auntie from Tohatchi died from breast cancer," Tsosie recalls. "Our fathers worked in the mines. My father died from lung cancer when he was 45. It was the same old stories, the clothes covered with dust. We grew up in the mountains. We drank that cold water from the mine, had picnics right there, played in the tailings. We didn't know what it was. We thought it was just a pile of dirt."

Navajo Nation council delegate Phil Harrison, who is Tsosie's cousin, also grew up near Cove. "Mine waters seeped into the arroyos, and contamination sat there for decades," he says. "I would say all the water in the area was contaminated. It's finally getting cleaned up."

The cleanup is due to the efforts of Harrison, Tsosie and other activists. Even before her diagnosis, Tsosie campaigned against a proposal by Hydro Resources Inc. to open a uranium mine near Church Rock and Crownpoint. As a member of Eastern Navajo Dine Against Uranium Mining, she's testified before state representatives, made videos and given press interviews. She lobbied the Navajo Nation to pass its landmark ban on uranium mining in 2005.

Many traditional Navajos consider breast cancer to be a taboo subject, but Tsosie, a school administrator and the president of the Shiprock agency school board, is willing - even eager - to talk about it. "I don't think it's so difficult to talk about breast cancer," Tsosie says. "It's better that people know about our health, our life. It's a waking call." Tsosie still has a mother to take care of, as well as her children and grandchildren. "I've helped so many people," she says. "I don't deserve this."

• Mining