Compared Perspectives of Arab Patients in Palestine and Israel on the Role of Complementary Medicine in Cancer Care

Ben‐Arye, Eran; Hamadeh, Amneh M.A.; Schiff, Elad; Jamous, Rana M.; Dagash, Jamal; Jamous, Rania M.; Agbarya, Abed; Bar-Sela, Gil; Massalha, Eias; Silbermann, Michael; Ali‐Shtayeh, Mohammed S.

doi:10.1016/j.jpainsymman.2014.10.006

Cited by 19 publications

(12 citation statements)

References 17 publications

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“…In the study conducted at the Wattani Hospital in Nablus, 53 of 100 patients with cancer reported using Alanda during chemotherapy. This contrasted greatly with the findings of a previous study which took place at the same hospital between December 2010 and June 2012 16 . In the earlier study, despite a high prevalence of herbal medicine use reported by patients, no mention was made of Alanda or related products.…”

Section: Resultscontrasting

confidence: 88%

Exploring an herbal “wonder cure” for cancer: a multidisciplinary approach

Ben‐Arye

Mahajna

Aly

et al. 2016

J Cancer Res Clin Oncol

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Context and objectives The unmonitored use of herbal medicinal remedies by patients with cancer presents a significant challenge to oncology healthcare professionals. We describe an increasingly popular herbal "wonder drug", Ephedra foemina (Alanda in Arabic), whose use has spread from the Palestinian patient population throughout the Middle East. We conducted a multi-centered and multidisciplinary collaborative research effort in order to understand the potential benefits and harms of this popular herbal remedy. Methods We conducted an in-depth search of the medical literature, both traditional and modern, for any mention of the clinical use of Alanda for the treatment of cancer. We then tested the remedy, first for toxic ephedra alkaloid components and then for anti-cancer effects, as well as effects on the cytotoxic activity of chemotherapy agents (cisplatin, carboplatin) on breast cancer cell cultures. Results We found no mention in the literature, both conventional and traditional, on the use of Alanda for the treatment of cancer. Laboratory testing did not find any toxic components (i.e., ephedra alkaloids) in the preparation. However, in vitro exposure to Alanda led to a reduced cytotoxic effect of chemotherapy on breast cancer cell cultures. Conclusions The use of an integrative ethno-botanical, laboratory and clinical research-based approach can be extremely helpful when providing non-judgmental and evidence-based guidance to patients with cancer, especially on the use of traditional herbal medicine. The effectiveness and safety of these products need to be examined by integrative physicians (IPs) who are dually-trained in both complementary medicine and supportive cancer care.

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Section: Resultscontrasting

confidence: 88%

Exploring an herbal “wonder cure” for cancer: a multidisciplinary approach

Ben‐Arye

Mahajna

Aly

et al. 2016

J Cancer Res Clin Oncol

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“…The absence of a validation process for the questionnaire used in the currentstudy needs to be addressed in future research. This questionnaire was designed based on insights gleaned from an HCP focus group, as well as from a previous validated patient‐oriented questionnaire that had been administered to patients with cancer in Israel and the Palestinian Authority . The use of CTM was based solely on the reports of oncology HCPs and not on those of their patients.…”

Section: Discussionmentioning

confidence: 99%

“…This questionnaire was designed based on insights gleaned from an HCP focus group, as well as from a previous validated patient-oriented questionnaire that had been administered to patients with cancer in Israel and the Palestinian Authority. 34,35 The use of CTM was based solely on the reports of oncology HCPs and not on those of their patients. As such, we could not explore any associations between the prevalence of herbal medicine use and demographic factors such as socioeconomic conditions or patients' motives to use herbal medicines (eg, CTM use as a more affordable treatment option).…”

Section: Discussionmentioning

confidence: 99%

“…The term “complementary traditional medicine” (CTM) was used to describe those therapies that are considered to be alternative, natural, folk/traditional, complementary, or integrative medicine. The study questionnaire was based on a validated questionnaire that was developed by us in a previous study that explored the perspectives of patients in Israel and Palestine regarding the integration of CTM within supportive cancer care . The study questionnaire was reviewed by a focus group of 12 HCPs from a variety of age and sex groups, religious self‐definitions, and cultural backgrounds, as well as other HCPs working in an oncology setting and with training in CTM.…”

Section: Methodsmentioning

confidence: 99%

“…The study questionnaire was based on a validated questionnaire that was developed by us in a previous study that explored the perspectives of patients in Israel and Palestine regarding the integration of CTM within supportive cancer care. 34,35 The study questionnaire was reviewed by a focus group of 12 HCPs from a variety of age and sex groups, religious self-definitions, and cultural backgrounds, as well as other HCPs working in an oncology setting and with training Risks Associated With Herbal Use/Ben-Arye et al Cancer February 15, 2016 in CTM. The English version of the questionnaire was again reviewed by 16 researchers from 11 Middle-Eastern countries, all of whom were members of the Middle East Cancer Consortium (MECC).…”

Section: Study Questionnairementioning

confidence: 99%

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Potential risks associated with traditional herbal medicine use in cancer care: A study of Middle Eastern oncology health care professionals

Ben‐Arye

Samuels

Goldstein

et al. 2015

Cancer

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113

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BACKGROUND The authors assessed the use of herbal medicine by Middle Eastern patients with cancer, as reported by their oncology health care professionals (HCPs). Herbal products identified by the study HCPs were evaluated for potential negative effects. METHODS Oncology HCPs from 16 Middle Eastern countries received a 17‐item questionnaire asking them to list 5 herbal products in use by their patients with cancer. A literature search (PubMed, Micromedex, AltMedDex, and the Natural Medicine Comprehensive Database) was conducted to identify safety‐related concerns associated with the products listed. RESULTS A total of 339 HCPs completed the study questionnaire (response rate of 80.3%), identifying 44 herbal and 3 nonherbal nutritional supplements. Safety‐related concerns were associated with 29 products, including herb‐drug interactions with altered pharmacodynamics (15 herbs), direct toxic effects (18 herbs), and increased in vitro response of cancer cells to chemotherapy (7 herbs). CONCLUSIONS Herbal medicine use, which is prevalent in Middle Eastern countries, has several potentially negative effects that include direct toxic effects, negative interactions with anticancer drugs, and increased chemosensitivity of cancer cells, requiring a reduction in dosedensity. Oncology HCPs working in countries in which herbal medicine use is prevalent need to better understand the implications of this practice. The presence of integrative physicians with training in complementary and traditional medicine can help patients and their HCPs reach an informed decision regarding the safety and effective use of these products. Cancer 2016;122:598–610. © 2015 American Cancer Society.

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Modeling Integrative Oncology for the Arab Population in Northern Israel

Ben‐Arye

Dagash

2016

Cancer Care in Countries and Societies in Transition

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Compared Perspectives of Arab Patients in Palestine and Israel on the Role of Complementary Medicine in Cancer Care

Cited by 19 publications

References 17 publications

Exploring an herbal “wonder cure” for cancer: a multidisciplinary approach

Exploring an herbal “wonder cure” for cancer: a multidisciplinary approach

Potential risks associated with traditional herbal medicine use in cancer care: A study of Middle Eastern oncology health care professionals

Modeling Integrative Oncology for the Arab Population in Northern Israel

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