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Bridging cross-cultural gaps: monitoring herbal use during chemotherapy in patients referred to integrative medicine consultation in Israel

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Abstract

Introduction

The high prevalence of the use of traditional herbs among patients with cancer is a cause for concern with regard to potentially adverse interactions with conventional oncology treatments. In this study, we explore herbal use among patients with cancer in northern Israel who are referred by their health care providers to complementary and traditional medicine (CTM) consultations provided to them within the conventional oncology department. The study’s objectives were to identify which herbs patients use and to examine the scope of current research on the efficacy and safety regarding the identified herbs.

Patients and methods

Herbal use by patients receiving oncology care was assessed prospectively from July 2009 to July 2012 by integrative physicians (IPs) trained in herbal medicine. Historical, ethnobotanical, basic research, and clinical data regarding the identified herbs were explored by using a keyword search in PubMed and Middle Eastern ethnohistorical literature.

Results

Disclosure of herbal use was reported by 154 of the 305 patients (50.5 %) interviewed by IPs. The use of 85 single herbs and 30 different herbal formulas was documented during the initial or follow-up IP assessments. Patients reported 14 quality of life-associated indications for herbal use. The ten most prevalent herbs displaying in vitro/in vivo anticancer activity and nine other herbs were preliminarily assessed concerning potential risks, safety, and interaction with chemotherapy.

Conclusions

Herbal use by patients with cancer in northern Israel is widespread and calls for further study in order to address issues of safety and effectiveness. We recommend constructing a multinational and multidisciplinary team of researchers with ethnopharmacological and clinical expertise that will explore the use of herbs among patients with cancer in a cross-cultural perspective attuned with patients’ affinity to traditional herbal medicine.

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Acknowledgments

We thank Ms. Marianne Steinmetz for editing the English manuscript.

Conflict of interest

The authors have declared no conflicts of interest.

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Authors and Affiliations

  1. Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, 35 Rothschild St., Haifa and Western Galilee District, Haifa, Israel

    Limor Almog & Eran Ben-Arye

  2. Graduate Studies Authority, University of Haifa, Haifa, Israel

    Limor Almog

  3. Department of Eretz Israel Studies, University of Haifa, Haifa, Israel

    Efraim Lev

  4. Department of Internal Medicine, Bnai-Zion Hospital, Haifa, Israel

    Elad Schiff

  5. Department for Complementary/Integrative Medicine, Law and Ethics, The International Center for Health, Law and Ethics, University of Haifa, Haifa, Israel

    Elad Schiff

  6. School of Public Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel

    Shai Linn

  7. Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    Eran Ben-Arye

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  1. Limor Almog
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  2. Efraim Lev
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Correspondence to Eran Ben-Arye.

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Almog, L., Lev, E., Schiff, E. et al. Bridging cross-cultural gaps: monitoring herbal use during chemotherapy in patients referred to integrative medicine consultation in Israel. Support Care Cancer 22, 2793–2804 (2014). https://doi.org/10.1007/s00520-014-2261-9

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