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Cancer. 2016 Feb 15;122(4):598-610. doi: 10.1002/cncr.29796. Epub 2015 Nov 24.

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

Author information

1
Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel.
2
Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
3
Tal Center for Integrative Oncology, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel.
4
Clinical Pharmacology Unit, Haemek Medical Center, Afula, Israel.
5
Center for Palliative Care Research and Education, Dokuz Eylul University, Inciralti Izmir, Turkey.
6
Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan.
7
Department of Internal Medicine and Integrative Medicine Service, Bnai-Zion Hospital, Haifa, Israel.
8
Department for Complementary Medicine, Law and Ethics, The International Center for Health, Law and Ethics, Haifa University, Israel.
9
Bank of Cyprus Oncology Center, Nicosia, Cyprus.
10
Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.
11
Makassed Charitable Hospital, East Jerusalem, Israel.
12
Division of Oncology, Rambam Health Care Campus, Haifa, Israel.
13
Dr. A.Y Ankara Oncology Training and Research Hospital, Ankara, Turkey.
14
National Center for Cancer Care and Research, Doha, Qatar.
15
Botany Department, National Research Centre, Dokki, Giza, Egypt.
16
Qasemi Research Center, Al-Qasemi Academy, Baqa El-Gharbia, Israel.
17
Faculty of Arts and Sciences, Arab American University, Jenin, Palestinian Authority.
18
Department of Cancer Prevention, Ministry of Health, Amman, Jordan.
19
Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
20
Middle East Cancer Consortium, Haifa, Israel.

Abstract

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 dose-density. 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.

KEYWORDS:

complementary traditional medicine; drug-herb interaction; integrative medicine; physician-patient communication; quality of life

PMID:
26599199
DOI:
10.1002/cncr.29796
[Indexed for MEDLINE]
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