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

Limor Almog, Efraim Lev, Elad Schiff, Shai Linn, Eran Ben-Arye

Research output: Contribution to journalArticlepeer-review


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.

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.

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.

Original languageEnglish
Pages (from-to)2793-2804
Number of pages12
JournalSupportive Care in Cancer
Issue number10
StatePublished - Oct 2014

Bibliographical note

Publisher Copyright:
© 2014, Springer-Verlag Berlin Heidelberg.


  • Chemotherapy
  • Cross-cultural medicine
  • Drug interactions
  • Herbal medicine
  • Integrative oncology
  • Traditional medicine

ASJC Scopus subject areas

  • Oncology


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