Stepping from traditional to integrative medicine: perspectives of Israeli-Arab patients on complementary medicine's role in cancer care

• Published in: Annals of oncology Vol. 25; no. 2; pp. 476 - 480
• Main Authors: Ben-Arye, E., Massalha, E., Bar-Sela, G., Silbermann, M., Agbarya, A., Saad, B., Lev, E., Schiff, E.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.02.2014; Oxford University Press
• Subjects: Antineoplastic agents; Arabs; Biological and medical sciences; complementary medicine; cross-cultural medicine; doctor–patient communication; Humans; Integrative Medicine; Israel; Medical sciences; Medicine, Traditional; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasms - therapy; Oncology Service, Hospital; Pharmacology. Drug treatments; Quality of Life; Surveys and Questionnaires; traditional Arab medicine; Tumors; Israel; complementary medicine; cross-cultural medicine; integrative medicine; quality of life; traditional Arab medicine; doctor–patient communication; Human; doctor-patient communication; Malignant tumor; Care; Quality of life; Physician patient relation; Folk medicine; Alternative medicine; Cancer
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdt554

Limited research is available on the perspectives of patients with cancer regarding integration of complementary medicine (CM) in conventional supportive cancer care. The purpose of this study was to explore patients' perspectives concerning CM integration within conventional oncology settings. A 27-item questionnaire was constructed and administered to a convenient sample of Arab patients receiving cancer care in three oncology centers in northern Israel. Of the 324 respondents (94.7% response rate), 124 of 313 (39.6%) reported the use of CM for cancer-related outcomes. A logistic regression model indicated that CM was used with active chemo- or radiotherapy treatment [EXP [B], 2.926, 95% confidence interval (CI) 1.276–6.708; P = 0.011] and a higher degree of spiritual quest (EXP [B], 3.425, 95% CI 1.042–11.253; P = 0.043). Herbal medicine was the leading CM modality (87.9% of CM users), which included the use of 28 plants and traditional remedies, of which 17 were used to improve QOL, with 5 of the herbs having potential interactions with chemotherapy. 83.1% of respondents stated that they would consult with a CM provider if CM were to be integrated into the oncology department. Patients’ expectation of CM consultation was clearly associated with expectations of QOL improvement, coping with cancer, and alleviating chemotherapy's side-effects when compared with expectations of cancer cure (P < 0.0001). The three leading concerns which patients expected to be improved by integrative CM treatment were gastrointestinal symptoms (63.2%), fatigue (51.9%), and pain (40.5%). Integrative CM consultations should focus on the improvement of QOL concomitant with safety concerns regarding potential drug–herb interactions. The need to integrate a nonjudgmental yet evidence-based CM consultation service may also be applicable to oncology institutions challenged with culturally diverse populations with a high prevalence of traditional medicine use.