Potential risks associated with traditional herbal medicine use in cancer care: A study of Middle Eastern oncology health care professionalsAuthorsEran Ben-Arye MD,Noah Samuels MD,Lee Hilary Goldstein MD,Kamer Mutafoglu MD,Suha Omran PhD,Elad Schiff MD,Haris Charalambous MD,Tahani Dweikat BSN,Ibtisam Ghrayeb BSN, MSN,Gil Bar-Sela MD,Ibrahim Turker MD,Azza Hassan MD,Esmat Hassan PhD,Bashar Saad PhD,Omar Nimri MD,Rejin Kebudi MD,Michael Silbermann DMD, PhDFirst published: 24 November 2015Full publication historyDOI: 10.1002/cncr.29796 View/save citationCited by (CrossRef): 7 articles Check for updates Citation toolsWe thank Dr. Jamal Dagash and Dr. Ariela Popper-Giveon for their contribution to the study design. We would also like to thank the following for their contribution in the monitoring of data acquisition and analysis: Dr. Orit Gressel-Raz, Ms. Ronit Leibowitz, Ms. Shimrit Roni, Mr. Shmuel Attias, and Ms. Sarah Ben Shlush.AbstractBACKGROUNDThe 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.METHODSOncology 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.RESULTSA 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).CONCLUSIONSHerbal 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.