Use of Complementary and Alternative Medicine, CAM, among Cancer Patients in Northern West Bank, Palestine

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Amneh "Mohammed Adel" Hamadah
Use_of_Complementary_and_Alternative_Medicine,_CAM,_among_Cancer_Patients_in_Northern_West_Bank,_Palestine.pdf1.04 MB

Background: The use of complementary and alternative medicine (CAM) by cancer patients is very common and varies between populations and has increased over the last decade all over the world. This study was conducted to define the prevalence, pattern of use, and factors influencing the use of CAM by Palestinian cancer patients. Objectives: To evaluate the extent of CAM use among cancer patients in Northern West Bank, and investigate the antioxidant activity of the main five plants used by cancer patients. Methods: This is a cross–sectional study involving the direct administration of questionnaire to all cancer patients seen at the Oncology Department, Wattani Hospital, Nablus, PA, from Dec 2010 to June 2011. Five of the most used plants were tested for antioxidant activity by determination of total phenolic compounds, total flavonoid concentration, DPPH, and B-Carotene–Linoleic assays. Results: A total of 300 cancer patients were interviewed; 65 (21.67%) were males and 235(78.33%) were females. Ages ranged from one year to 85years. Breast cancer 81(27%), colon 29(9.67%), liver and skin 16(5.33%) were predominated. 165 (55%) patients have used CAM at some time during their current cancer illness; 135 (45%) patients have not used any form of CAM. There were more females than males among the CAM users. The use of CAM was not affected by age, marital status, level of education, religion, place of birth, and residence but significantly associated with breast cancer and stage of treatment chemotherapy. The most frequently used CAMs were, herbs 153(92.73%), animal products 132 ( 44% ) especially honey 98(32.67%), prayers and Koran, oil treatment and Folk remedy. Most CAM users 118 (39.33%) were achieved the sought effects, but 38 (12.67%) did not. The majority of patients 104 (34.67%) did not discuss their use of CAM with their doctors- mostly because doctors did not believe. Friends 90 (30%) and family members 89(29.67%) were the main referrals for CAM use. Most of CAM users reported that they used CAM because they believed it strengthen the immune system, curing disease, slow down progress of disease, relief of symptoms and reducing medication side effects. The most five plants used by cancer patients were Arum palaestinum, Nigella ciliaris, Phoenix dactylifera, Matricaria aurea, Citrus limon. Ethanolic and water extracts of these plants were investigated by determination of total phenolic compounds, total flavonoid concentrations, DPPH, and carotene-Linoleic acid assays using different concentrations of extracts and DPPH. The scavenging effect against DPPH was calculated as mg/ml IC50 compared to α-tocopherol, the higher the concentration of extracts the higher the inhibition effect and in ethanolic extracts more than water extracts. Phoenix dactalifera had the highest free radical scavenging capacity while Citrus limon had the highest of total flavonoid and phenolic compounds concentration. Matricaria aurea had the least B-carotene degradation compared to synthetic α-tocopherol. Conclusion Our study confirms that CAM use is common among cancer patients in Northern Wes Bank, Palestine. It is significantly associated with breast cancer and stage of treatment chemotherapy and most common in females than males. Most of patients achieve the sought effects, and did not discuss CAM use with doctors. Friends and family members were the most referrals for CAM use. The most five plants used were tested for antioxidant activities using DPPH, Carotene-linoleic acid assay, total flavonoid concentrations, and total phenolic compounds concentration. Citrus limon, Nigella ciliaris, Phoenix dactylifera and Matricaria aurea were the most plants had antioxidant activities but Arum palaestinum soaked in water dried, and boiled revealed antioxidants activity but the less compared to others. These plants can be used for cancer treatment either by killing tumor cells or reducing its number and strengthen the immune system of patients.