Noah Samuels

Sheba Medical Center, Gan, Tel Aviv, Israel

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Publications (52)95.67 Total impact

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    ABSTRACT: Context and objectives The use of complementary and traditional medicine (CTM ) in Middle Eastern countries is widespread, including among patients with cancer. Perspectives of oncology healthcare professionals (HCPs) in this region regarding the integration of CTM within conventional supportive cancer care were explored. Methods An 11-item questionnaire with an open-ended question asking respondents to comment about the integration of CTM within supportive cancer care was sent to Middle Eastern oncology HCPs, using snowball sampling methodology. The narratives provided were examined using thematic analysis. Results A total of 339 oncology HCPs completed and returned the study tool (80.3 % response rate ), of which 178 from 15 Middle Eastern countries responded to the open-ended question. The majority of respondents are in favor of the integration of CTM within supportive cancer care, though ideas on how this should be implemented varied. Thematic analysis identified multifactorial barriers to integration, which focused on HCPs’ perspectives (e.g., a lack of knowledge and training; a skeptical approach to CTM), attitudes of patients and caregivers (e.g., unrealistic expectations regarding the outcomes of CTM treatments) and HCP–patient communication. In order to overcome these barriers, respondents suggested education and training programs for oncology HCPs which would focus on improving patients’ quality-of-life-related outcomes. Conclusions Middle Eastern oncology HCPs support the integration of CTM within supportive cancer care, while recognizing the need for education and training in this field. A better understanding of CTM would provide the knowledge and skills which would promote a non-judgmental, evidence-based approach, fostering better communication with patients.
    No preview · Article · Feb 2016 · Journal of Cancer Research and Clinical Oncology
  • Eran Ben-Arye · Noah Samuels · Elad Schiff · Ofer Lavie

    No preview · Article · Jan 2016 · Supportive Care Cancer
  • Eran Ben-Arye · Noah Samuels
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    ABSTRACT: In this editorial, the authors comment on a recently published review paper by Molassiotis et al. on the developments made over the past 40 years in supportive care for patients with lung cancer. During this period, a paradigm shift promoting patient-centered care (PCC) has led to an important change in the approach of supportive cancer care, from a purely disease-centered approach, measuring survival-related outcomes, to recognizing the importance of quality of life outcomes as well. This change of understanding in supportive and palliative care for patients with lung cancer can be further advanced through the understanding that there is a need to address bio-psycho-spiritual concerns and health belief models, within the context of the family socio-cultural environment, for both patients and their caregivers. There is also a need to address the psycho-spiritual effects of cancer on those health care professionals treating patients with lung cancer, in order to reduce compassion fatigue and increase resilience. Future directions for supportive care for patients with lung cancer may include the development of a patient-tailored treatment approach, assisted by the integration of a multidisciplinary team of health care providers and evidence-based complementary medicine practices, within conventional supportive care practice.
    No preview · Article · Dec 2015
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    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 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 2015. © 2015 American Cancer Society.
    No preview · Article · Nov 2015 · Cancer
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    ABSTRACT: Objective: Patients undergoing chemotherapy frequently suffer from gastrointestinal (GI) symptoms and functional difficulties in preparing and eating meals. We conducted a qualitative assessment of an integrative cuisine workshop program designed for patients receiving chemotherapy, examining the effects of the program on patient-reported GI symptoms and nutritional challenges. Patients and methods: Patients were referred to a complementary/integrative medicine (CIM)-trained physician for consultation, followed by a patient-tailored treatment program. Patients with GI-related symptoms and nutritional concerns were offered a two-session integrative cuisine workshop program. The effects of the workshops were examined using inductive and deductive qualitative research methodologies. Patient narratives, as recorded in the Measure Yourself Concerns and Wellbeing (MYCAW) study tool, and electronic medical files were analyzed. Results: Of 125 patients referred to the integrative cuisine program, 86 participated in at least one workshop. Participants and non-participants had similar demographic and disease-related characteristics, as well as quality-of-life (QOL)-related concerns. Inductive analysis suggested that participation in the workshops was helpful in developing social relationships, providing emotional support, and enhancing spirituality and nutritional awareness. Implementing the recommended changes at home led to improved QOL-related outcomes. The predominant themes derived from deductive analysis were the implementation of dietary changes and improved gastrointestinal and emotional issues. Conclusions: Chemotherapy-treated patients participating in an integrative cuisine workshop program showed improved QOL outcomes, specifically GI and emotional-related symptoms, and a reduction in nutritional and functional concerns. Increased knowledge and awareness of nutrition and supplement use ultimately resulted in implementation of the CIM recommendations by patients at home.
    No preview · Article · Sep 2015 · Supportive Care in Cancer
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    ABSTRACT: The introduction of a quality of life (QOL)-centered complementary medicine (CM) consultation over the past decade has been integrated within various oncology departments in Israel and around the globe. The consultation is provided by an integrative physician (IP) trained in CM who recommends treatment options attuned with patients' expectations, concerns and QOL, while taking safety and efficacy into consideration. To identify, based on the initial IP consultation, factors predicting patients' compliance to a QOL-oriented integrative treatment. Analysis of demographic data was conducted, together with an assessment of patients' concerns and well-being as documented in a registry protocol. Dependent and non-dependent factors were compared in two groups of patients: those with a low and a high degree of adherence to the integrative consultation. Patients in the low- and high-adherence groups (83 and 160, respectively) shared similar demographic, disease- and treatment-related, as well as QOL-dependent data. Adherence to the CM treatments was higher in patients reporting prior CM use, and in patients with less severe gastro-intestinal complaints. IP assessment regarding patients' difficulties in undergoing the CM treatment process predicted low patient adherence. We recommend including an initial IP assessment of patients undergoing chemotherapy, using a structured assessment in order to identify the following factors predicting low adherence to a CM treatment program: absence of prior CM use, severe gastro-intestinal symptoms, and IP assessment of expected difficulties in implementing the treatment plan.
    No preview · Article · Mar 2015 · Harefuah
  • Noah Samuels · Ofir Morag · Yair Maimon
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    ABSTRACT: Cancer treatment-related toxicities often require dose reductions and delays. Herbal medicine use is prevalent among cancer patients. Though evidence is lacking regarding benefits in treatment outcomes and immunity, a large body of evidence supports the use of herbals for reducing treatment-induced toxicities. We present three cases where herbal medicine provided relief from side effects of anti-cancer treatment, enabling the completion of treatment protocols. In the first case, a 79 year-old female patient with metastatic breast cancer developed flushing and excessive sweating from Tamoxifen treatment. Herbal medicine reduced symptoms significantly, enabling the continuation of treatment with partial disease resolution. In the second case, a 69 year-old male with esophageal cancer terminated treatment on the adjuvant treatment protocol because of severe nausea and vomiting, diarrhea, peripheral neuropathy and fatigue. Herbal medicine reduced symptom severity and chemotherapy was reinstituted. In the third case, a 58 year-old female patient with advanced metastatic colon cancer was referred by her oncologist for treatment with herbal medicine for alleviation of fatigue and weakness, flushing and palpitations, mouth ulcers and dyspnea. Despite significant symptom reduction, with completion of treatment regimens, her disease progressed and she subsequently succumbed to the disease. In summary, the above cases illustrate potential benefits of herbal medicine in the reduction of cancer treatment-related symptoms, enabling patients to complete their anti-cancer treatment regimen. Further research examining the efficacy and safety of herbal compounds is needed, in light of potential toxicity and negative interactions with conventional treatment.
    No preview · Article · Mar 2015 · Harefuah
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    ABSTRACT: Integrative oncology incorporates complementary medicine (CM) therapies in patients with cancer. We explored the impact of an integrative oncology therapeutic regimen on quality-of-life (QOL) outcomes in women with gynecological cancer undergoing chemotherapy. A prospective preference study examined patients referred by oncology health care practitioners (HCPs) to an integrative physician (IP) consultation and CM treatments. QOL and chemotherapy-related toxicities were evaluated using the Edmonton Symptom Assessment Scale (ESAS) and Measure Yourself Concerns and Wellbeing (MYCAW) questionnaire, at baseline and at a 6-12-week follow-up assessment. Adherence to the integrative care (AIC) program was defined as ≥4 CM treatments, with ≤30 days between each session. Of 128 patients referred by their HCP, 102 underwent IP consultation and subsequent CM treatments. The main concerns expressed by patients were fatigue (79.8 %), gastrointestinal symptoms (64.6 %), pain and neuropathy (54.5 %), and emotional distress (45.5 %). Patients in both AIC (n = 68) and non-AIC (n = 28) groups shared similar demographic, treatment, and cancer-related characteristics. ESAS fatigue scores improved by a mean of 1.97 points in the AIC group on a scale of 0-10 and worsened by a mean of 0.27 points in the non-AIC group (p = 0.033). In the AIC group, MYCAW scores improved significantly (p < 0.0001) for each of the leading concerns as well as for well-being, a finding which was not apparent in the non-AIC group. An IP-guided CM treatment regimen provided to patients with gynecological cancer during chemotherapy may reduce cancer-related fatigue and improve other QOL outcomes.
    No preview · Article · Mar 2015 · Supportive Care Cancer
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    ABSTRACT: Chemotherapy-induced gastrointestinal (GI) toxicities often impair quality-of-life (QOL) and require reduction of the chemotherapy dose intensity. We explored the effects of a complementary integrative medicine (CIM) therapeutic process, administered in conjunction with conventional supportive care, on GI-related symptoms and concerns in patients undergoing chemotherapy. We conducted a prospective, pragmatic study among patients undergoing chemotherapy referred by their healthcare providers to a CIM-trained integrative physician (IP) for consultation, followed by CIM treatments. Symptom severity and patient concerns were assessed at baseline and at an IP follow-up visit at 6-12 weeks, using the Edmonton Symptom Assessment Scale (ESAS) and the Measure Yourself Concerns and Wellbeing (MYCAW) questionnaires. Adherence to the integrative care (AIC) program was defined as attendance of ≥4 CIM treatments, with ≤30 days between sessions. Of the 308 patients referred to the IP consultation, 275 (89.3%) expressed GI symptoms and concerns, 189 of whom attended the follow-up IP assessment. Of these, 144 (46%) were found to be adherent to the treatment plan (AIC group). Repeated measure analysis indicated a statistical interaction between baseline and follow-up scores, for ESAS (appetite, p = 0.005; drowsiness, p = 0.027; shortness of breath, p = 0.027; and sleep, p = 0.034) and for MYCAW outcomes. This when comparing the AIC to the non-AIC group responses. Reduction of GI concerns (p = 0.024) was greater among patients in the AIC group (MYCAW questionnaire), with significantly less chemotherapy-related hospitalizations found in this group (p = 0.008). The participation of a registered dietitian during CIM treatments led to greater reduction in nausea (from 4.24 to 1.85 vs. 2.73 to 1.36, respectively; p = 0.017). Integration of CIM with standard supportive care, especially in patients adhering to the CIM treatment regimen, may help reduce chemotherapy-induced GI symptoms and concerns, as well as QOL-related non-GI symptoms. Further research is needed in order to explore the effects of specific CIM modalities on GI symptoms and concerns during chemotherapy. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
    No preview · Article · Dec 2014 · Clinical nutrition (Edinburgh, Scotland)
  • Eran Ben-Arye · Noah Samuels
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    ABSTRACT: The Middle-East is characterized by a rich spectrum of complementary and traditional medicine therapies, which are used by patients in parallel with conventional medicine. Indigenous traditional medicine practices in the region focus mainly on herbal medicine and far less on the use of European-based complementary medicine modalities such as homeopathy. Little has been reported on the extent to which homeopathy is being used in the Middle-East, this despite an emerging body of basic science and clinical research on the subject from countries such as Egypt, Iran, Iraq, Israel, and Lebanon. We compare the foundations of homeopathy with those of traditional Middle-Eastern medicine in the Middle-East, and explore the possibilities of collaborative research and clinical practice. In particular, qualitative research is warranted to explore patients’ expectations regarding homeopathic consultation and feasibility of its integration into Middle-Eastern health systems. Studying patient–homeopath communication patterns may be used to promote the clinical implementation of patient-centered care, based on a bio-psycho-social-spiritual health model.
    No preview · Article · Dec 2014
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    ABSTRACT: There is a need for new options for reducing the side effects of cancer treatment, without compromising efficacy, enabling patients to complete treatment regimens. The botanical compound LCS101 exhibits inhibitory effects on cancer cell growth, and reduces chemotherapy-induced hematological toxicities. The aim of the present study is to examine the selectivity of the effects of the compound, alone and in conjunction with conventional chemotherapy agents, on cancer cell proliferation. The effects of LCS101 were tested on a number of cancer cell lines (breast, MCF7, MDA-MB‑231; colorectal, HCT116; prostate, PC-3, DU-145) and on non-tumorigenic normal human epithelial cells (breast, MCF10A; prostate, EP#2). Cell viability was analyzed using an XTT assay and observed by light microscopy. Necrosis and apoptosis were examined using FACS analysis and immunoblotting. LCS101 selectively induced cell death in breast, colon and prostate cancer cell lines, as measured by XTT assay. Light microscopy and FACS analysis showed changes indicative of a necrotic process. LCS101 was also found to induce PARP-1 reduction in breast cancer cells, with no effect on non-tumorigenic breast epithelial cells. While LCS101 increased cell death in cancer cells exposed to doxorubicin and 5-FU, it showed a protective effect on non-tumorigenic human epithelial cells from chemotherapy-induced cell death. A similar selective effect was observed with apoptosis-associated PARP-1 cleavage. The findings demonstrate that the anti-proliferative effects exhibited by the botanical compound LCS101 are selective to cancer cells, and offer protection to non-tumorigenic normal epithelial cells from chemotherapy agents.
    No preview · Article · Oct 2014 · International Journal of Oncology
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    ABSTRACT: Background The integration of complementary medicine is gradually becoming an accepted part of standard care for patients with cancer. In our integrative oncology program we have encountered difficulties in recruiting Arab patients. In order to understand the special needs of this population, we conducted interviews among Arab practitioners of complementary and traditional medicine (CTM). The characteristics of practitioners and their views regarding the therapeutic process were examined. Methods Semi-structured qualitative interviews were administered to 27 Arab practitioners of CTM whose clientele was comprised primarily of Arab cancer patients. Conventional content analysis of the transcribed interviews and field notes were performed in order to identify key themes. Result Three groups of CTM practice were identified: Folk-herbal medicine (n=9); complementary medicine (CM; n=14); and religious healing (n=4). Seven factors were identified in the practitioner accounts: the duration and scheduling of treatment sessions; the language of communication; the presence of family members; the appearance of the practitioner; the definition of treatment goals; the discussion of behavioral and lifestyle changes; and finally, the use of tangible elements in treatment. Conclusions The study of Arab CTM practitioner recommendations may help facilitate a culture-sensitive encounter with Arab patients with cancer. This approach may also have implications for other ethno-culturally unique populations. [207 words]
    No preview · Article · Aug 2014 · EXPLORE The Journal of Science and Healing
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    ABSTRACT: Purpose: The purpose of this study is to compare the rationale given by oncology health care practitioners (HCPs) for referral of their patients with breast cancer to a complementary medicine (CM) consultation with patient expectations from the CM treatment process. Methods: We conducted a prospective, registry protocol-based, open-label study. We compared the indications given by oncology HCPs for their referral of patients to the CM consultation with patient expectations from the CM therapeutic process. Patients were asked regarding prior CM use for cancer- and non-cancer-related indications. Results: A total of 127 patients referred to the CM consultation were studied, with half reporting prior CM use. The most popular treatment for non-cancer-related indications was acupuncture (46.9 %), with only 20.3 % reporting herbal medicine use (P ≤ 0.04). For cancer-related indications, herbal medicine was the most popular modality (42.4 %), with 11.6 % reporting acupuncture use. The most frequently cited indications for referral were general symptom reduction (19.7 %), emotional/spiritual relief (18.1 %), alleviation of weakness and fatigue (17.3 %), and reduction of gastrointestinal symptoms (10.2 %). For patients, the most important outcome was alleviation of weakness and fatigue (70.4 %), followed by emotional/spiritual relief (50 %), and the reduction of gastrointestinal symptoms (33.3 %). The correlation between HCP indications for referral and patient expectations was poor (Cohen's kappa of 0.19, 0.328, and 0.20, respectively). Conclusions: The findings suggest that expectations from a CM treatment process differ greatly between oncology HCPs and patients with breast cancer. The use of a structured clinical referral process and a better understanding of patient concerns are factors which play a central role in the CM referral process.
    No preview · Article · Jul 2014 · Supportive Care Cancer
  • Yael Keshet · Elad Schiff · Noah Samuels · Eran Ben‐Arye
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    ABSTRACT: Objective The aim of this study was to assess patient perspectives regarding non-specific effects of a complementary medicine (CM) consultation and intervention within an integrative oncology setting.Methods Patients undergoing chemotherapy in a community-based oncology service were referred by oncology healthcare providers to an integrative oncology physician trained in CM-oriented supportive care. Assessment of concerns and well-being was made using the Measure Yourself Concerns and Wellbeing questionnaire, at baseline and after 3 months of CM treatments, which were designed to improve quality of life (QoL) outcomes. Patients were asked to describe the most important aspects of the integrative treatment process. Free-text narratives were examined using content analysis with ATLAS.Ti software for systematic coding.ResultsOf 152 patients' narratives analyzed, 44% reported an experience of patient-centered care, including CM practitioners' approach of togetherness, uniqueness, and the invoking of an internal process. CM practitioner approach was experienced within a context of an enhanced sense of confidence; gaining a different perspective; and acquiring emotional resilience and empowerment.Conclusions Short patient narratives should be considered for patient-reported outcomes, expressing perspectives of both effects and experience of care. CM may promote patient QoL-related outcomes through non-specific effects, enhancing patient-centered care. The benefits of CM dependent on general therapeutic incidental aspects (i.e., common factors) warrant attention regarding non-specific components of treatment. Copyright © 2014 John Wiley & Sons, Ltd.
    No preview · Article · Jul 2014 · Psycho-Oncology

  • No preview · Article · May 2014 · Journal of alternative and complementary medicine (New York, N.Y.)
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    ABSTRACT: The use of complementary traditional medicine (CTM) is prevalent among patients with cancer. An understanding of cultural and religious values is needed to design an effective patient-centered supportive treatment program. To examine gender-related demographic and professional characteristics; treatment goals and approaches; and attitudes toward integration among Arab practitioners of CTM. Male and female Arab CTM practitioners treating patients with cancer were located by snowballing through practitioner and clientele networks. Participants underwent semi-structured, in-depth interviews which were analyzed thematically, with a focus on gender-related issues. A total of 27 Arab CTM practitioners participated in the study (17 males, 10 females). Female practitioners were found to be treating women exclusively, with male practitioners treating both genders. Female practitioners tend to be younger, unmarried, urban-based and non-Muslim. Male practitioners set out to "cure" the cancer, while female practitioners focus on symptoms and quality of life. Male practitioners employ a more schematic and structured therapeutic approach; female practitioners a more eclectic and practical one. Male practitioners employ a collectivist approach, involving family members, while female practitioners interact exclusively with the patient. Finally, male CTM practitioners see integration as a means for recognition, increasing their power base. In contrast, female practitioners perceive integration as a foothold in fields from which they have previously been shut out. A number of gender-related issues can have a significant impact on CTM therapy among Arab patients. Further research is needed in order to understand the implications of these differences.
    No preview · Article · Apr 2014 · Journal of Immigrant and Minority Health
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    ABSTRACT: Patients with cancer are frequently turning to complementary medicine (CM), often with the goal of improving quality of life outcomes. The purpose of the present study was to assess the adherence of patients referred by oncology practitioners to a CM consultation and treatment program. A prospective registry protocol-based, preference study was conducted at a conventional oncology department. Patients undergoing chemotherapy were referred by participating oncology practitioners to a CM-trained integrative physician (IP) for consultation. Adherence to the integrative care (AIC) program was defined as attendance by patients at ≥4 CM treatment sessions, with an interval of no more than 30 days between each session. A total of 282 patients were referred by the study health-care professionals (HCPs), of whom 243 (85.8 %) were eventually seen by the study IP. Of these, 160 were found to be adherent to the treatment plan (AIC group), and 83 were nonadherent (non-AIC group). No significant differences were found between the two groups with respect to demographic characteristics, medical history, site of malignancy and/or recurrence, chemotherapy regimen, or severity of symptoms at baseline. The AIC group reported significantly greater rates of CM use for noncancer-related indications than the non-AIC group (EXP(B) = 2.174, 95 % confidence interval (C.I.) = 1.1-4.295, p = 0.025). Patients in the non-AIC group were referred more frequently by their HCP for gastrointestinal concerns than those in the AIC group (p = 0.022). Previous use of CM for noncancer-related outcomes was found to be predictive of patient adherence to a CM treatment regimen provided within conventional oncology service.
    Full-text · Article · Oct 2013 · Supportive Care in Cancer
  • Eran Ben-Arye · Elad Schiff · Orit G Raz · Noah Samuels · Ofer Lavie
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    ABSTRACT: To explore oncology healthcare providers' (HCPs') patterns of referral of women undergoing chemotherapy to a complementary medicine (CM) consultation integrated within a conventional oncology service. Oncology HCPs used a structured referral system for referral to an integrative physician (IP) for CM consultation. Referral goals were in accordance with a specified list of quality-of-life (QOL) outcomes. In total, the study HCPs referred 282 female patients, of whom 238 (84.4%) underwent CM consultation by the study IP: 59 (24.8%) with gynecologic cancer and 179 (75.2%) with non-gynecologic cancer. Use of CM for cancer-related outcomes was significantly higher among referred patients with gynecologic cancer than those with non-gynecologic cancer (69.5% vs 46.9%; P=0.003). Oncologists initiated most of the referrals in the gynecologic oncology group, whereas oncologic nurses referred most patients in the non-gynecologic oncology group. Among patients with gynecologic cancer, the correlation between HCP indication and patient expectation was high for gastrointestinal concerns (κ 0.41). The integration of a structured and informed process of referral to CM consultation may enhance patient-centered care and QOL during chemotherapy.
    No preview · Article · Oct 2013 · International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics
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    ABSTRACT: Background and aim: Current treatment of gingival recession (GR) is limited to surgical procedures. We describe a case series of 18 patients with GR who were treated with a botanical patch and rinse following standard conservative therapy. CASE SERIES DESCRIPTION: A total of 22 sites with GR > 1 mm were studied. Following scaling and root planing (SRP) and oral hygiene instruction, patients received two courses of patch treatment (3 days each) and botanical rinse administered twice daily throughout the treatment period. Outcome measures (GR, gingival index (GI) and gingival thickness (GT) were taken at baseline; at 1 to 2 weeks; 2 to 4 weeks; and at 6 to 8 weeks. Miller classifcation and plaque index (PI) were measured at baseline and at 6 to 8 weeks. At the end of the treatment period, mean GR decreased from 4.18 ± 1.74 mm to 3.31 ± 1.51 mm (20.8%); Miller grade from 1.86 ± 0.56 to 1.06 ± 0.43; GI scores from 1.45 ± 0.63 to 0.17 ± 0.38 (88.3%); and PI scores from 1.33 ± 0.59 to 0.78 ± 0.94. GT increased from 0.74 mm ± 0.40 to 1.21 ± 0.39 (63.5%). No adverse effects were reported with either the patch or rinse treatments. Conclusion: We observed a decrease in GR and GI scores in 18 patients (22 sites) treated with the study patch and rinse, with increased GT. Clinical significance: A combined botanical patch-rinse treatment may be effective as adjuvant treatment to standard conservative care for GR. Further research is needed to verify these fndings.
    No preview · Article · Sep 2013 · The journal of contemporary dental practice
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    ABSTRACT: CONTEXT: Many cancer patients are using non-herbal nutritional supplements (NHNS), often without informing their oncologists. OBJECTIVES: To review the literature and summarize the beneficial effects and safety of NHNS in the prevention and reduction of treatment-related symptoms. METHODS: Databases were searched for randomized, controlled clinical trials (Jadad score ≥ 2) using AltHealthWatch, Cochrane Database of Systematic Reviews, Embase, MEDLINE, Memorial Sloan-Kettering Integrative Medicine Service Database, Natural Standard Database, and PubMed. The key words searched were the following: alternative and/or complementary medicine, nutritional and/or dietary supplements, quality of life, symptoms and/or side effects, specific toxicities (e.g., neuropathy, mucositis), and specific supplements (e.g., vitamin E, glutamine, etc.). RESULTS: A number of NHNS products were found to be effective. The incidence and severity of peripheral sensory neuropathy associated with taxane-agents such as paclitaxel can be reduced with vitamin E, glutamine, and acetyl-L-carnitine. Vitamin E and glutamine also have been shown to reduce oral mucositis resulting from radiation and chemotherapy, and glutamine and probiotics can reduce chemotherapy-induced diarrhea. CONCLUSION: There is a need to develop an open and nonjudgmental dialogue between oncologists and cancer patients, addressing the needs of the patient while dealing with issues related to the efficacy and safety of these products. Referral of patients to an integrative medicine consultant may help achieve these goals, providing both parties with the option of reaching an informed and respectful decision about treatment.
    Full-text · Article · May 2013 · Journal of pain and symptom management

Publication Stats

268 Citations
95.67 Total Impact Points


  • 2010-2015
    • Sheba Medical Center
      Gan, Tel Aviv, Israel
  • 2008-2013
    • Shaare Zedek Medical Center
      • Center for Integrative Complementary Medicine
      Yerushalayim, Jerusalem District, Israel
  • 2011-2012
    • Bikur Holim Hospital,
      Yerushalayim, Jerusalem, Israel
  • 2005
    • Tel Aviv Sourasky Medical Center
      Tell Afif, Tel Aviv, Israel