title: We and they in the house of healing: debate among Arab complementary medicine practitioners on an integrative versus alternative approach to supportive cancer care.
abstract: OBJECTIVE
  Complementary and traditional medicine (CTM) plays an important role in culture-centered care for cancer patients in the Middle East. In this article, we have studied the attitudes of Arab CTM therapists concerning integration of complementary medicine within the conventional supportive cancer care of Arab patients in northern Israel.
  
  
  METHODS
  Semistructured interviews were held with 27 Arab therapists who use medicinal herbs, the Quran, and various CTM modalities, with the aim of characterizing their treatment practices and learning about their perspectives regarding conventional cancer care.
  
  
  RESULTS
  We first summarized the different characteristics of the various CTM therapists, including training, typical practice, and so on. Thematic analysis revealed that folk healers and complementary medicine therapists describe their role as supportive and secondary to that of physicians. Their goal was not to cure patients with cancer but rather to enhance their quality of life by reducing the severity of both the disease symptoms and the side effects of cancer treatment. Religious healers, by contrast, purport to cure the disease. While folk healers opt for parallel alternative care and complementary therapists support integrative care, religious healers claimed that they offer an alternative to conventional medicine in terms of both etiology and practice.
  
  
  CONCLUSIONS
  The majority of Arab CTM therapists support integration of their treatments with the conventional system, but in practice, they are not sure how to bring about this change or create a parallel model in which 2 different systems are active, but not integrated. Our findings emphasized the need to promote doctor-CTM practitioner communication based on structured referral and bidirectional consultation. Moreover, we recommend intensifying research on the efficacy and safety of CTM in the Middle East and the potential role in promoting culture-based supportive care.
authors.affiliation: Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Ariela
authors.initials: A
authors.lastname: Popper-Giveon
authors.forename: Elad
authors.initials: E
authors.lastname: Schiff
authors.forename: Eran
authors.initials: E
authors.lastname: Ben-Arye
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018912:Arabs; D001291:Attitude of Health Personnel; D003142:Communication; D000529:Complementary Therapies / Q000009:adverse effects / Q000379:methods*; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration; D005260:Female; D006282:Health Personnel / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D007557:Israel; D008297:Male; D008519:Medicine, Traditional / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology / Q000628:therapy*; D011788:Quality of Life; D012017:Referral and Consultation; D012068:Religion and Medicine; D012720:Severity of Illness Index; D055815:Young Adult
keywords: cancer; complementary medicine; cross-cultural medicine; supportive care; traditional medicine