title: Exploring an herbal "wonder cure" for cancer: a multidisciplinary approach.
abstract: OBJECTIVE
  The unmonitored use of herbal medicinal remedies by patients with cancer presents a significant challenge to oncology healthcare professionals. We describe an increasingly popular herbal "wonder drug," Ephedra foeminea (Alanda in Arabic), whose use has spread from the Palestinian patient population throughout the Middle East. We conducted a multicentered and multidisciplinary collaborative research effort in order to understand the potential benefits and harms of this popular herbal remedy.
  
  
  METHODS
  We conducted an in-depth search of the medical literature, both traditional and modern, for any mention of the clinical use of Alanda for the treatment of cancer. We then tested the remedy, first for toxic ephedra alkaloid components and then for anticancer effects, as well as effects on the cytotoxic activity of chemotherapy agents (cisplatin and carboplatin) on breast cancer cell cultures.
  
  
  RESULTS
  We found no mention in the literature, both conventional and traditional, on the use of Alanda for the treatment of cancer. Laboratory testing did not find any toxic components (i.e., ephedra alkaloids) in the preparation. However, in vitro exposure to Alanda led to a reduced cytotoxic effect of chemotherapy on breast cancer cell cultures.
  
  
  CONCLUSIONS
  The use of an integrative ethnobotanical, laboratory and clinical research-based approach can be extremely helpful when providing nonjudgmental and evidence-based guidance to patients with cancer, especially on the use of traditional herbal medicine. The effectiveness and safety of these products need to be examined by integrative physicians who are dually trained in both complementary medicine and supportive cancer care.
authors.affiliation: Integrative Oncology Program, Haifa and Western Galilee Oncology Service, Clalit Health Services, Haifa, Israel. eranben@netvision.net.il.|Lin Medical Center, Affiliated with the Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. eranben@netvision.net.il.|Complementary and Traditional Medicine Unit, Department of Family Medicine, Affiliated with the Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. eranben@netvision.net.il.|The Oncology Service, Lin Medical Center, 35 Rothschild St., Haifa, Israel. eranben@netvision.net.il.
authors.forename: Eran
authors.initials: E
authors.lastname: Ben-Arye
authors.affiliation: Cancer Drug Discovery Program, Galilee Technology Center, Kiryat Shmona, Israel.
authors.forename: Jamal
authors.initials: J
authors.lastname: Mahajna
authors.affiliation: Department of Plant Pathology and Weed Research, ARO, Newe-Yaar Research Center, Ramat Yishay, Israel.
authors.forename: Radi
authors.initials: R
authors.lastname: Aly
authors.affiliation: Biodiversity and Biotechnology Research Unit, Biodiversity and Environmental Research Center, BERC, Til, Nablus, Palestine.
authors.forename: Mohammed Saleem
authors.initials: MS
authors.lastname: Ali-Shtayeh
authors.affiliation: Israel Poison Information Center, Section of Clinical Pharmacology and Toxicology, Rambam Health Care Campus, The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
authors.forename: Yedidia
authors.initials: Y
authors.lastname: Bentur
authors.affiliation: Department of Eretz Israel Studies, University of Haifa, Haifa, Israel.
authors.forename: Efraim
authors.initials: E
authors.lastname: Lev
authors.affiliation: Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Deng
authors.affiliation: Integrative Oncology Program, Haifa and Western Galilee Oncology Service, Clalit Health Services, Haifa, Israel.|Lin Medical Center, Affiliated with the Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.|Tal Center for Integrative Medicine, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Noah
authors.initials: N
authors.lastname: Samuels
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D029789:Ephedra; D029001:Herbal Medicine; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents
keywords: Complementary medicine; Drug–herb interactions; Ephedra foeminea; Herbal medicine; Integrative medicine; Quality-of-life (QOL)