WTG Israel

ADVANCE COMMENTS
“Ralph Moss’s report on CAM and cancer in Israel is extensive and enlightening.
I thank him for his significant contribution and support of our activities in the
Holy Land.”
—Eran Ben-Arye, MD, Haifa, Israel
“ Ralph Moss’s report provides in-depth research on a subject never investigated

before. In the course of his visit he reached most of the serious CAM-cancer
practitioners in this country. He has shown that CAM can be practiced in a serious
way and add greatly to the treatment of cancer patients. ”
—Joseph Brenner, MD, Tel Aviv, Israel
“In this report, the story of CAM in Israel is told in a powerful, comprehensive and
interesting way by a keen outside observer. I am impressed by Moss’s systematic
and informative coverage, including relevant background information, a vast number
of facts, and a balanced description of a large variety of CAM activities. Moss has
done a great job. ”
—Jacob Shoham, MD, PhD, Ramat-Gan, Israel
“Ralph Moss provides an in-depth report on CAM and cancer in Israel. His
detailed encounter with the various experts is an important and much needed guide
for both health providers and patients who are interested in this thriving field. ”
—Isaac Eliaz, MD, Santa Rosa, Calif.
Moss / CAM and Cancer in Israel
CAM AND CANCER IN ISRAEL

© 2010 by Ralph W. Moss, PhD
(Including photos)
All rights reserved
Figure 1 Israeli Flag Atop Masada
2
Table of Contents
Historical Context ........................................................................................5

Science in Israel ...........................................................................................7
Further Considerations On CAM In Israel ....................................................8
Historical Roots of CAM in Israel ................................................................9
Popularity of CAM.....................................................................................10
CAM and Family Medicine ........................................................................11
CAM and Nurse Midwives .........................................................................12
CAM And Medical Coverage .....................................................................12
CAM in the Military...................................................................................15
Relative Strength of CAM in Israel.............................................................15
CAM and HMO Health Services ................................................................16
Eran Ben-Arye (Haifa) ...............................................................................16
Gil Bar-Sela (Haifa) ...................................................................................18
Jacob Shoham And KaMaH .......................................................................21
Hadassah University Hospital, Ein Kerem (Jerusalem) ...............................25
Medical Marijuana .....................................................................................29
Shimon Slavin and the CTCI ......................................................................29
Joseph Brenner, Tel Aviv ...........................................................................36
Conclusions................................................................................................39
Appendix A: CAM Treatment Resources ...................................................42
Appendix B: Co-sponsors of the 2010 Jerusalem International
Conference on Integrative Medicine ........................................................49
Appendix C: Peer-reviewed Articles on CAM in Israel...............................50
References..................................................................................................61
3
Table of Figures
Figure 1 Israeli Flag Atop Masada....................................................................... 2

Figure 2 Hyssop................................................................................................ 10
Figure 3 Moshe Frenkel .................................................................................... 13
Figure 4 Eran Ben-Arye with Middle Eastern Herbs.......................................... 17
Figure 5 Gil Bar-Sela ........................................................................................ 19
Figure 6 Jacob Shoham ..................................................................................... 22
Figure 7 Martine Toledano, Reuven Or, Ruth Radiano,
and Gisele Obadia-Aferiat ......................................................................... 25
Figure 8 Reflexology at Hadassah University Hospital...................................... 27
Figure 9 Shimon Slavin..................................................................................... 31
Figure 10 Joseph Brenner.................................................................................. 37
Acknowledgements: The author wishes to thank Reliable Cancer Therapies (RCT)

(www.reliablecancertherapies.com) for their financial support of this site visit to
Israeli cancer clinics. Moshe Frenkel, MD, of Zichron Ya’akov, originally
suggested this project to me when he was still the head of CAM at the University
of Texas M.D. Anderson Cancer Center, Houston. He served as my host during
my Israeli journey and introduced me to most of the physicians I interviewed. I
also wish to thank the following for reading and commenting on advance versions
of this report: Tibor Bakacs, MD, PhD, DSc; Gil Bar-Sela, MD; Eran Ben-Arye,
MD; Isaac Eliaz, MD; Martine Toledano, MD; Jacob Shoham, MD and Shimon
Slavin, MD. Their help was invaluable. All opinions, including any remaining
errors and omissions, are the author’s sole responsibility.
4
This is a report on the use of complementary and alternative medicine (CAM) in

the state of Israel, particularly for the treatment for cancer. I will focus on four
questions:
1. What is being done for cancer in Israel, in an alternative or

complementary way, that is not be done elsewhere?
2. What are some of the most promising findings or discoveries?
3. How does the Israeli medical establishment’s attitude towards CAM
differ from that in other countries, particularly in the US?
4. If the situation in Israel is unique, why is that so?
To investigate these questions I visited Israel in July 2010. A non-profit

organization that provides information on evidence-based cancer therapies
supported this fact-finding mission. I visited a total of 15 hospitals, clinics and
laboratories in Tel Aviv, Haifa and Jerusalem, as well in some smaller localities.
The types of facilities that I visited included CAM research and practices in:
1. Accredited universities
2. Major hospitals
3. Independent private practices
4. HMO networks
5. Research facilities
I came away deeply impressed by the degree of CAM’s integration into the
standard medical system in Israel. As the Israeli epidemiologist Liat Lerner-Geva,
MD, PhD, has stated: “Assimilation of complementary medicine into the health
system of Israel is one of the highest in the world.”1
Historical Context
Israel is a land steeped in history; it is therefore logical to put the use of CAM
(specifically for cancer) into a broad historical context.
The territory that is now the state of Israel was for a millennium or more the
ancestral homeland of the Jewish people. In 70 CE,* after decades of political and
military conflict, the Romans destroyed the Second Temple in Jerusalem.
Eventually the Emperor Hadrian barred Jews from Jerusalem and most of what
was then the Roman colony of Judea. Thus began 2,000 years of forced exile of
*
CE, which stands for Common Era, is a designation for the world’s most
common year numbering system. It corresponds to AD (Anno Domini), just as
“BCE” equates with BC (Before Christ). According to two scholars, the terms
CE and BCE “are meant, in deference to non-Christians, to soften the explicit
theological claims made by the older Latin terminology, while at the same time
providing continuity with earlier generations of mostly western Christian
historical research” (Irvin, DT and Sunquist, SW. History of the World Christian
Movement, Maryknoll, NY: Orbis, 2001, p. xi.).
5
the Jews in the so-called Diaspora.† During this time the great majority of Jews
settled in diverse parts of the world. In Europe, they settled first in Spain and in
Germany and later in the Hapsburg Empire and the Russian-dominated parts of
Eastern Europe. A long period of anti-Semitic discrimination, persecution and
pogroms culminated in the Nazi-led Holocaust, the murder of six million Jews in
concentration camps as well as by other means. In 1948 came the creation of the
state of Israel, and the well-known tumultuous political developments and
conflicts that have followed.
Israel is the only country in the world with a majority Jewish population:
5,726,000 out of a total population of 7,587,000 (or 75.5 percent).2 Despite many
wars and conflicts, and the burden of a huge military budget, the country has
thrived. Israel is now the only country in the Middle East to approximate a
Western degree of affluence. According to the World Bank, its gross national
income is now over USD $200 billion. (It was less than $27 billion in 1980) and
the per capita income is $26,175 (2009), which is greater than Slovenia, Portugal
or South Korea.3
During their long period of exile, the Jewish people were generally scorned,
persecuted and barred from most spheres of gainful employment. For various
reasons, one field in which Jews were generally allowed to earn a living was in
medicine. Even in the Middle Ages, Jewish physicians were highly regarded by
those who were otherwise vehemently anti-Semitic. For instance, every ruler of
Castille (Spain) had Jewish physicians, including Ferdinand and Isabella4 (who
nonetheless in 1492 expelled all Jews from Spain). Many members of the nobility
insisted on being treated by Jewish physician even when Christian doctors were
available.
In modern times, despite frequently being discriminated against in admission to

medical school, Jews managed to maintain their tradition for excellence in
medicine (as well as many other fields of scholarship). One way of estimating the
extent of their accomplishments is by looking at the winners of the Nobel Prize.
This provides a metric of different peoples’ achievements vis-à-vis the world
population in general. Thus, between 1901 and 2009, there were 829 Nobel prizes
awarded and Jews (i.e., individuals defined by having at least one Jewish parent)
received 180 of these, or 21.7 percent of the total. In physiology and medicine,
Jews won 27 percent of the total. Jewish achievement in this regard is all the
more remarkable when one considers that globally the Jewish community is just
13.2 million, or just two-tenths of one percent (0.00218) of the world population.
This general trend continues, as two of the 2010 Nobel laureates (Peter A.
Diamond and André Geim) are also Jewish. There is nothing unique in this regard
about the Nobel Prizes. Jews have similarly won 32 percent of Japan’s Kyoto
Prizes for advanced technology, 40 percent of the Wolf Prizes for medicine, 33
†
Jews had already settled in various parts of the ancient world, such as at Rome,
Alexandria and Babylon, but after this period were forced to do so and were
denied a homeland to which they could return.
6
percent of the Lasker Awards, and 38 percent of the U.S. National Medals for
Science.5
Israel is a young country, which only began building most of its world-class
research establishments since gaining independence in 1948. So far nine Israelis
have won Nobel Prizes. In 2009, Ada Yonath, an Israeli-born and educated
scientist, won the prize for chemistry, the first Israeli woman to do so.
Science in Israel
Although a young country, Israel’s accomplishments in complementary and

alternative medicine (CAM) are formidable. CAM requires not just excellent in
medical practice but also an innovative attitude towards radically different
treatment ideas. Israel is such an innovative place that it has been called “the
start-up nation,” because of the myriad new companies spawned by its
universities and medical schools.6 In complementary medicine, Israelis are also
known for inventing, or testing, numerous innovative medical products and
procedures. We might mention several of these:
1. The homeopathic preparation Traumeel, which was first subjected to a

randomized controlled trial (RCT) by Menachem Oberbaum, MD, et
al. of Shaare Zedek Medical Center, Jerusalem. This positive study
was published in the scientific journal of the American Cancer
Society, Cancer.7
2. The 3rd generation photosensitizer Tookad (which means “the warmth

of light” in Hebrew), which was developed at the Weizmann Institute
by Profs. Avram Scherz and Yoram Salomon.8
3. Punisyn, a mixture of aqueous and lipid pomegranate extracts, which

has demonstrated activity against both breast9 and prostate10 cancer,
developed by the “medical punicologist” Ephraim Lansky, MD
(www.rimonest.com)
4. The cytotoxic effects of homeopathic remedies on breast cancer cells

was pioneered by the Israeli physician Moshe Frenkel, MD, formerly
of M.D. Anderson Cancer Center, Houston, and his colleagues.11
5. The discovery at Hadassah University Hospital of the benzoquinone

HU-331, which is ultimately derived from the marijuana plant, and is a
less toxic alternative to the standard cancer drug doxorubicin.12
6. Novocure, a novel apparatus that deliver alternating electrical field, is

being employed with promising results in the treatment of brain
tumors. It was developed by Prof. Yoram Palti and his colleagues at
the Technion, the Israel Institute of Technology in Haifa.13
7
7. Scientists at the Integrated Cancer Prevention Center of the Tel Aviv

Sourasky Medical Center have invented a dietary supplement called
Coltect for the prevention of colorectal cancer. Coltect contains
curcumin, green tea and selenomethionine. Experimentally, it causes a
40-70 percent reduction in precancerous lesions in the colon.14 It is
also being tested for ulcerative colitis.15
At the same time, a high level of innovation and scholarship marks Israeli
participation in CAM. Israel scientists are not only inventive but are quick to
grasp the importance of new developments and find ways to put them into
practice.
Further Considerations On CAM In Israel
Israel is the size of the state of New Jersey and one can drive from Kiryat
Shemonah in the north to Eilat in the south in less than six hours. This
compactness is combined with an astonishing degree of diversity in the
population. This confounds any preconceived idea of “Jewishness.” Virtually all
the nations and languages of the world are represented, and sometimes all seem to
be speaking at once!
While I was in Israel I met not just Ashkenazim and Sephardim (some of whose
ancestors had been there since the expulsion of the Jews from medieval Spain),
but also Jews from North Africa, sub-Saharan Africa, including Ethiopia, France,
Great Britain, Australia, Canada, Iran, China, and of course Russia and many
other parts of the former Soviet Union. I also met Israeli Arabs and Bedouins,
Christians, and Druse, as well as “guest workers” from Thailand and the
Philippines. Israel could be called a microcosm of humanity.
Superficially at least, medicine in Israel is practiced much as in the US. Israel’s

four medical schools‡ and various postgraduate programs mainly utilize American
textbooks and journals. A high percentage of Israeli medical school graduates
participate in fellowship programs in the US and many Americans come to Israel
for education or training. According to my host, Moshe Frenkel, MD, American
influence has been formalized in various ways. Three of the four Israeli medical
schools have collaborative agreements with US medical schools. These attract US
students to obtain their MD degrees in Israel and then return to the US for
‡
These are (1) Ben Gurion University of the Negev (founded 1974), (2) Joyce &
Irving Goldman Medical School at the Technion in Haifa (found 1969), (3)
Hebrew University of Jerusalem, Hadassah Medical School in Jerusalem
(founded 1949) and (4) Tel Aviv University, Sackler Faculty of Medicine
(founded 1963). They all follow the six-year European curriculum model, except
for Tel Aviv, which in 2009 in addition to the 6 year program introduced the
American style four-year curriculum. A new fifth medical school is scheduled to
open in 2011 in Zfat. In addition, there is on paper at least a Palestinian Faculty of
Medicine in Nablus in cooperation with An-Najah University, Nablus; Al-Quds
University, Jerusalem, and Al-Azhar University, Gaza.
8
postgraduate training and practice. Similarly, almost every Israeli doctor I met
trained in the US…usually at top institutions such as Memorial Sloan-Kettering
Cancer Center, the University of Texas M.D. Anderson Cancer Center, Roswell
Park Memorial Institute, Brown University, the University of Maryland, etc. I
also met Israeli doctors who were American or Canadian in origin but had
immigrated to Israel, often for religious or nationalistic reasons.
Historical Roots of CAM in Israel
There are interesting points of similarity between modern-day CAM treatments

and ancient medical and religious practices of the Jewish people. For instance, the
Torah (i.e., the first five books of the Hebrew Bible) enjoins Jewish men to put on
‘tefillin’ each day. Wearing tefillin is a prayer ritual during which two small
leather boxes, attached to leather straps, are placed on the biceps of the weaker
arm and on a particular location on the head. The biceps strap is wound on the
arm in a carefully prescribed fashion while the head strap is tied in a knot, which
is then placed at the base of the skull. The overall purpose of tefillin is to raise
spiritual awareness.
It is astonishing to learn that the tefillin and wraps actually “form a potent
acupuncture point formula focused on the Governing vessel (Du Mai) and aimed
at elevating the spirit and clearing the mind.”16 In a fascinating article on this
topic, the New York acupuncturist Steven Schram, PhD, states:
“If someone handed an acupuncturist the above point formula and asked
what was being treated, there is little doubt that mental…issues would be
a strong part of the pattern. What is surprising is that such a point formula
would be found in a non-Chinese procedure that has been continuously
practiced for many thousands of years. It may be that the originators of the
tefillin ritual had some inkling of its special effects, even though they may
have lacked the depth and specific knowledge we have today.”17
There are also points of similarity between ancient food and herbal prescriptions
and rational hygienic practices. The Biblical injunctions against consuming
scavenger animals (Leviticus 11:31) or utilizing bowls or vessels in which
animals have died (Leviticus 11:31-32) have long been interpreted as a way of
preventing animal-borne diseases. (According to WebMD, there are at least 39
serious diseases people catch directly from animals.18)
The Bible similarly enjoins inspection of the lungs of slaughtered animals, a

practice that would help prevent the spread of tuberculosis. The ban on
consuming unconscious animals would further prevent the consumption of sick
animals. And the prohibition against consuming pigs (Leviticus 11:3-8) –“of their
flesh ye shall not eat” (KJV) --would have similarly prevented the transmission of
the roundworm, Trichinella spiralis, and other parasites. Even to this day,
trichinosis (also known as trichinellosis) is exceedingly rare in Israel19 and is
mostly seen among Thai immigrant workers.20
9
The ancient Hebrews were also familiar with the cultivation of herbs for various
purposes, including healing. In 1 Kings 21:2 Ahab proposed planting a “garden of
herbs” (KJV). In particular, the herb hyssop (Hyssopus spp.) is often referred to
as an herb of purification, because it is a purgative cathartic herb. (“Purge me
with hyssop and I shall be clean,” Psalms 51:7) It is said to expel phlegm from
the respiratory tract.
Figure 2 Hyssop
Frankincense (Boswellia spp.), ketoret in Hebrew, was not strictly speaking a

medicinal herb, but was an ingredient in the incense offered up twice daily in the
ancient Temple. According to the Gospel of Matthew, one of the three Magi who
visited the infant Jesus in the manger brought a gift of frankincense. Frankincense
is now being explored as a treatment for colon21, bladder, prostate22 and brain
cancer,23 as well as for cerebral metastases.24 So, in a sense, the use of “CAM” in
Israel has ancient roots.
Popularity of CAM
In Israel, as in the US and Europe, CAM has become popular with the general
patient population. Estimates of CAM use has been measured at 32.4 percent
among cancer patients in Haifa,25 36 percent of patients seen in primary care
clinics26 and 50 percent among patients with chronic diseases. 27 CAM use appears
to be increasing rapidly. In fact, Prof. Amir Shmueli of Hebrew University
Medical School found that CAM use in Israel doubled between 1993 and 2007.28
In a study conducted in 2003 at Meyer Children’s Hospital in Haifa, it was found

that CAM was used by 61 percent of patients, with an average of three different
treatments per patient. Usage was higher among those who had previously used
CAM (85 percent), had a higher educational status (79 percent), and came from
secular families (71 percent). Patients with a higher socioeconomic status tended
to use chemical-biological remedies as well as homeopathy, where those with a
10
lower status mainly used traditional Arab treatments. Significantly, a beneficial

effect was reported by 69 percent of CAM users, which is a high rate of
satisfaction. Most pediatric cancer patients, regardless of ethnic origin, used CAM
without informing their physicians.29 According to Frenkel, Israelis in general are
looking for additional options, especially when conventional practices do not
produce a clear-cut solution. Nowadays, he adds, there is greater openness among
family physicians, while there is a growing number who actually and actively
refer patients to CAM. There is much less resistance among the other physicians,
while the availability and easy access of the therapists is another factor favoring
use of CAM.30
This interest in CAM is not limited to the Jewish portion of the population. In
2005-2006, Eran Ben-Arye and colleagues conducted a survey of CAM usage in
northern Israel. The respondents were 58 percent Arab, 41.6 percent Jewish.
Women were more likely to use CAM. He reported: “Arab women reported less
CAM use than Jewish women but were more interested in experiencing CAM,
had a higher degree of confidence in CAM efficacy and safety, and more
frequently supported the integration of CAM practitioners in primary care
clinics.”31
CAM and Family Medicine
Family medicine doctors often practice CAM in Israel. In fact, Israel is

considered to be a world leader in this sort of primary care. This contrasts sharply
with the situation in the United States. From 1979 to 2007, family medicine
declined by 40 percent as a residency choice in the US. By contrast, in Israel
family medicine continues to be seen as a field that offers job flexibility, good
work hours, and clear societal benefit.”32 The number of medical students
entering family medicine in Israel remained stable from 1980 to 1995 and,
according to my informants, remains a highly desirable career path. One reason
for this is that the gap between the salaries of family physicians and medical
specialists is not nearly as great in Israel as it is in the US.33
The department of family medicine in Haifa is a leading academic center in Israel

for integrative family practice and CAM. The department is affiliated with the
Haifa and Western Galilee district of Clalit Health center and the Rappaport
Faculty of Medicine in the Technion, Haifa. Since 1998, Drs. Eran Ben-Arye,
Moshe Frenkel, Amnon Oren, and other family physicians have taught elective
courses in CAM within the department residency program as well as CME
courses. In 2002, this group formed the Complementary and Traditional Medicine
Unit within the Department of Family Medicine. The courses were designed to
expose family physicians to common CAM methods, to provide these physicians
with an additional perspective that would allow them to better understand the
doctor-patient relationship, and to provide sufficient information to enable
physicians to provide their patients with informed, evidence-based, safe and
balanced advice. The concentration of medical ‘talent’ in Haifa is truly
impressive, and could form the basis for fruitful collaborative projects with
researchers in Israel as well as other countries.
11
CAM and Nurse Midwives
Another focus of CAM practice is the nurse-midwife movement. A study at

Shaare Zedek medical center found that a majority of Israel’s nurse-midwives use
and recommend CAM to their patients. (238 nurse-midwives were identified, of
whom 173 responded to the survey.) Most of them (87.3 percent) reported using
some form of CAM (67.1 percent used or recommended massage, 48.6 percent
herbal medicine, 42.2 percent meditation, etc.). As a group, they believe that
CAM can be used to complement conventional medical therapies. The authors
concluded: “Health care providers could benefit from education with regard to the
efficacy and safety of CAM modalities during pregnancy and childbirth.”34
CAM And Medical Coverage
Israel is one of the few countries to provide a wide array of CAM choice as part
of its universal health coverage. This development is the official policy of both
the public and private sectors. According to Frenkel, “The extent of CAM
services provided to the general public is quite extensive, if not the most
extensive CAM public system in the western world.”35 (Drs. Ben-Arye and
Shoham believe that the public CAM system is working in parallel tracts but is
not yet actually integrated into the conventional system.)
The US and Israel share another demographic characteristic, says Frenkel, who,
before returning to Israel, was Medical Director of the Integrative Medicine
Program at the University of Texas M.D. Anderson Cancer Center in Houston,
TX: both countries contain a large number of immigrants from diverse countries
and cultures around the world. This multi-ethnicity, he claims, is one of the
reasons that CAM is so popular in both countries.
12
Figure 3 Moshe Frenkel
Another important consideration is that, historically, health care in Israel is based

on the principle of ‘socialized’ medicine. I repeatedly found, among physicians at
least, a suspicion of medical treatments that benefited the doctors who provided
them. (Sometimes this hostility was mingled with concerns over quality or other
factors.)
According to Frenkel, however, there are an increasing number of health services

that are provided on a fee-for-service basis (such as that of Joseph Brenner, MD,
or Shimon Slavin, MD, below). The cost of some of these may be covered by
additional health insurance policies. But, in Israel, health care services on the
whole are provided by four major health maintenance organizations (HMOs) that
provide for the health care needs of the general population under a National
Health Insurance Law passed in January 1995. This law assures that every citizen
receive the basic and necessary health care. This system provides extensive
medical coverage through a large network comprising over 20 hospitals, as well
as many clinics and mother-and-child care centers. The quality of this medical
care can be gauged by the present life expectancy at birth of 82.8 years for
women and 78.5 for men, or a cumulative total of 80.7. This is the eighth highest
in the world; the US, by comparison, is 38th!36 The infant mortality rate of 4.7 per
1000 live births is lower than in the US, UK, Belgium, etc.37
13
In addition, the use of CAM is expanding.§ Due to public demand and as part of
the competition to attract patients, says Frenkel, “all the HMOs made a strategic
decision in the mid-1990s to sponsor to some extent CAM outpatient clinics.”
These services are partially covered by optional supplementary insurance policies
as well as self-pay. By the year 2000, 45% of the population had purchased the
supplementary insurance, which covers CAM and some additional services not
covered by the National Health Insurance Law.
As a result, somewhere between 42 and 60 percent of general practitioners have

reported referring patients to non-conventional practitioners.38 In 1998, it was
estimated that there about 10,000 students in Israel who were participating in a
variety of CAM training programs with about 45,000 graduates from a variety of
CAM schools. This includes immigrants from other countries, particularly the
former Soviet Union. There are a few hundred graduates per year from all schools
of alternative and/or complementary practices. Recently the Gertner Institute for
Epidemiology and Health Policy Research in Israel has begun a systematic
national research network in the field of complementary medicine in Israel,
perhaps the first such network in the world.39
According to various estimates there are between 50 and 100 schools in Israel
providing training in the various branches of CAM, with courses ranging from a
few months to 4 years duration. There is an extraordinary level of involvement
with CAM in Israel, probably equal to or greater than any other country in the
world.
The actual number of people making their living from CAM is of course much
smaller, as a country of 7.5 million can hardly support tens of thousands of
alternative practitioners. However, according to Frenkel, there are about 7,000
non-physicians actively practicing CAM in Israel at any one time, in addition to
700 physicians who practice CAM and conventional practice. Accordingly, there
is nearly one practitioner actively practices per 1,000 population. These
practitioners generally operate in private clinics on a fee-for-service basis. They
may also operate in CAM outpatient clinics sponsored by the HMOs as well as at
some public hospitals. According to new data that was presented in the Jerusalem
International Conference on Complementary Medicine, 19-22 October 2010,40 it
is estimate that there are 3 million visits to CAM practitioners in 2009, for a 25
percent increase over the previous year.41
As mentioned, all of the four HMOs as well as some of the public hospitals have
expanded their services and number of CAM clinics. Consequently, in the past
few years it has been estimated that there are close to 100 regional CAM
outpatient clinics covering the whole state of Israel with an average of about one
CAM clinic to every 60,000 people.
§
This situation is unlike in Germany, where government support has been
shrinking for the past decade, and some CAM-oriented hospitals, such as the
Leonardis Klinik in Bad Heilbrunn, have been forced to close their doors.
14
CAM in the Military
Public support for CAM is not limited to the civilian sector but is also
characteristic of the Israeli Ministry of Defense, which sends military veterans to
a large CAM clinic that is affiliated with the Sheba Medical Center in Tel
Hashomer.42 The broad public’s interest in CAM has also affected academia. The
interest in CAM among health care providers is also quite high. As a result, there
are a relatively large number of publications on this topic in the medical
literature. Frenkel reports that there were 100 abstracts of scientific articles in
PubMed written by Israeli authors between 1994-2004. This compared to 700 for
the US, 200 for the UK, 120 for Canada and 85 for Germany.
Relative Strength of CAM in Israel
If we search using country names plus four representative search terms,

acupuncture, herbalism, homeopathy and reflexology, we can get a more exact
picture of the relative strengths of CAM research:
Table 1
Research on Select CAM Topics in Five Countries
Israel US UK Canada Germany

Acupuncture 88 1,061 283 192 365
Herbalism 213 939 166 215 183
Homeopathy 42 225 313 39 317
Reflexology 65 691 186 183 213
Source: PubMed, September 2010
If we consider that the US population is 42 times greater than Israel’s we get

some idea of the extent of research on this topic. When it comes to homeopathy,
for instance, the US would have to produce 1,764 papers (not 225) in order to
match Israel’s output. Put another way, Israel is outperforming the US in this
topic by a factor of 8:1.
These sort of facts and numbers, says Frenkel, “make Israel an interesting place to
study CAM integration in the conventional setting.” He himself recently returned
from a six-year stint at the University of Texas to practice CAM in Israel. “Since
the conventional medical system is closely related to the US in terms of medical
education and clinical care,” he adds, “ it would be quite appealing to study the
lessons learned in these practices with their extensive experience compared to the
limited integration that is currently happening in the US health care system.”
I shall now give a brief description of the facilities I visited on this trip.
15
CAM and HMO Health Services
One cannot understand CAM use in Israel without understanding something

about the basic structure of providing health care in that country. In January 1995,
a national health insurance law went into effect. This created a compulsory health
care system that was based around four non-governmental, non-profit service
providers (i.e., HMOs). Every citizen in Israel pays in proportion to his or her
income, and each is thereby entitled to the same quality and range of medical
services. All of these organizations are deeply involved with providing CAM.
Three of them (Clalit, Maccabi-Tivi and Meuhedet) cosponsored the 2010
Jerusalem International Conference on Integrative Medicine (see Appendix C),
while the fourth, the Leumit Health Fund, promises potential clients “extensive
complementary medicine services with an unlimited number of visits at low
subsi[di]zed rates.”43
The largest of the HMOs is Clalit Health Service (CHS).44 According to

webometrics.info, Clalit is the 172nd best hospital system in the world. Clalit dates
from 1911, when 150 immigrants pooled their resources to form a mutual aid
health society. With the founding of the state of Israel in 1948 Clalit greatly
expanded, especially in new immigrant neighborhoods. Clalit now covers health
services for more than half of the Israeli population (3.8 million people) from
every ethnic and demographic group. Clalit has 14 hospitals and 1,200 primary
and specialized clinics. It is the only health fund with a countrywide network of
state-of-the-art pharmacies, dental clinics, laboratories, diagnostic imaging and
specialist centers. It also provides the largest CAM public service in Israel. Clalit
has a particularly strong involvement with CAM. It operates 40 CAM clinics
around the whole country, with 400 CAM practitioners providing over 1,000,000
treatments per year. Maccabi Health Services, the second largest HMO, has a
similar system, which provides an additional 700,000 treatments per year.
Eran Ben-Arye (Haifa)
A Haifa researcher of note with whom I met was Eran Ben-Arye, MD. Ben-Arye
is an expert in complementary therapies and on the general topic of physician-
patient relations and of the attitude of health personnel towards CAM. Since
2001, he has been the author of 40 PubMed-listed articles on complementary
medicine (with a total of 47 manuscripts accepted or published in peer-reviewed
journals). Many of these are coauthored with Moshe Frenkel (who lives in a
nearby town and has close links to Haifa) and Elad Schiff, MD.
16
Figure 4 Eran Ben-Arye with Middle Eastern Herbs
Ben-Arye led the first course in Israel in integrative medicine for oncologists in
2002. He has dual training in complementary medicine and family medicine. He
has also had an exceptional education in CAM. He did a fellowship with Brian
Berman, MD, at the University of Maryland’s pioneering CAM department. Ben-
Arye taught the course on CAM for fourth year medical students. He has studied
homeopathy and Ayurvedic medicine. He did studies on herbal medicine at
Hadassah University Hospital in Jerusalem. He studied the so-called French
school of homeopathy, using low dilutions. He finds homeopathy to be a very
practical type of treatment to use with his patients. He also studied
Anthroposophical medicine in Arlesheim.
In his clinic in Haifa, Ben-Arye uses an interesting combination of herbal

medicine, Chinese medicine (including acupuncture), homeopathy, folk and
traditional remedies, dietary/nutritional therapy (including nutritional
supplements), chiropractic, movement/manual healing therapies (including
massage, reflexology, yoga, and Alexander and Feldenkrais techniques), mind-
body techniques (including meditation, guided imagery, and relaxation), energy
and healing therapies, and other naturopathic therapies (ibid.).
In 2002, Ben-Arye was first author of one of the few randomized controlled trials
on the use of wheat grass juice, for distal ulcerative colitis. Twenty-one patients
17
completed this study, and full information was available on 19 of them.

Treatment with wheat grass juice was associated with significant reductions in
overall disease activity as well as severity of rectal bleeding. There were no
serious side effects associated with this treatment. The healing effect was ascribed
to its antioxidant potential.45
Since 2007, Ben-Arye has been the chairperson of the Israel Society for
Complementary Medicine (ISCM) of the Israel Medical Association. The ISCM
has more than 150 members (2/3 are physicians and the other researchers, health
care providers active in integrative practices). Ben-Arye and his colleagues in the
ISCM board lead international collaborations with leading academic centers in
the US (called the Consortium), as well as in Europe and the Middle East.
In 2008, Ben-Arye founded the Integrative Oncology Program (IOP) within the
Clalit Oncology Service (COS) of the Haifa and Western-Galilee district of Clalit
Health Organization, the largest Health Maintenance Organization (HMO) in
Israel. The IOP offer a research-based free of charge service to patients during
chemotherapy and in advanced disease state and is based on a multi-disciplinary
team that include Ben-Arye with a multi-disciplinary team of social worker,
occupational therapists, physiotherapists, nutritional specialist, and spiritual
support therapist. The COS envisions this service as an integral part of the
mission aiming to promote patients’ well being during chemotherapy and in
advanced disease. Structured referral from the oncologist, nurse or social worker
is mandatory. The IOP activities are based on a registry protocol research
approved by Helsinki committee (a.k.a., the institutional review board).
Ben-Arye sees complementary medicine as a way to improve medicine as a

whole, to change things at their roots. All the CAM treatments done in his
program is free-of-charge. This is especially important for reassuring people in
Israel, who (because of the long history of ‘socialized’ medicine) tend to be
suspicious of fee-for-service medicine. This is labor-intensive work. There is a
one-hour intake process to evaluate their needs. Patients are then enrolled in a
clinical trial. Most patients come to 10 to 20 CAM sessions. The treatment is
always tailored to the individual patient.
Gil Bar-Sela (Haifa)
I visited Gil Bar-Sela, MD, an integrative oncologist at the Rambam Health Care
Campus in Haifa. Bar-Sela is a graduate of the Ben Gurion University Faculty of
Medicine in Beer Sheva, who obtained his oncology training at Rambam Medical
Center in Haifa. In addition, he has trained in complementary medicine at two
outstanding European centers: the world-famous Anthroposophical center in
Dornach, Switzerland and at the Witte Herdeke University, the only accredited
private university in Germany.
Bar-Sela is also associated with the Harduf kibbutz, which is located in the Lower
Galilee, not far from Haifa. This kibbutz, which pioneered organic food in Israel,
18
was established in 1982 by followers of Rudolf Steiner. The name Harduf means
“oleander” (coincidentally, oleander is used in some countries as an experimental
cancer medicine). The Kibbutz members live according to Steiner’s
anthroposophy philosophy. Harduf has several well-known health centers: Beit
Elisha, for the rehabilitation of adults with special needs; Tuvia, for young people
who have been removed from their homes and need a foster family; and Hiram,
which helps young people who are suffering from emotional problems.46
Figure 5 Gil Bar-Sela
During 2006 Bar-Sela worked in research at the Radiation Oncology Branch of

the National Cancer Institute - NCI, Bethesda, Maryland. He is currently a senior
physician in the oncology department and leads the supportive care center in the
division. Gil’s main research and clinical interests are the basic research of
epigenomics and the clinical field of integrative medicine in oncology
treatment.47
As part of his work, Bar-Sela provides what he calls supportive oncology services
to his patients. He has a nurse who covers the booking of patients in the
outpatient department. As a regular oncologist the meeting time for each patient is
very brief. But the supportive clinic allowed complementary medicine
19
consultation with more time, between 40 minutes and 1 hour for each patient. He
always sees each patient with a nurse. If he is seeing someone who is not his
oncology patient he tries not to contradict the recommendations of the other
oncologist.
The first thing to determine is what the symptoms are. He also wants to know if
the patient is using any non-conventional treatments. He usually starts with
Anthroposophical medicine. They are using Iscador (mistletoe) in the hospital
with IRB (Helsinki) permission. In his private clinic he has seen some tumor
regression and decline in patients’ tumor markers using mistletoe without any
conventional medicine.
The Rambam Health Care Campus (HCC) in Bat Galim, Haifa, was founded in
1938 and is the largest medical center in northern Israel. Rambam serves as a
referral medical center, which treats 75,000 in patients each year. An additional
500,000 are treated as outpatients. The Technion’s medical school is located next
to the hospital.
At Rambam HCC, all the CAM treatments done in the supportive oncology center
are free of charge as part of the oncology division’s services. These include art
and music therapy, reiki, shiatsu, reflexology, oil anointing, guided imagination,
healing, the nutrition clinic and spiritual care.
Bar-Sela comments that in Israel CAM is closely integrated into the various
cancer centers. This allows patients to get both conventional and complementary
safely, a major consideration. The situation in Israel, he says, is unique because
there is more freedom for the doctors and less regulations than in the US;
nonetheless, the various unconventional treatments are given at the big centers
and not in small clinics (as often happens in the US). A great deal of research is
done in Israel. “Personally, the research I am doing now with mistletoe in non-
small cell lung cancer (NSCLC) failed to recruit a sufficient number of patients in
Germany because of the requirement that it be randomized. In addition, the
ongoing studies here using wheat grass juices in conjunction with chemotherapy,
curcumin (a turmeric extract) with the standard drug gemcitabine, mistletoe
extracts in ascites, and so forth, are all unique.”
Bar-Sela consults for patients from abroad, mainly from East Europe, the US and
South Africa. He mainly tries to help them via email and by giving them
directions for medications and referrals to physicians working in their respective
countries.
In the next five years, Bar-Sela said, there will be a floor for CAM at Rambam in
the new oncology building. The problem is that the hospital administration must
first building an emergency 500-bed underground hospital under the proposed
new hospital building. I was told that this was a result of a rocket attack on
downtown Haifa in 2006. Although Haifa seemed peaceful enough, the prospect
of rockets or worse coming from the northern border is ever-present.
20
Jacob Shoham And KaMaH
On a very hot day in July I met Jacob Shoham, MD, PhD, at his office at Bar Ilan
University in Ramat Gan, to the east of Tel Aviv proper. Bar Ilan is Israel’s
largest and fastest growing university. The University is unusual in many
respects, one of which is that it has an overtly religious orientation. At its Web
site it states: The University regards the sacred principles of Judaism as the
manifestation of the Jewish people’s uniqueness….” At the same time, it
proclaims its promotion of “tolerance and coexistence between religious and
secular, and Arab and Jewish students.” This is not an idle boast. In keeping with
these principles, this university is simultaneously a magnet for both the orthodox
Jewish community and the Israeli Arab population. Indeed, I was surprised to see
a considerable number of Arab students, male and female, strolling on campus.**
Shoham has been active in the cancer field for 40 years. He serves as the
international editor of the peer-reviewed journal, Integrative Cancer Therapies.
Shoham reminded me that we met in 2000 in a very unlikely setting: a clinic in
Tijuana, that specializes in administering and teaching the controversial Gerson
dietary approach to cancer. At the time, Shoham was studiously taking notes and I
hardly registered his presence. In retrospect, I think it is remarkable that such a
distinguished physician/scientist would take the time and trouble to visit an
obscure cancer clinic in Tijuana. Very few others have, and I think this incident
speaks volumes about the man and his character.
Shoham earned his medical degree from Hebrew University-Hadassah Medical

School and his doctorate at the famed Weizmann Institute in Rehovath in 1970,
working with Leo Sachs, MD, winner of both the Wolf Prize for medicine and the
Israel Prize.48 Hebrew University and Weizmann are two of the top academic
centers in Israel (equivalent to Harvard and M.I.T. in the United States). In an
earlier phase of his career, Shoham conducted in-depth research on the role of the
thymus and factors secreted by it in T-cell development, including exploration of
their clinical relevance in cancer and other diseases. He also studied experimental
and clinical aspects of interferon activities, including collaborative studies with
Michel Revel’s group at the Weizmann Institute.
**
At most of the CAM facilities I visited Jewish doctors went out of their way to
affirm their commitment to both treat Arab patients and collaborate, whenever
possible, with Arab physicians, although they were frank about the difficulties
involved in implementing such cooperation.
21
Figure 6 Jacob Shoham

Photo courtesy Jacob Shoham
Shoham is board certified in internal medicine in both Israel and the U.S. He
accomplished a medical oncology fellowship at Roswell Park Memorial Institute,
Buffalo, NY, one of the most venerable cancer centers in the U.S. In addition, he
has also completed studies in Nutritional Medicine, Medical Ecology, Clinical
Immunology, Chinese and Western Herbal Medicine, Psycho-oncology, medical
hypnosis and Mind-Body Medicine. His research focus is in cancer and
immunology.
While serving as a fellow in medical oncology at Roswell Park Memorial

Institute in the 1970s he became disillusioned with the exclusive focus on
conventional medicine. “We were bringing people to the door of death,” he told
me. “People died of the treatment.” He decided that he couldn’t do this anymore.
When he returned to Israel he went to work as a senior physician in internal

medicine at the Chaim Sheba Medical Center in Tel Hashomer. This functions as
Israel’s national medical center in many fields. In 1985, Shoham lost his first wife
to breast cancer, which was discovered when it was already in stage IV. This
needless to say gave him a new perspective on cancer and what patients endure.
He says that his main mission is to understand cancer better and implement this
understanding to clinical practice.. The medical status quo won’t yield big
22
solutions, he says. He sees the struggle as one of complex systems vs. the
prevailing reductionism in most of science. The science of complex systems is a
new, vital phase in modern science which better reflects the real world. It has the
potential of opening a new era in medicine, particularly when dealing with
chronic diseases. Human beings and their health problems can be better viewed
from this perspective. When dealing with cancer, this disease should be conceived
as a new system (‘neo-plasm’), created within the hierarchy of body’s normal
systems and displays features of a complex, adaptive and dynamic system. The
patient and his cancer are intimately interacting systems. Treatment should be
directed to both. This view has implications to all aspects of cancer medicine –
diagnosis, follow-up, prognosis and treatment, as well as to cancer experimental
and clinical research. The molecular and reductionist approach to cancer is over
emphasized, he says. It should be balanced by a complexity science approach.
After serving as a senior physician at the Sheba Medical Center he became Vice-
President of R&D at Interpharm, an Israeli pharmaceutical company. He was a
member of the Israeli National Committee for Biomedical Research Policy. He is
currently developing the conceptual and practical foundations of Health-
Promoting Medicine in addition to his clinical work in his private clinic,
emphasizing recruitment of inner healing forces, and his research at Bar-Ilan
University on cancer therapies. Shoham is also Chairman of the “KaMaH”
Association's Executive Committee and serves as the Center's Medical and
Scientific Director.
Although he currently serves as an emeritus professor at The Mina & Everard

Goodman Faculty of Life Sciences,49 most of his energy is presently used in
promoting the formation KaMaH, the Israel Center for Health Promoting
Therapies. KaMaH’s aim is to enable individuals suffering from severe health
problems to recover and heal, by using what Shoham calls Health Promoting
Medicine
The organization’s motto is taken from “The Physician’s Prayer” of Moses

Maimonides (1135-1202 CE): “In the patient let me always see the human being.”
Shoham interprets this to mean the following:
1. Let me approach the patient with respect, empathy, compassion, and hope.
2. Let me see his enormous capacity to take responsibility, to heal himself, to
transform and to grow.
3. Let me see the patient as a unique whole.
Although Shoham is the driving force, the idea of KaMaH has attracted
prominent physicians, therapists and scientists in Israel. KaMaH is at present
Shoham’s dream. He projects that the clinic will be in the hills surrounding
Jerusalem. He wants international patients to come there for (a) health promotion,
(b) combating of disease and (c) to provide motivation to patients to cope more
efficiently with their disease and by doing so live longer and healthier lives. One
of Shoham’s mentors is Lawrence LeShan, who is famous for his promotion of
mind-body medicine in cancer.50
23
KaMaH is striving to institute a new approach to medicine, which views the

patient as an integrated whole, identifies internal healing powers that are related
to various dimensions of an individual's life – the physical, emotional, spiritual
and social-environmental – and mobilizes them in order to facilitate health
rehabilitation.. The aim is to create a compassionate climate of health care
delivery, in a healing environment, which will encourage and facilitate these
processes.
The KaMaH association is determined to establish a scientific basis for
approaching severe disease conditions through treatment of the whole individual.
KaMaH's treatment programs combine disease-specific, non-toxic therapies and
health-building resources, as carefully integrated means of overcoming the
disease and regaining health. These systematic and individualized programs are
based on principles derived from the science of complex systems, employing
means developed from a variety of medical disciplines – modern medicine,
modern biology, biochemistry, physiology and immunology, nutritional and
environmental medicine, traditional medicines – Chinese, Ayurvedic, and native
American, psychological counseling, and several other disciplines. KaMaH is not
a hospital. It is an outpatient clinic that provides medical treatments that
systematically integrate non-medical mans of promoting healing and recovery.
The current focus is on cancer, employing science-based means to outsmart the
cancer process, by using an indirect attack strategy on the cancer process, in
addition to or instead of the prevailing direct means of treatment, while fortifying
inner defense mechanisms. The program cultivates a life-affirming outlook by
encouraging patients to view the disease as a turning point in their lives and
reassess their beliefs, values, priorities and meaning in life. The aim is to heal life
and not only disease, by guiding the patient on a path of personal growth and
fulfillment.
KaMaH will convey, through its services, a message of humanistic medicine that
may balance the growing inclination in contemporary medicine towards medical
technology.
The fact that KaMaH is non-profit is very important in the Israeli context. It
removes the suspicion that the motive behind such a venture is selfish or
exploitative. In this way KaMaH can preserve its focus on professional concerns
without having to address pressures applied by investors seeking yields on their
investment. The focus of contemporary medical R&D on profit-bearing themes has
led to the atrophy of R&D that investigates the potential inherent in treatments that
have not been labeled as having a profit potential. These are, among others, the
therapeutic directions that the KaMaH will try to develop and prove their value.
The Israeli Ministry of Health has endorsed the Center's establishment and attaches
importance to its plans – namely, to make practical and controlled use of non-
medical means for coping with chronic and complex medical problems and to
scientifically examine their contribution to health promotion and rehabilitation, an
enhanced quality of life and increased life expectancy. This KaMaH project seems
most worthy of support.
24
Hadassah University Hospital, Ein Kerem (Jerusalem)
One of the big surprises of this visit was Hadassah University Hospital in Ein
Kerem, in the far southwestern suburbs of Jerusalem. First, for clarification, there
are two Hadassah Hospital. The original facility is located on Mt. Scopus,
overlooking northeast Jerusalem. Hadassah, the Women’s Zionist Organization of
America built this in the 1930s. Hadassah was and is one of the largest Jewish
organizations in the world, with some 300,000 members. In 1948, the invading
Jordanian army blockaded the road to Mt. Scopus. As a result, in 1960-1961,
Hadassah built another hospital in Ein Kerem, an 800-bed tertiary care facility
further from the “front line” of what is now northeastern Jerusalem. This is where
the medical school is located and also where I visited the complementary
medicine team. Mt. Scopus was, of course, part of Jerusalem eventually
recaptured by the Israelis in the Six Day War of 1967 and now primarily serves
the Arab population of East Jerusalem.
Figure 7 Martine Toledano, Reuven Or, Ruth Radiano, and Gisele Obadia-
Aferiat
Hadassah Hospital is ranked #1 in Israel and #158 in the world, according to the
Web site, webometrics.info.51 It is the leading medical center in the entire Middle
East (its closest competitor is the Hadad Medical Corporation in Doha, Qatar.) To
put this in perspective, its world ranking puts it ahead of L’Institut Curie in Paris,
the 22 Shriner’s Hospitals for Children, and Dana-Farber Cancer Center in
Boston.
Hadassah offers state-of-the-art treatment, with excellent physicians and

advanced medical and surgical staff and equipment. It participates in numerous
clinical trials and has a strong relationship to US medicine. (It is actually a hybrid
Israeli-American institution and is a member of the American Hospital
Association.52 One meets many American and Canadian physicians there.)
In 1990, Hadassah became one of the first hospitals in Israel to open a

complementary and alternative medicine (CAM) clinic. To put this in perspective,
this was before the founding of the Office of Alternative Medicine at the US
25
National Institutes of Health, now the National Center for Complementary and
Alternative Medicine. There was a certain irony to this, as Hadassah has a
reputation as Israel’s most high tech hospital.
This clinic offers both traditional and complementary medicine, with a unique
way of approaching patients’ needs and providing optimal treatment that draws
on both traditions. This was the brainchild of Martine Toledano, M.D., Director
of Integrative Medicine of Hadassah Medical Center, Jerusalem and head of
research discipline and Director of Acupuncture studies Hebrew University,
Jerusalem.
The CAM clinic operates entirely within the framework of the Medical Center.
This allows for a close contact between staff and patients, and also allows access
to the advanced laboratory and imaging facilities of the hospital. At present, more
hundreds of patients use the clinic’s services monthly.
Martine Toledano
Martine Toledano, MD, is the heart and soul of the CAM program at Hadassah
(and the pioneer of integrative medicine in Israel as a whole). She has a
charismatic personality, and combines a profound knowledge and enthusiasm for
CAM with a realistic recognition of its strengths and weaknesses. “What’s
important is recognizing your limits,” says Toledano. “Sometimes, conventional
therapy is the best way. A choking child needs an Emergency Room, for example.
A cancer patient needs chemotherapy.”
Hematopoietic stem cell transplantation (HSCT) must receive pre-transplant

conditioning. This involved high doses of combined chemo-radiotherapy. After
the transplant, the side effects of this treatment can be further increased by
neutropenia-associated infections, gastrointestinal mucositis and graft-vs.-host
disease (GVHD). In addition to the physician symptoms, patients understandably
suffer various negative emotional responses such as stress, anxiety and far.
The staff decided to use reflexology (a special kind of foot massage) in order to
try and relieve these symptoms. The medical and nursing teams hold a conference
to decide on integrating reflexology into the conventional treatment plan. Patients
then receive individualized reflexology sessions twice per week from licensed
professionals.
26
Figure 8 Reflexology at Hadassah University Hospital

Photo courtesy Department of Bone Marrow Transplantation, Hadassah
University Hospital
Reflexology has been shown to improve the patients’ quality of life by

diminishing the side effects of chemotherapy, including nausea, vomiting, pain,
anxiety and insomnia. It affects the whole cycle of activities of daily living.
Along with mainstream care, and in addition to the usual MRI scans, organ
transplantation and chemotherapy, the complementary department uses a variety
of non-conventional treatments:
1. Acupuncture
2. Alexander method
3. Aromatherapy
4. Auricular therapy
5. Biofeedback
6. Craniosacral therapy
7. Homeopathy
8. Hypnosis
9. Meditation
10. Mesotherapy
11. Naturopathy
12. Osteopathy
13. Phytotherapy
14. Reflexology
15. Relaxation
16. Tai-chi
17. Yoga
“At a first consultation, we give a patient a full conventional medical

examination,” Toledano told me that they take a medical history, and review the
X-rays, CT-scans or biochemical test results and possibly request additional
standard tests. But they also do less conventional studies, with the help of
Chinese and/or homeopathic questionnaires, and so on.
In fact, oncology was the first entry point for CAM at Hadassah. “Most of our
patients look for other options at some point during their long and difficult
27
treatment,” said Tamar Peretz, MD, head of Hadassah’s Sharett Institute of

Oncology. “Some seek help in fighting their illness or in coping with therapy;
others want ‘natural treatment’ together with conventional approaches. Not only
are these patients entitled to every viable treatment option, but homeopathy and
reflexology are known to markedly diminish side effects of chemotherapy in
many patients.”53 Needless to say, such statements would be highly unusual
coming from a leading academic oncologist in the US.
“Today, scores of oncology patients come to our clinic for help in offsetting side-
effects of treatment,” says Toledano. “And they do it knowing they have the full
support of their oncologists.” Originally, the Complementary Medicine Unit was
a kind of ‘stepchild’ of the medical center. Its mandate was to use “all treatments
and therapies not included under conventional medicine.” Then, in 2008, because
of the excellent relations between the CAM doctors and the regular staff, it was
invited into main hospital. The service quickly took off, and was soon handling
hundreds of cases per month.
“People with intractable problems will understandably do or pay almost anything

for hope or relief,” said Toledano. “If conventional medicine hasn’t helped them
enough, many will look to complementary medicine.” She points out that in
Israel, as in the US, patients frequently hide their CAM usage from their
conventional doctors, because of fear of censure, rejection or denial of services.
But this can result in dangerous or even disastrous drug interactions. There is also
the problem of charlatanism, which has bedeviled the field of complementary
medicine from its inception. But administering CAM within Hadassah itself, and
adhering to the ethical and scientific standards of a modern medical center, these
problems all but disappear.
Recently, the unit was given permission to open and run clinics in many fields for
which there is reliable evidence-based research that complementary medicine is
effective. During the course of my visit, Toledano took me to the various clinics
that are currently offering CAM to their patients. This included not just adult and
pediatric oncology but gynecology, cardiology and the pain clinic. “The list of
disciplines is growing all the time.”
Conventional medicine tends to treat all patients with similar diagnoses the same.
But in complementary medicine, the treatment tends to vary with the individual
patient. It is customized medicine, just as, Toledano says, modern conventional
medicine is. “If a woman comes to me with an intractable headache that responds
neither to Voltaren (diclofenac) nor to pain-blocks, I have several choices,” she
says. “If this patient sits and weeps and tells me she can no longer bear her
headache because she’s already burdened by problems at work or at home, I may
recommend a mind body technique such as yoga, hypnosis, meditation, or
relaxation. If her headaches began after a car accident or strenuous exercise, I’ll
recommend a mechanical response, such as osteopathy. If she has painful
menstruation in addition to her aching head, I’ll think in terms of a poly-systemic
problem, and start her on acupuncture, for example.”
28
The unit is plagued by some of the same problems as CAM units in other
countries—a lack of money for documenting and researching promising results.
“We’ve reduced back pain so radically that patients no longer require surgery,”
Toledano says. Several women with unexplained infertility have become
pregnant following acupuncture in our unit, which means that complementary
medicine offers solutions to problems that conventional medicine either could not
handle, or ‘solved’ by performing more drastic procedures. These are exciting
results and we’d like to investigate them in full.”
Nonetheless, the Unit continues to grow. “It’s clear from both the demand for
complementary medicine and its successes that some additional form of treatment
is needed,” Toledano says. “Complementary medicine techniques add therapeutic
tools to the doctor’s arsenal, often giving patients very great benefit at very low
risk. Today, most doctors recognize there are many ways to help a patient, and
understand that complementary medicine approaches are among those ways. My
dream,” she adds, “is to see a new approach to patient care – known, perhaps, as
integrative medicine – which embraces both conventional and non-conventional
therapies.
Medical Marijuana
Medical marijuana is being intensively researched in Israel. Much of this is due to

the work of Raphael Mechoulam, PhD, a professor in Hadassah’s School of
Pharmacy.54 The endogenous cannabinoid neurotransmitter, anandamide, was
discovered in Mechoulam’s laboratory at Hadassah hospital in the 1990s.55 But
Mechoulam has been researching the chemistry of cannabinoids (their isolation,
structure elucidation and synthesis), as well as synthesis of novel agonists to
cannabinoid receptors, since 1965. He then tests these novel compounds for
action on suitable in vitro and animal models, with the financial support of the US
National Institutes of Health (NIH). In fact, he is the author of over 360 scientific
papers, over 75 of these on marijuana constituents and derivatives.56
Shimon Slavin and the CTCI
Shimon Slavin, MD is one of the most accomplished physicians involved in basic

science in Israel. Slavin’s work focuses on stem cell transplantation and
innovative cellular therapies for treatment of malignant and non-malignant
disorders, including the use of donor stem cells for induction of transplantation
tolerance to foreign organs (i.e., allografts). He is also a specialist in the use of
stem cells for regenerative medicine.
Slavin is the author of four books and more than 500 scientific publications. A
1967 graduate of Hadassah-Hebrew University School of Medicine in Jerusalem,
he is board certified in internal medicine (1970-1975) and took postdoctoral
training in clinical immunology at Stanford University, Palo Alto, CA, and the
29
Bone Marrow Transplant Center at the Fred Hutchinson Cancer Research Center,
Seattle, WA. He is also board certified in clinical immunology and allergy and
holds license to practice medicine in California and Illinois.
Upon returning to Israel in 1978, he opened the first bone marrow transplantation
(BMT) unit, which was subsequently recognized as Israel’s National BMT
Center. Slavin became its first and long-term chairman. In 1980 Slavin
established the first center for stem cell transplantation and cancer
immunotherapy in Israel. He has attracted patients as well as doctors from around
the world. Two years ago, he left his long-term post at Hadassah Hospital to
establish a private clinic in Tel Aviv. (He retains an academic appointment at the
Hebrew University School of Medicine.)
His new clinic is called the International Center for Cell Therapy & Cancer
Immunotherapy (CTCI). Although it is sometimes stated that his center is located
“at the Tel Aviv Medical Center,”57 I discovered that this is a misnomer. CTCI is
physically located adjacent to the Sourasky Medical Center and although its
Clean Rooms and GMP Cell Processing Center are both located at the Sourasky-
Tel Aviv, it has no official affiliation with that hospital. It is a private fee-for-
service clinic.
Slavin believes that the immune system may be the most promising tool for
eradicating cancer. This include cancer stem cells, which are primarily resistant to
all available anti-cancer agents and are widely believed to be the main cause of
recurrent disease. Slavin says that the best and, in some cases, the only chance to
eradicate all malignant cells is when the tumor has been reduced (via the
conventional means of surgery, radiation and/or chemotherapy) to a state he calls
“minimal residual disease.”
30
Figure 9 Shimon Slavin
Unfortunately, conventional oncologists and hematologists recommend no further

treatment when patients show no evidence of disease (NED), although this is
probably the best time to eradicate the invisible disease. After all, one million
cancer cells is still only the size of the head of a pin. Therefore, many millions of
cancer cells may be already on board but cause no symptom and remain invisible
by any available diagnostic method.
Every oncologist or hematologist can easily recognize their high risk cases, i.e.,
those that are unlikely to be cured by any of the conventional anti-cancer
modalities. Unfortunately, most cancer specialists are not yet convinced that
immunotherapy can be the answer for curing such cases. At the point of minimal
residual disease, Slavin says, the immune system can be activated to wipe out
these small but potentially dangerous nests of malignancy, including cancer stem
cells. Slavin says that the activation of the patient’s own immune system may be
sufficient for eradicating minimal residual disease. However, patients with more
aggressive malignancy, or whose tumors are much larger, the use of foreign
(allogeneic) lymphocytes may be required for induction of a much more effective
warfare against cancer. This is because immunologically mismatched
lymphocytes can kill cancer cell faster and more effectively.
31
One method of activating a patient’s own immune system against cancer is to

administer a drug that unblocks the immune system’s attack on cancer. Slavin
believes that this can sometimes be done with a substance in the aspirin family. It
has been shown that people who use aspirin or similar non-steroidal anti-
inflammatory agents (NSAIDs) regularly have a diminished likelihood of
developing cancers of various kinds. He has co-authored papers on the use of the
common NSAID indomethacin (Indocid, Indocin, etc.) in inducing immunity in
mice. This drug is typically used to diminish the symptoms of arthritis. But it has
anticancer potential as well. When mice that normally failed to induce an immune
response against metastatic breast cancer were given indomethacin in the drinking
water they would resist a subsequent breast cancer challenge.
Indomethacin has potential as an adjuvant anticancer agent. Here is what the

National Cancer Institute drug dictionary has to say about this drug:
“A synthetic nonsteroidal indole derivative with anti-inflammatory

activity and chemopreventive properties. As a nonsteroidal anti-
inflammatory drug (NSAID), indomethacin inhibits the enzyme
cyclooxygenase, thereby preventing cyclooxygenase-mediated DNA
adduct formation by heterocyclic aromatic amines. This agent also may
inhibit the expression of multi-drug-resistant protein type 1, resulting in
increased efficacies of some antineoplastic agents in treating multi-drug
resistant tumors. In addition, indomethacin activates phosphatases that
inhibit the migration and proliferation of cancer cells and down regulates
survivin, which may result in tumor cell apoptosis.”58
In the US, indomethacin is available by prescription. One attractive fact about

these drugs is that they are inexpensive. At the Israeli drug exporting Web site,
www.israelpharm.com, 30 x 25 mg capsules of Indocid sell for $10 (plus s&h),
which works out to 33¢ per capsule. The normal dose for treating arthritis is 2 or
3 x 25 mg capsules per day (~$1 per day). The maximum dose is 200 mg per day.
Even at this high dose, the cost of the drug is $2 per day. Thus, for a drug with
such promising anticancer activity this is a “bargain.” A similar drug, Celebrex
(celecoxib) results in less gastric acidity and probably has a similar effect. (NB:
These drugs are subject to an FDA ‘black box’ warning on the label, explaining
the increased risk of cardiovascular disease in those who take the drug, especially
for a prolonged period.59)
Another treatment that Slavin sometimes recommends is a natural cytokine

named interleukin-2 (IL-2). In a recombinant form, this is a standard immune
therapy for a few types of malignancy, including melanoma and kidney cancer.60
It has been used experimentally to treat other cancer types as well. Slavin finds
IL-2 to be useful in conjunction with cell therapy (q.v.) to improve the outcome
of leukemia patients. He employs a combination of BMT, or stem cell
transplantation, and IL-2. He can pre-treat lymphocytes (particularly T cells and
natural killer, or NK, cells) with IL-2 in order to give them an enhanced ability to
attack and destroy the remaining tumor cells. The treatment Slavin uses with IL-2
is different from the treatment provided by other centers because he uses IL-2
activated donor lymphocytes, not only patient’s own lymphocytes, and uses a
32
short course of IL-2 administered subcutaneously to continue to activate donor

lymphocytes after they have been infused to the patient. Furthermore, Slavin
developed special approaches for targeting the killer cells (IL-2 activated donor T
cells and NK cells) to the malignant cells by antibodies against antigens that are
over-expressed on the tumor cells.
Slavin likes to pose hypothetical situations in order to explain his treatment

approach. For instance, he points out that normally a tumor transplanted from a
cancer patient into a healthy stranger will not “take.” Within a few days the
recipient’s normal immune system would energetically attack these unmatched
tumor cells and wipe them out. This is similar to how a transplanted organ can be
rejected by the host when there is a poor match between donor and host. Slavin’s
idea was to use lymphocytes that are taken from the blood of a healthy person,
activate them in the laboratory, and then administer them to the cancer patient.
Since these lymphocytes of normal people are presumed to be able to destroy
foreign tumors in their own body, he reasons that they can also kill tumor in
another person’s body. These specially prepared cells are called “activated donor
lymphocytes.”61 Slavin finds that this is a very effective way to wipe out a
relatively small number of malignant cells often remaining in the body of a
person who has been treated for cancer.
Why not use this against large tumors? The reason is that the “activated donor
lymphocytes” would have to remain for weeks and months in the body of the
patient in order to do this. But the obvious difficulty is that the patient’s immune
system senses the presence of these donor cells, identifies them as foreign, and
kills them before they have a chance to destroy the tumor. Hence, donor
lymphocytes can kill all cancer cells if the job can be accomplish within less than
a week, while they circulate in the host. If longer time is required to eliminate
large masses of tumor cells, the permanent survival of donor lymphocytes is
required. This can be accomplished by prior transplantation of donor stem cells
through a procedure called allogeneic stem cell transplantation. The engraftment
of donor stem cells ensures durable engraftment of donor lymphocytes. And hen,
following transplantation “donor lymphocyte infusion” (DLI) can be used to
amplify the anti-cancer effects mediated by donor lymphocytes.
This is accomplished with a rather elaborate procedure. First, the bulk of the
cancer has to be eliminated (through surgery, radiation, chemotherapy, etc.)
Second, the patient’s bone marrow is destroyed and then replaced by newly
grafted bone marrow or blood stem cells from the donor. In this way, the patient
becomes tolerant of the donor’s lymphocytes. At this point, the patient is ready
for a transfusion of activated lymphocytes from the donor. These are the cells
designed to finish off the last cancer cell.
Slavin speaks movingly about one of the first cases treated with this new
technology, a two-and-a-half year old toddler with leukemia who had gone
through many forms of conventional treatment. This included radiation given at
four times the lethal dose and treatment with some of the most poisonous drugs
known to man. He survived the treatment, but unfortunately the cancer returned
with visible tumor masses on his forehead and next to his trachea, threatening to
33
close his airway. As a last desperate measure, once per week for six weeks the
little boy was given an injection of blood from his sister. Amazingly, the tumor
masses disappeared and the young boy was completely cured! He is in fact still
alive and well, more than 24 years after the fact.
This was the first patient ever to be cured by donor lymphocytes when all
available anti-cancer modalities, including supra-lethal radiation and
chemotherapy failed, thus proving the working hypothesis: activated lymphocytes
can be more effective than any available anti-cancer treatment once used
correctly. Since that time many thousands of patients (most of them with
leukemias or lymphomas) have been treated in a similar fashion, sometimes using
short-lived donor lymphocytes or else more long-lived donor lymphocytes after
tolerance has been induced by stem-cell transplantation.
In the abovementioned case, tolerance of the foreign blood was made possible
because the boy underwent bone marrow transplantation (BMT), and so his
immune system became tolerant of his sister’s blood. Her blood then did the work
of killing off his cancer, a fine example of sisterly love! Today, because of
improvements in technology, DLI can be performed without performing a BMT
or finding an immunological match. In fact, Slavin says, mismatched, half
matched donor lymphocytes are actually preferred because the greater the
mismatch, the strong the anticancer effect of the donor lymphocytes. The cells
that are most desirable are the donor’s “natural killer” (or NK) cells. This is
because T-cells (a broad category of white blood cells) would attack all of the
patient’s cells, including normal ones, in a potentially disastrous process called
graft vs. host disease (GVHD). NK cells do not cause this problem, even if they
are fully mismatched. Such an approach developed recently by Slavin, makes it
possible, he says, to cure patients considered incurable using an innovative
procedure for safer engraftment of donor stem cells. In this way, donor NK cells
can be activated to become vicious cancer killer cells without also attacking
patient’s normal tissues.
Therefore, Slavin says one can separate out the harmful effects of GVHD from
the beneficial type of graft-vs-tumor effects by first separating the NK cells from
the T-cells and only then injecting the former into the body. The selection of NK
cells is effected using antibodies that are bound to metal beads that specifically
bind only to NK cells. These are then removed through the use of a special
magnetic device called a CliniMACS® Cell Separation System (from the German
company, Miltenyi Biotech). Alternately, they can remove the T-cells by using
antibodies against the latter.
Slavin himself recognizes the limits of DLI in patients with bulky and end stage
disease. No one should mistake this as a cure for very advanced disease.
However, he believes that the use of haploidentical stem cell transplantation with
DLI from the mismatched donor using guided killer cells, may eventually provide
a much more effective tool against cancer in its earlier or residual stages.
In addition to these original methods, Slavin is also employing a number of other

innovative treatments. For instance, he creates a vaccine against cancer using the
34
patient’s surgically removed cells, modifying them slightly, and then

reintroducing them into the body. Alternately, he uses cancer cells of the same
histological type, but from a different patient, to create a vaccine to induce an
immune response against the patient’s cancer cells. He also uses antibodies to
target cancer cells. They are first bound to the surface of natural killer (NK) cells
and then hone in on specific markers on the surface of the cancer cell. This brings
the NK cell into close proximity to the cancer cell, leading to the elimination of
the malignant cell.
Lately, he told me, he has been experimenting with an antibody that can deliver
both NK cells and T-cells to the tumor site. He is also working with an antibody
that binds to a T-cell and a human melanoma cell. All of the antibodies removed
from that cow’s blood would be capable of destroying human melanoma cells. In
addition, this ability will be passed along to their offspring, thus ensuring an
almost limitless supply of what Slavin calls “anticancer smart bombs.” This is
being mass-produced in transgenic cows that have been cloned by a German
scientist, Gottfried Brem, who is an expert on genetically modified animals.
Slavin is also working with Newcastle Disease Virus (NDV) vaccine as a

potential treatment for cancer. This is a treatment that has been intensively
investigated at Hadassah Hospital.62 This virus, which causes a deadly lympho-
proliferative disorder in poultry, is essentially apathogenic in humans (i.e., its
worst side effect is conjunctivitis, or pink eye). But this virus sometimes attacks
cancer cells selectively, which results in their replication inside cancer cells and
ends in the death of the affected cell. At the same time, this process releases new
viruses into the vicinity of the tumor. These viruses also pass through the blood-
brain barrier and have been observed to cause remissions even in glioblastoma
multiforme (a kind of stage IV brain tumor). While these observations are
relatively well known, it has proven difficult to produce a pharmaceutical grade
NDV and to get rigorous clinical trials in motion.
Although immunotherapy has made great strides around the world, as a general
rule it is only used when every other conventional treatment has failed. “This is
too late for a cure to be expected,” says Slavin. “One can only anticipate more
successful treatments if they were administered at an early stage of the disease
against minimal tumor burden.” He says that prospective randomized clinical
trials are urgently needed to prove the value of such procedures.
Slavin says that this kind of treatment has been used successfully in thousands of
patients. In a 2010 paper, Slavin, et al. discuss the feasibility of his approach,
called IMAK (intentionally mismatched rIL-2 activated killer lymphocytes) in
patients with advanced (chemotherapy-resistant) blood (hematological) cancers as
well as metastatic solid tumors. According to Slavin, the procedure was
successful in 5 out of 39 patients. These were all end-stage patients —
“desperately sick patients, all comers, no exclusion.”63 The point of the paper is to
show that the procedure is safe and to justify the application of a similar approach
to patients who might be cured if treated at the stage of minimal residual disease
(MRD). Slavin and his coauthors conclude that the procedure is in fact “feasible,
safe and potentially effective,”64 especially when applied to earlier-stage patients.
35
Joseph Brenner, Tel Aviv
Joseph Brenner, MD, is arguably the best-known CAM practitioner in Israel.

Being a pioneer in introducing CAM treatments (such as hyperthermia) in
oncology in Israel, he has had a high profile controversy with the leaders of the
medical board in Israel and as a consequence became a well-known figure in the
news in Israel. But his struggle paid off. In 2010 he was invited to give a
presentation on hyperthermia at a large conference in Jerusalem on
complementary medicine co-sponsored by the Ministry of Health. Since the time
of his struggle with the medical authorities, CAM units have become an
integrated part of every oncology department in Israel.
Despite his history, Brenner is not as anti-establishment as he may sound.

Brenner is a board-certified head of the oncology department oncologist at the
Edith Wolfson Medical Center in Holon, but also maintains a private CAM clinic
in Tel Aviv. Born in Israel, he studied medicine at the University of Siena, Italy,
for three years. In 1971, he received his medical degree from Tel-Aviv University
in Israel.
36
Figure 10 Joseph Brenner
In the following five years Brenner completed a Residency Fellowship in Internal

Medicine and Oncology at Sheba Medical Center, Tel Hashomer. For the
following four years he received a fellowship in radiation oncology at Rhode
Island Hospital in Providence, following this with a fellowship in medical
oncology at Memorial Sloan Kettering Cancer Center (MSKCC), New York.
After returning to Israel in 1982, he joined the medical oncology department at
Wolfson.
Despite (or because of) this long involvement with conventional oncology,
Brenner has maintained a deep interest in CAM approaches to cancer. As a result,
he has sought out training in such diverse fields as acupuncture, homeopathy,
Reiki, applied kinesiology, dark field and oxidative test microscopy, German
electro-acupuncture testing (EAV), nutrition and more.
Brenner is the founder director of the New Hope clinic, an outpatient center for
biologic and metabolic non-toxic medicine in oncology, in Tel-Aviv. At this
Center, he implements the new techniques developed in Europe and the United
States, such as superficial, regional, and whole body hyperthermia. He is more or
less synonymous with the use of hyperthermia in Israel.
37
In the past, Brenner has been closely associated with the late Prof. Luigi Di Bella,
MD, of Modena, Italy, who treated more than 10,000 cancer patients with a
unique method combining the drug somatostatin with high melatonin. He has also
collaborated closely with Friedrich Douwes, MD, of the St. Georg Hospital in
Bad Aibling, Germany.
Brenner recently installed the Oncothermia 3000, the most advanced

hyperthermia (also called oncothermia) equipment available, manufactured by a
company in Budapest. He typically combines this with insulin potentiation
therapy (IPT) and hyperthermia (which he believes to be a good combination) as
well as high-dose vitamin C infusions. He also has started to use the controversial
substance, GcMAF. He uses galvanotherapy externally, putting electrodes above
and below the tumor.
Brenner is well known for his battle with the Israeli Medical Association. He
initiated a libel suit against the four top medical doctors in the IMA. He says he
had no choice but to do this because his reputation would have been ruined if he
had failed to respond to their insults and provocations. After seven years of
litigation the case was essentially fought to a draw.
In a sense, he has a kind of split personality. In the mornings he practices as a

regular medical oncologist. In the afternoon he runs his personal clinic. The
clinic, he says, is as busy as he wants it to be. After 15 years of administering
hyperthermia he feels confident in the methodology and says he gets very good
results. Due to this 15 years experience in hyperthermia treatments, Brenner is
often invited to lecture in the most important hyperthermia conferences all over
the world. As an oncologist, he knows what constitutes a result. For instance, he
has recently seen a patient who had a CA 19-9 marker go down from 50,000 to
under 1,000. He also had a patient whose bilirubin went from 7 to 0.8 using
hyperthermia. But he has not published his results with this modality, at least not
in peer-reviewed journals.
Whole body hyperthermia at Brenner’s clinic costs $3-4,000 per session, and
local-regional hyperthermia is $400 per treatment. An IV infusion of vitamin C is
$400-500. Brenner says the costs of treatment at his clinic are similar to those in
the European CAM clinics. That may be true for some clinics (such as St. Georg.)
Most of the criticism I heard of Brenner on this trip had to do with the allegedly
high cost of his treatment, which contrasts with most Israeli medicine that is
covered by the insurance plans.
Brenner gives whole body hyperthermia once per week for three weeks, and then
the patient takes two months off. Surprisingly, he says that he does not generally
like to use whole body hyperthermia. He considers it risky because if there are
brain metastases, he says, you are in danger of killing the patient. He also cannot
treat patients with whole body hyperthermia if they have high blood pressure,
heart or lung conditions. He doesn’t sedate the patients and he takes their
temperature to 40.5º C (104.9º F) not to 41.5º C (106.7º F), where there is
definitely a need to sedate the patients. He keeps an anesthesiologist on hand
when he does WBH.
38
He tests markers after one month of treatment and CT scans after two months. He
claims to be able to shrink or stabilize the tumor in 50-60 percent of cases using
these more natural methods.
Conclusions
It is now possible to answer the four questions raised at the beginning of this
report.
1. What is being done for cancer in Israel, in an alternative or

complementary way, that is not be done elsewhere?
Most everything done in Israeli clinics is also done at other hospitals,

clinics and private practices around the world. So the distinctiveness of
Israel is not in what is being done but how it is done, i.e., in how well
integrated complementary measures are with the conventional medical
treatments.
2. What are some of the most promising findings or discoveries?
Israeli doctors (and non-physician CAM practitioners) are finding new

uses for acupuncture, homeopathy, reflexology, medical marijuana, and a
host of other substances and techniques. The most promising discovery is
actually that a full spectrum of CAM can be practiced in a conventional
setting, even in the seemingly unpromising setting of an HMO.
3. How does the Israeli medical establishment’s attitude towards CAM

differ from that in other countries, particularly in the US?
One of the most surprising findings is that medical leaders in Israel are
favorably inclined towards the idea of CAM and towards specific CAM
approaches, such as acupuncture, homeopathy, medical marijuana and
reflexology.
4. If the situation in Israel is unique, why is that so?
As I have said, what is unique is the degree to which CAM has been
integrated and accepted by Israeli medical profession, including the top
leadership. The establishment there seems to not have the same morbid
fear of “quackery” that has historically marked CAM’s development in
the United States.65 In some ways, such as its tolerant attitude towards
homeopathy, Israel seems more European than American influenced.
(Israel was in fact the first non-European country to be associated to the
European Union’s Framework Programme for Research and Technical
Development, the RTD. In some research contexts, Israel is in fact treated
as a European country!66
39
Doctors in Israel are quick to grasp the potential of new treatments and
quick to commercialize these. Being highly pragmatic, they are less
swayed by ideological considerations and able to see more clearly whether
something has promise or not. Those things are then fairly explored and, if
possible, developed. This behavior befits a country that has been called
the “start-up nation.”
My visit to some of Israel’s complementary and alternative (CAM) doctors and

clinics was full of surprises. The greatest of these was the degree to which CAM
is integrated into the conventional health care system. This was most evident at
Israel’s largest and most prestigious health organizations: Hadassah Hospital as
well as its largest HMO, the Clalit system. At Hadassah this was largely due to
the two decades of work by Martine Toledano, MD. There, step by careful step,
CAM has entered the former bastions of conventional medicine (surgery,
pediatric oncology, internal medicine, etc.) and earned the trust of medical
colleagues in all of these disciplines. It was astonishing to see such CAM
modalities as homeopathy, reflexology, and acupuncture, being so
enthusiastically embraced as part of standard medicine.
Another surprising development is the degree to which CAM has found a home in
the major HMOs, including Clalit. There is a widespread perception in the US
that managed care is necessarily antithetical to complementary medicine. In
Israel, however, HMOs compete among themselves as to who can provide the
most comprehensive CAM services! According to everyone I spoke to, this has
led to an enormous expansion of CAM services that are available to the average
patient.
Finally, Israel is also seeing the rise of some interesting fee-for-service options.
Most noteworthy are the two private Tel Aviv clinics of Joseph Brenner, MD and
of Shimon Slavin, MD. Both have distinguished records as oncologists. The cost
of these clinic services may be prohibitive for many Israelis (and the idea of fee-
for-service treatment is still repugnant to many people brought up with a non-
profit ethos concerning medical care). But it seems possible that these facilities
might grow in number and importance, especially if they can attract international
patients in the future. The KaMaH clinic, or a contemplated consortium of Haifa
CAM doctors, might provide the ideal solution, by providing innovative cancer
treatments, with an international appeal, but under the aegis of a strictly non-
profit foundation.
More to the point, I found a genuine openness to CAM among the various
department heads and non-CAM doctors with whom I met. One of them even said
that she saw CAM as not just interesting in its own right, but as the future of
medicine. One can certainly find such sentiments expressed by CAM practitioners
in the US, but I am unaware of any leaders of American conventional medicine
who have ever publicly expressed this view. In this sense, Israel is a very
forward-looking country, as well as an eminently pragmatic one: they are in favor
of whatever works. In the field of CAM, Israel truly earns its sobriquet of the
“start-up nation.”
40
THE END
41
Appendix A: CAM Treatment Resources
Most Israeli CAM doctors are members of the Israeli Society for Complementary
Medicine (http://www.cam.org.il/)
Bar-Sela, Gil, MD, director

Rambam Health Care Campus
Integrated Oncology and Palliative Care Center
Division of Oncology
POB 9602
Haifa 31096 Israel
Tel: +972-50-2061207
Hospital: +972-4-8543810
Fax: +972-4-8541810
E-mail: g_barsela@rambam.health.gov.il
Coworkers: Prof. Haim N., MD, Epelbaum R. MD
Main research themes: Supportive oncology; Anthrophosophical medicine in
integrative oncology; CAM; Stomach cancer
No. of publications (integrative oncology): 8
Ben-Arye, Eran, MD, director

The Complementary & Traditional Medicine Unit
Department of Family Medicine,
Rappaport Faculty of Medicine,
Technion Institute of Technology;
Clalit health services, Haifa and Western Galilee, Haifa
6 Hashahaf Street, Haifa 35013, Israel.
Tel: +972-528709282
Fax: +972-4-851-3059
E-mail: eranben@netvision.net.il
Coworkers: Oren A. MD, Frenkel M. MD, Karkabi K. MD, Lev E. MD, Keshet
Y. PhD , Schiff E. MD
Main research themes: Integrative family medicine; CAM medical education;
Doctor-patient communication; Evidence- & Narrative-based medicine; Bio-
Psycho-Social-Spiritual patient-centered approach; CAM and ethics; Traditional
& Cross-cultural medicine; Integrative oncology; Herbal medicine
No. of publications (peer-reviewed journals): 38
Ben-Arye Eran, MD, Director

Integrative Oncology Program
Haifa and Western Galilee Oncology Service,
Lin Medical Center of Clalit Health Services
Haifa, Israel
Tel: +972-528709282
E-mail: eranben@netvision.net.il
Coworkers: Lavie O. MD, Steiner M. MD, Schiff E. MD, Frenkel M. MD,
Shalom T. PhD, Levi M. MD Main research themes: Evidence-based and
42
narrative-based medicine; Family medicine; Doctor-patient communication; Bio-

Psycho-Social-Spiritual patient-centered approach; Anthroposophic Herbal &
medicine
No. of publications: 11 articles, 2 book chapters
An outstanding program in complementary/integrative medicine in northern Israel
in family medicine and integrative oncology.
Brenner, Joseph, MD
New Hope Clinic
62 Hei Be-Iyar St.
Kikar Hamedina
Tel Aviv, Israel
Mobile = +054-660-6864
Tel: +972-3-5467733
Private practitioner of hyperthermia, IPT, etc.
Caspi, Opher, MD, PhD

Director, Integrative Medicine
Davidoff Comprehensive Cancer Center,
Rabin Medical Center, Petach-Tikva, Israel
E-mail: ocaspi@clalit.org.il
Tel: +972-504065528
Coworkers: Baranovitch O. DOM, PhD, Lac, Argash O., Sheinman, N., ND
Main research themes: patient care; decision-making; methodology; health
policy; shiatsu and fatigue in breast CA; Integrative medicine outcomes & lung
CA; TCM for peripheral neuropathy. Stress & GYN cancer
No. of CAM-related publications: 6
Frenkel, Moshe, MD
Integrative Oncology Consultant
Tel: +972-52-3311255
Web: www.moshefrenkelmd.com
Email: office@moshefrenkelmd.com
Former Medical Director of The Integrative Medicine Program, M.D. Anderson
Cancer Center, presently provides international consultations on the integration of
homeopathy and complementary medicine in cancer care
Gamus, Dorit, MD, PhD, Director

Complementary Medicine Service Chaim Sheba Medical Center,
Tel-Hashomer (Affiliation:Tel-Aviv University, Sackler School of Medicine)
Tel: +972-35303956
E-mail: dorit.gamus@sheba.health.gov.il
Main fellow contributors: Siev-Ner I. MD, Perla D. MA, Lic. Acup, Kleinhauz
M. MD, Mesinger A. Lic. Acup.
Main research themest: Rehabilitation; Post-traumatic stress disorder;
Dermatology; Pain; Palliative care/oncology; Gastroenterology;
Gynecology/infertility; Hypnosis; Acupuncture; Reflexology
No. of CAM related publications: 8
43
Kaufman, Yakir, MD
Neurology Services
Sarah Herzog Memorial Hospital
POB 3900, Jerusalem, Israel
Tel: +972-2-531-6814 or +972-2 531980
Fax: +972-2-653-6075
E-mail: ytkaufman@hotmail.com or ykaufman@herzoghospital.org
Fellow contributors: Lichtenberg, P., Epstein, D., Heresco-Levy, U.
Main research themes: Spiritual Well-being and Alzheimer's Disease; Shiatsu
therapy & Schizophrenia; Placebo effect; Genetics of Personality Traits;
Hypnosis Neurodegenerative Diseases; Orthomolecular therapy
Kuten, Abraham, MD
Director, Division of Oncology
Rambam – Health Care Campus
POB 9602, Haifa 31096, Israel
Email: a_kuten@rambam.health.gov.il
Tel: +972-4-8543003
Fax: +972-4-8543008
Mobile: +972-50-2062003
A major hospital with a CAM presence
Lerner-Geva, Liat, MD, PhD

CAM Research Network
Gertner Institute for Epidemiology and Health Policy Research
Chaim Sheba Medical Center,
Tel Hashomer, 52621, Israel
Phone: +972-35303505
E-mail: LiatL@gertner.health.gov.il
Improving communication between MDs and CAM practitioners, collect data
from CAM clinics, improve quality of treatment, follow-up, and provide the data
to Israeli policy makers. with expert in cancer care in both Israel and the US
Lev, Prof. Efraim, PhD

School of Public Health
Faculty of Social Welfare and Health Studies
University of Haifa,
Haifa 31905, Israel
Phone: +972-4-8240949
Email: efraiml@research.haifa.ac.il, elev@univ.haifa.ac.il
Expert on historical use of medicinal herbs in the Holy Land
Obadia-Aferiat, Gisele, MD
Integrative Medicine, Acupuncture, Homeopathy
Director of Acupuncture Course-Hebrew University
Hadassah University Hospital, Ein Kerem
POB 12000, Jerusalem 91120, Israel
Tel: +972-2-6777111
44
Mobile: +972-52-3558640
Email: Giseleo@hadassah.org.il
Toledano’s deputy and an outstanding practitioner of acupuncture and
homeopathy of the French school.
Oberbaum, Menachem, MD, director

Center for Integrative Complementary Medicine
Shaare Zedek Medical Center
E-mail: oberbaum@szmc.org.il
Tel: +972-26666395
Coworkers: Samuels, N., MD, Singer, R., MD.
Main research themes: pain; sepsis; intensive care; infertility; obstetrics:
oncology; homeopathy.
No. of CAM related publications: 22 articles, 9 book chapters
Or, Reuven, MD
Director, Department of Bone Marrow Transplantation
Cancer Immunotherapy and Immunobiology Research Center
P.O.B. 12000, Jerusalem 91120, Israel
Tel: +972-2-6776561
Fax: +972-2-6777540 or +972-2-642-2731
Mobile: +972-52-3376992
Email: reuvenor@hadassah.org.il
Radiano, Ruth, RN, BSN, MPH, Head Nurse

Dept. of Bone Marrow Transplantation and Cancer Immunotherapy
P.O.B. 12000, Jerusalem, Israel 91120
Tel: +972-2-677-6680
Fax: +972-2-677-6693
Mobile: +972-50-787-4726
Email: radiano@hadassah.org.il or radiano@netvision.net.il
Reshef, Alon, MD
Psychiatric service,
Integrative psychiatry research unit
Ha Emek Medical Center (affiliated with Technion medical school)
Tel: +972-46494351
E-mail: reshef_a@clalit.org.il
Fellow contributors: Tamar Eshel Bialer
Main research themes: Mental reactions to acupuncture; Therapeutic relationships
of TCM in psychoanalytic terms; Creating a model of dialogue between Western
therapies and TCM
Schachter, Leora, MD
Integrative Pain Medicine Center
Maccabi HMO group
45
E-mail: schachter_l@mac.org.il
Tel: +972-508800122
Fellow contributors: Faculty of the Meirav school of CAM
Main research themes: mind-body aspect of pain management; CAM & pain
perception
Schiff, Elad, MD, director

Department of CAM/Integrative Medicine
Ethics & Law at the International Center for Health, Law & Ethics,
Haifa University
Tel: +972-506267243
E-mail: eschiff@bezeqint.net
Fellow contributors: Golan O. PhD, Wietchner N. Adv.
Main research themes: Assessing and developing ethical frameworks for CAM
research and utilization; doctor-patient-CAM practitioner communication;
Development of ethical codes; Ethics of touch based therapies; Informed consent
in CAM; Mind-Body Medicine; Integration of traditional systems of care.
Shoham, Boaz, and Levin, Avi, co-founders

Efranat Phagogen, Bio Immune Therapeutics
3 Maharal St.
Tel Aviv, Israel
Tel: +972-3-522-1894
Fax: +972-3-522-2130
A serious effort to manufacture and clinically investigate Nobuto Yamamoto’s
natural compound “GcMAF” in cancer patients.
Shoham, Jacob, MD, PhD

Medical oncologist, nutritional medicine, Chinese and Western herbal medicine,
mind-body medicine
98 Hagefen St.
Gimzo, 73130, Israel
Tel: +972-8-9285043
Fax: +972-8-9285053
Email: shohamj@gmail.com
Integrative oncology
Slavin, Shimon, MD
Professor of Medicine
International Center for Cell Therapy and Cancer Immunotherapy Ltd.
14 Weizman St., 20th floor
Tel Aviv 64239 Israel
Tel: +972-2-6777270
Tel: +972-54-9425456
Tel: +972-77-777-9255
Fax: + 972-77-777-9247
Email: slavin@CTCIcenter.com
46
A private center located near Tel Aviv Sorasky Medical Center with an original
program in deliberately partial mismatched stem cell transplantation as well as
other innovative cancer treatments, such as Newcastle Disease Virus Vaccine
therapy.
Sterian, Chaya, Mrs., general director

Zwang-Gonen, A., medical director
Maccabi Tivi CAM in Maccabi HMO group, Tel Aviv
Tel: 972-508802039
E-mail: zwang_a@mac.org.il
Coworkers: Y. Sandhaus, A. Shmueli, F. Wood, C. Shelhav
Main research themes: integrative pediatrics- handling technique; Cost
effectiveness of CAM; Community CAM –a research network
The Yuri Shtern Holistic Center for Cancer Patients

c/o the Yuri Shtern Foundation
Clinic Coordinator: Hila Sivan
Tel-Hai st. 14,
The German Colony, Jerusalem
Phone: +972-77-5181021
e-mail clinic@yurishtern.org.il
The Center provides treatment for individuals suffering from cancer as well as for
their families, at no charge, helping to ease the process and length of the illness.
The Center's goals stem from the belief of its namestake, the late Knesset
legislator, that alternative treatments benefit both the mind and the body and ease
the psychological stress of battling cancer, thus increasing the chances of
recovery.
Toledano, Martine, MD
Director of Integrative Medicine
Head of Research Discipline
Director of Acupuncture Course-Hebrew University
Hadassah Integrative Research Center
Hadassah University Hospital,
Ein Kerem, P.O.B. 12000, Jerusalem 91120, Israel
E-mail: toledano@hadassah.org.il
Tel: +972-2-6777111
Mobile: +972-507874747
Coworkers: Obadia-Aferiat, Kaplan A., Dema R., Baris-Ginat J.
Main research themes: Integrative oncology, cardiology, women's health & pain
research
Weintraub, Michael, MD
Director, Department of Pediatric Hematology-Oncology
P.O.B. 12000, Jerusalem 91120, Israel
Tel: +972-2-6777408
Fax: +972-2-6777833
47
Mobile: +972-50-7874025
Email: michaelw@hadassah.org.il
Zajicek, Gershom, MD, director

Hebrew University of Jerusalem
E-mail: gzajicek@what-is-cancer.com
Tel: +972-39784985
Main research themes: Induction of a prolonged cancer remission (dormancy);
Mobilization of healing processes in cancer; Guided imagery and meditation
48
Appendix B: Co-sponsors of the 2010 Jerusalem

International Conference on Integrative Medicine
Shaare Zedek Medical Center, Jerusalem

E. Wolfson Medical Center, Holon
The Tel-Aviv Sourasky Medical Center
Israeli Chamber for Complementary Health Professions
Lady Davis Carmel Medical Center, Haifa
Hadassah Medical Organization, Jerusalem
Israeli Association for Classical Homeopathy (IACH)
Sarah Herzog Memorial Hospital. Jerusalem
Bnai Zion Medical Center, Haifa
The Lowenstein Rehabilitation Hospital, Raanana
Israel Reflexology Association
Asaf Harofeh Medical Center
The Israeli Feldenkrais Guild
Rambam Health Care Campus, Haifa
Rabin Medical Center, Beilinson Hospital
The Israeli Association of Traditional Chinese Medicine
The Israeli Osteopathic Association
Maccabi-Tivi, Complementary and Integrative Medicine Services - HMO
Israeli Organization of Medicinal Plants
Meuhedet Complementary medicine - Israeli Health Maintenance Organization
(HMO)
IPEC Therapist Association
Reidman International College for Complementary Medicine, Tel Aviv
School of Homeopathy in Broshim Campus, in Tel Aviv University
Clalit Complementary Medicine services - HMO
Israeli Yoga Teachers' Association
Wingate Institute
Israeli Massage and Bodywork Association
Israeli Association for Lousky Method Therapists
I.R.U - Israel Reiki Unity
Practitioners Association of Structural Integration - Rolfing Israel
Ministry of Health, Israel
49
Appendix C: Peer-reviewed Articles on CAM in Israel
Abdul-Hai A, Ben-Yehuda A, Galsky H, Slavin S, Or R. Interleukin 2

regulation following semi-allogeneic bone marrow transplantation in mice.
Cancer Immunol Immunother. 2006;55(11):1330-1336.
Abdul-Hai A, Weiss L, Slavin S, Or R. Improved survival following induction
of GVHD following lipopolysaccharide immunization. Exp Hematol.
2006;34(4):549-553.
Abrahamov A, Abrahamov A, Mechoulam R. An efficient new cannabinoid
antiemetic in pediatric oncology. Life Sci. 1995;56(23-24):2097-2102.
Ahn AC, Nahin RL, Calabrese C, et al. Applying principles from complex
systems to studying the efficacy of CAM therapies. J Altern Complement
Med. 2010;16(9):1015-1022.
Amar S, Tiben N, Karkabi K, Hermoni D. [The efficacy of a doctor-patient
appointment in a primary care setting dedicated to preventive medicine].
Harefuah. 2001;140(8):689-693, 808, 807.
Argash O, Caspi O. [Touching cancer: shiatsu as complementary treatment to
support cancer patients]. Harefuah. 2008;147(8-9):707-711, 750, 749.
Azaizeh H, Saad B, Cooper E, Said O. Traditional Arabic and Islamic
medicine, a re-emerging health aid. eCAM [E-pub ahead of print: 13 June
2008].
Azaizeh H, Saad B, Khalil K, Said O. The state of the art of traditional Arab
herbal medicine in the eastern region of the Mediterranean: a review. eCAM
2006;3:229–35.
Bachrach U. Antiviral activity of oxidized polyamines. Amino Acids.
2007;33(2):267-272.
Bar-Eli N, Giloh H, Schlesinger M, Zakay-Rones Z. Preferential cytotoxic
effect of Newcastle disease virus on lymphoma cells. J. Cancer Res. Clin.
Oncol. 1996;122(7):409-415.
Bar-Sela G, Atid L, Danos S, Gabay N, Epelbaum R. Art therapy improved
depression and influenced fatigue levels in cancer patients on chemotherapy.
Psychooncology. 2007;16(11):980-984.
Bar-Sela G, Ben Arush MW, Sabo E, et al. Pediatric nasopharyngeal
carcinoma: better prognosis and increased c-Kit expression as compared to
adults. Pediatr Blood Cancer. 2005;45(3):291-297.
Bar-Sela G, Epelbaum R, Schaffer M. Curcumin as an Anti-Cancer Agent:
Review of the Gap between Basic and Clinical Applications. Curr. Med.
Chem. 2009. Available at: http://www.ncbi.nlm.nih.gov/pubmed/19941470
[Accessed October 7, 2010].
50
Bar-Sela G, Epelbaum R, Schaffer M. Curcumin as an anti-cancer agent:

review of the gap between basic and clinical applications. Curr. Med. Chem.
2010;17(3):190-197.
Bar-Sela G, Gershony A, Haim N. [Mistletoe (Viscum album) preparations:
an optional drug for cancer patients?]. Harefuah. 2006;145(1):42-46, 77.
Bar-Sela G, Goldberg H, Beck D, Amit A, Kuten A. Reducing malignant
ascites accumulation by repeated intraperitoneal administrations of a Viscum
album extract. Anticancer Res. 2006;26(1B):709-713.
Bar-Sela G, Haim N. Abnoba-viscum (mistletoe extract) in metastatic
colorectal carcinoma resistant to 5-fluorouracil and leucovorin-based
chemotherapy. Med. Oncol. 2004;21(3):251-254.
Bar-Sela G, Kedem E, Hadad S, et al. Successful desensitization protocol for
hypersensitivity reaction caused by sunitinib in a patient with a
gastrointestinal stromal tumor. Jpn. J. Clin. Oncol. 2010;40(2):163-165.
Bar-Sela G, Omer A, Flechter E, Zalman D. Treatment of lower extremity
edema by subcutaneous drainage in palliative care of advanced cancer
patients. Am J Hosp Palliat Care. 2010;27(4):272-275.
Bar-Sela G, Tsalic M, Fried G, Goldberg H. Wheat grass juice may improve
hematological toxicity related to chemotherapy in breast cancer patients: a
pilot study. Nutr Cancer. 2007;58(1):43-48.
Bay J, Cabrespine-Faugeras A, Tabrizi R, et al. Allogeneic hematopoietic
stem cell transplantation in ovarian cancer-the EBMT experience. Int. J.
Cancer. 2010;127(6):1446-1452.
Bayewitch M, Rhee MH, Avidor-Reiss T, et al. (-)-Delta9-
tetrahydrocannabinol antagonizes the peripheral cannabinoid receptor-
mediated inhibition of adenylyl cyclase. J. Biol. Chem. 1996;271(17):9902-
9905.
Ben-Arye E, Attias S, Tadmor T, Schiff E. Herbs in hemato-oncological care:
an evidence-based review of data on efficacy, safety, and drug interactions.
Leuk. Lymphoma. 2010;51(8):1414-1423.
Ben-Arye E, Bar-Sela G, Frenkel M, Kuten A, Hermoni D. Is a
biopsychosocial-spiritual approach relevant to cancer treatment? A study of
patients and oncology staff members on issues of complementary medicine
and spirituality. Support Care Cancer 2006;14:147–52.
Ben-Arye E, Frenkel M, Bar-Sela G, et al. Teaching complementary medicine
at an academic oncology department. J Cancer Educ. 2008;23(1):46-50.
Ben-Arye E, Frenkel M, Klein A, Scharf M. Attitudes toward integration of
complementary and alternative medicine in primary care: perspectives of
patients, physicians and complementary practitioners. Patient Educ Couns.
2008;70(3):395-402.
Ben-Arye E, Gamus D, Frenkel M, Hermoni D. [Complementary medicine
research in Israel between the years 1994-2004]. Harefuah. 2006;145(6):441-
445, 469.
51
Ben-Arye E, Goldin E, Wengrower D, et al. Wheat grass juice in the

treatment of active distal ulcerative colitis: a randomized double-blind
placebo-controlled trial. Scand. J. Gastroenterol. 2002;37(4):444-449.
Ben-Arye E, Goldin E, Wengrower D, Stamper A, Kohn R, Berry E. Wheat
grass juice in the treatment of active distal ulcerative colitis: a randomized
double-blind placebo-controlled trial. Scand J Gastroenterol 2002;37:444–9.
Ben-Arye E, Karkabi K, Karkabi S, et al. Attitudes of Arab and Jewish
patients toward integration of complementary medicine in primary care clinics
in Israel: a cross-cultural study. Soc Sci Med. 2009;68(1):177-182.
Ben-Arye E, Karkabi S, Shapira C, et al. Complementary medicine in the
primary care setting: Results of a survey of gender and cultural patterns in
Israel. Gend Med. 2009;6(2):384-397.
Ben-Arye E, Katz I, Hochman O, Hermoni D. Exploring Feldenkreis
practitioners’ attitudes toward clinical research. J Altern Complement Med.
2007;13(6):593-594.
Ben-Arye E, Lev E, Keshet Y, Schiff E. Integration of Herbal Medicine in
Primary Care in Israel: A Jewish-Arab Cross-cultural Perspective. Evid Based
Complement Alternat Med. 2009. Available at:
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Ben-Arye E, Scharf M, Frenkel M. How should complementary practitioners
and physicians communicate? A cross-sectional study from Israel. J Am
Board Fam Med. 2007;20(6):565-571.
Ben-Arye E, Schiff E, Golan O. Ethical issues in integrative oncology.
Hematol. Oncol. Clin. North Am. 2008;22(4):737-753, x.
Ben-Arye E, Schiff E, Karkabi K, Karkhabi K, Lev E. Attitudes of patients
with diabetes about complementary medicine in Israel: a cross-cultural
perspective. J Altern Complement Med. 2009;15(3):211-212.
Ben-Arye E, Schiff E, Karkabi K, Keshet Y, Lev E. Exploring association of
spiritual perspectives with complementary medicine use among patients with
Type 2 diabetes in Israel. Ethn Health. 2010:1-10.
Ben-Arye E, Shapira C, Keshet Y, Hogerat I, Karkabi K. Attitudes of Arab-
Muslims toward integration of complementary medicine in primary-care
clinics in Israel: the Bedouin mystery. Ethn Health. 2009;14(4):379-391.
Ben-Arye E, Ziv M, Frenkel M, Lavi I, Rosenman D. Complementary
medicine and psoriasis: linking the patient’s outlook with evidence-based
medicine. Dermatology 2003;207:302–7.
Bieder A, Weiss L, Slavin S. The role of recombinant cytokines and other
immunomodulators on engraftment following allogeneic bone marrow
transplantation in mice. Bone Marrow Transplant. 1992;9(6):421-426.
Cannan R, Hayman-Kochli E. A Comparison of the Allocation of
Professional Human Resources Positions for Social-Personal Services in the
Jewish Sector and in the Non-Jewish Sector. Tel Aviv: Igud Ha’Ovdim
Hasotzialim, 1983.
52
Caspi O, Baranovitch O. When science meets medical tradition: what is

needed for a dialogue on integrative medicine? J Altern Complement Med.
2009;15(5):579-583.
Caspi O, Shalom T, Holexa J. Informed Consent in Complementary and
Alternative Medicine. Evid Based Complement Alternat Med. 2009.
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Castel OC, Karkabi S, Dahan R, Karkabi K, Hermoni D. [A review of the
evidence based smoking cessation interventions delivered by the family
physician]. Harefuah. 2005;144(10):724-728, 750, 749.
Ciceri F, Bonini C, Stanghellini MTL, et al. Infusion of suicide-gene-
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cell transplantation for leukaemia (the TK007 trial): a non-randomised phase
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Cohen Castel O, Alperin M, Ungar L, et al. Urologists’ attitudes regarding
information sharing with prostate cancer patients—Is there a common ground
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Cohen Castel O, Ungar L, Alperin M, Amiel GE, Karkabi K. Family
physicians’ perceptions, beliefs, and attitudes regarding information sharing
with prostate cancer patients throughout the course of the disease. Support
Care Cancer. 2008;16(8):955-961.
Ernst E, Siev-Ner I, Gamus D. Complementary medicine--a critical review.
Isr J Med Sci. 1997;33(12):808-815.
Framme C, Sachs HG, Flucke B, Theisen-Kunde D, Birngruber R. Evaluation
of the new photosensitizer Tookad (WST09) for photodynamic vessel
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Freeman AI, Zakay-Rones Z, Gomori JM, et al. Phase I/II trial of intravenous
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Frenkel M, Ben-Arye E, Cohen L. Communication in cancer care: discussing
complementary and alternative medicine. Integr Cancer Ther. 2010;9(2):177-
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Frenkel M, Cohen L, Peterson N, et al. Integrative medicine consultation
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53
Frenkel M, Mishra BM, Sen S, et al. Cytotoxic effects of ultra-diluted

remedies on breast cancer cells. Int J Oncol. 2010;36(2):395-403.
Galanti G, Fisher T, Kventsel I, et al. Delta 9-tetrahydrocannabinol inhibits
cell cycle progression by downregulation of E2F1 in human glioblastoma
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Gamus D, Kokia I. [Complementary medicine in treatment of asthma and
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Gamus D, Meshulam-Atzmon V, Pintov S, Jacoby R. The effect of
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56
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63

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“ Ralph Moss’s report provides in-depth research on a subject never investigated

CAM AND CANCER IN ISRAEL

Figure 1 Israeli Flag Atop Masada

Historical Context ........................................................................................5

Figure 1 Israeli Flag Atop Masada....................................................................... 2

Acknowledgements: The author wishes to thank Reliable Cancer Therapies (RCT)

This is a report on the use of complementary and alternative medicine (CAM) in

1. What is being done for cancer in Israel, in an alternative or

To investigate these questions I visited Israel in July 2010. A non-profit

In modern times, despite frequently being discriminated against in admission to

Although a young country, Israel’s accomplishments in complementary and

1. The homeopathic preparation Traumeel, which was first subjected to a

2. The 3rd generation photosensitizer Tookad (which means “the warmth

3. Punisyn, a mixture of aqueous and lipid pomegranate extracts, which

4. The cytotoxic effects of homeopathic remedies on breast cancer cells

5. The discovery at Hadassah University Hospital of the benzoquinone

6. Novocure, a novel apparatus that deliver alternating electrical field, is

7. Scientists at the Integrated Cancer Prevention Center of the Tel Aviv

Further Considerations On CAM In Israel

Superficially at least, medicine in Israel is practiced much as in the US. Israel’s

Historical Roots of CAM in Israel

There are interesting points of similarity between modern-day CAM treatments

The Bible similarly enjoins inspection of the lungs of slaughtered animals, a

Frankincense (Boswellia spp.), ketoret in Hebrew, was not strictly speaking a

In a study conducted in 2003 at Meyer Children’s Hospital in Haifa, it was found

lower status mainly used traditional Arab treatments. Significantly, a beneficial

CAM and Family Medicine

Family medicine doctors often practice CAM in Israel. In fact, Israel is

The department of family medicine in Haifa is a leading academic center in Israel

CAM and Nurse Midwives

Another focus of CAM practice is the nurse-midwife movement. A study at

CAM And Medical Coverage

Figure 3 Moshe Frenkel

Another important consideration is that, historically, health care in Israel is based

According to Frenkel, however, there are an increasing number of health services

As a result, somewhere between 42 and 60 percent of general practitioners have

CAM in the Military

Relative Strength of CAM in Israel

If we search using country names plus four representative search terms,

Israel US UK Canada Germany

Source: PubMed, September 2010

If we consider that the US population is 42 times greater than Israel’s we get

CAM and HMO Health Services

One cannot understand CAM use in Israel without understanding something

The largest of the HMOs is Clalit Health Service (CHS).44 According to

Eran Ben-Arye (Haifa)

Figure 4 Eran Ben-Arye with Middle Eastern Herbs

In his clinic in Haifa, Ben-Arye uses an interesting combination of herbal

completed this study, and full information was available on 19 of them.

Ben-Arye sees complementary medicine as a way to improve medicine as a

Gil Bar-Sela (Haifa)

Figure 5 Gil Bar-Sela

During 2006 Bar-Sela worked in research at the Radiation Oncology Branch of

Jacob Shoham And KaMaH

Shoham earned his medical degree from Hebrew University-Hadassah Medical

Figure 6 Jacob Shoham

While serving as a fellow in medical oncology at Roswell Park Memorial

When he returned to Israel he went to work as a senior physician in internal

Although he currently serves as an emeritus professor at The Mina & Everard

The organization’s motto is taken from “The Physician’s Prayer” of Moses

KaMaH is striving to institute a new approach to medicine, which views the

Hadassah University Hospital, Ein Kerem (Jerusalem)