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Background Cancer is a global concern because it affects and kills millions of people worldwide. In South Africa, patients frequently move between traditional health practitioners and radiation oncologists to seek cure of cancer, yet these health practitioners do not communicate with each other. Consequently, the treatment is often disrupted and imcomplete therefore compromising the survival of patients. The future of the health system in effective treatment of patients with cancer is dependent on health practitioners’ changing fundamentally in their co-operative practice. The aim of this study was to explore the practice of traditional health practitioners in the treatment of patients with cancer in order to describe a viable co-operative practice between them and radiation oncologists and ultimately develop traditional health practitioners as a component in the health system in the treatment of patients with cancer.   Methods An exploratory descriptive qualitative study using an interpretive phenomenological approach was employed to collect data from 28 traditional health practitioners and four radiation oncologists in KwaZulu-Natal utilising snowball and stratified purposive samplings for the former and latter, respectively. Semi-structured face-to-face and group interviews were employed to collect primary data from traditional health practitioners and data from the radiation oncologists were collected through face-to-face and email interviews. Data were transcribed verbatim and analysed using framework analysis.   Results It emerged that the referral of patients, in addition to external conditions, individual attributes, trusting attitudes of participants as well as organisational dynamics and philosophy of practice, were the main categories used by participants in their understanding of co-operative practice in KwaZulu-Natal. The patient is the main player in the co-operation between parties, and coordinates the health practitioners’ activities during treatment. Effective co-operative practice is time consuming and requires commitment, co-operation and training of the participants.   Conclusion Considering the problems associated with treatment of cancer when patients move freely between the traditional health practitioners and radiation oncologists, resulting in interruptions in treatment, co-operative practice between the two health practitioners is paramount. The development of traditional health practitioners could result in extending their role in the management of cancer and therefore increasing the accessibility of cancer services. It follows that a workable practice between traditional health practitioners and radiation oncologists in the treatment of patients with cancer could be an inclusive health system where the parties work in parallel with the patient being the main actor in the collaboration. There should be a healthy relationship between all those involved in the collaboration in order to facilitate referral of patients between the health practitioners.

A framework of co-operative practice between radiation oncologists and traditional health practitioners in the management of patients with cancer in KwaZulu-Natal province