Mistletoe
Extracts from this woody plant are injected or infused for cancer treatment, often reducing side effects and improving quality of life, and perhaps improving survival.
Mistletoe at a glance
Mistletoe is a woody plant, with different species found in many places. Mistletoe is available in three main varieties:
- European mistletoe (Viscum album)
- Korean mistletoe (Viscum album var. coloratum)
- American mistletoe (Phoradendron leucarpum)
This summary focuses on European mistletoe. The US Food and Drug Administration (FDA) has not approved mistletoe as a treatment for cancer or any other medical condition. Mistletoe preparations are most commonly administered as an injection below the skin or as an intravenous infusion.1Mistletoe (Viscum album). Centre for Health Innovation. February 2024. Viewed May 28, 2024.
Some evidence shows improved tumor response or survival with mistletoe extracts, often used along with conventional treatmentsthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy. Several studies show improved quality of life among people with cancer, often due to fewer side effects of treatments.
CancerChoices ratings for mistletoe
We rate mistletoe on seven attributes, with 0 the lowest rating and 5 the highest. We rate the strength of the evidence supporting the use of mistletoe for a medical benefit, such as improving treatment outcomes or managing side effects.
See how we evaluate and rate complementary therapies ›
Improving treatment outcomes
See More- Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better survival among people with cancer as a whole treated with Iscador
- Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of better survival among people with locally advanced or metastatic pancreatic cancer treated with subcutaneous injections of Viscum album [L.] extracts
- Preliminary evidence of better survival among people with stage 4 non-small cell lung cancer treated with mistletoe extract
- No evidence of an effectoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. on relapse or metastasis among people with breast cancer treated with mistletoe during chemotherapy in a preliminary study
- Insufficient (conflicting) evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of clinical benefit among people with gynecologic cancers treated with mistletoe
Optimizing your body terrain
See More- Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of higher immune activation among people with tumors and healthy volunteers treated with mistletoe extracts
Managing side effects and promoting wellness
See More- Good evidencesignificant effects in one large or several mid-sized and well-designed clinical studies (randomized controlled trials (RCTs) with an appropriate placebo or other strong comparison control or observational studies that control for confounds) (this is the CancerChoices definition; other researchers and studies may define this differently) of fewer side effects of conventional treatmentsthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy among people treated with mistletoe
- Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better quality of life without regard to treatment phase among people treated with mistletoe
- Modest evidence of better quality of life during chemotherapy among people treated with mistletoe
- Modest evidence of fewer reductions in white blood cells from chemotherapy, surgery, and/or radiotherapy among people treated with mistletoe
- Modest evidence of better appetite among people with cancer treated with mistletoe
- Modest evidence of less fatigue among people with cancer treated with mistletoe
- Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of less anxiety among people treated with mistletoe at the time of surgery
- Preliminary evidence of better weight gain among people with metastatic pancreatic cancer receiving no conventional treatment and treated with mistletoe extract
- Preliminary evidence of less diarrhea among people undergoing oral chemotherapy treated with mistletoe
- Preliminary evidence of less pain among people with breast cancer or locally advanced or metastatic pancreatic cancer treated with mistletoe
Reducing cancer risk
See More- Insufficient evidencepreclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example) (this is the CancerChoices definition; other researchers and studies may define this differently) of lower tumor recurrence among people with bladder cancer treated with mistletoe
- No evidenceoverall, one or more studies did not demonstrate that a treatment or intervention led to an expected outcome; this does not always mean that there is no effect in clinical practice, but that the studies may have been underpowered (too few participants) or poorly designed. Larger, well-designed studies provide more confidence in making assessments. of lower risk of recurrence of cancer as a whole among people treated with mistletoe in a combined analysis of studies
Use by integrative oncology experts
See More- Recommended in a clinical practice guideline for consideration
- Used in a few of our program sources
- Used in traditional Chinese medicine and traditional Korean medicine
Safety
See More- Moderate caution is needed
- May interact with interferon or interleukin therapies
- Supervision by a medical professional is highly recommended
Affordability and access
See More- Available with considerable difficulty within the US, but widely available in Europe
- Expensive (between $2000 US and $10,000 US per year)
Keep reading about mistletoe
Author
Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.
Reviewers
Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.
For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.
Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.
Dr. Kienle studied medicine in Witten-Herdecke and Göttingen, Germany, and received methodological training at Harvard University in the USA. Her research interests and activities include clinical trials on anthroposophic medicine, mistletoe therapy, eurythmy therapy, placebo effects, clinical research methodology, clinical judgement, single-case study designs, case reporting, cognition-based medicine, systematic reviews on pre-clinical and clinical studies on mistletoe therapy, and reviews on tumor biology, tumor immunology, bacterial vaccine therapy, and system approaches in medicine. Dr Kienle has conducted a health technology assessment report on anthroposophic medicine.
Last update: October 22, 2024
Last full literature review: October 2021
CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.
Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.
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References[+]
| 1 | Mistletoe (Viscum album). Centre for Health Innovation. February 2024. Viewed May 28, 2024. |
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