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.

How do experts use mistletoe?

Both medical groups and integrative experts provide recommendations for this therapy in treating people with cancer. Learn more about the approaches and meanings of recommendations.

Clinical practice guidelines

Society for Integrative Oncology

This set of guidelines has been endorsed by the American Society of Clinical Oncology (ASCO).1Lyman GH, Greenlee H et al. Integrative therapies during and after breast cancer treatment: ASCO endorsement of the SIO clinical practice guideline. Journal of Clinical Oncology. 2018 Sep 1;36(25):2647-2655.

Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment

These 2017 guidelines regarding breast cancer patients provide these statements regarding mistletoe:

  • Can be considered for improving quality of life in those with breast cancer
  • Insufficient evidence for use for neutropeniaan abnormally low number of neutrophils in the blood, leading to increased susceptibility to infection/leukopeniaan abnormally low number of white cells in the blood, leading to increased susceptibility to infection

Published protocols, programs, and approaches

Mistletoe is used in programs, approaches, and protocolsa package of therapies combining and preferably integrating various therapies and practices into a cohesive design for care from these integrative oncologists, drawing from both scientific research and observations from years or even decades of treating people with cancer.

Lise Alschuler, ND, FABNO, and Karolyn Gazella

Approaches are described for certain cancer types, or along with certain conventional therapy treatments, or for particular conditions such as insulin resistance.

Uses of mistletoe:

  • Bladder cancer
  • Breast cancer
  • Colorectal cancer
  • Leukemia
  • Lymphoma
  • Multiple myeloma
  • Pancreatic cancer

Neil McKinney, BSc, ND

McKinney N. Naturopathic Oncology, Fourth Edition. Victoria, BC, Canada: Liaison Press. 2020.

This book includes descriptions and uses of many natural and complementary protocols for cancer in general and for specific cancers. It also includes information on integrative support during conventional cancer treatment.

Dr. McKinney points out that the type of mistletoe you use is important: Helixor type A or P or Iscador type P, etc. He distinguishes which type he uses with different cancer types.

Uses of mistletoe:

  • Brain cancer (noting that the type of mistletoe in this setting is very important, as some can cause brain swelling and inflammation)
  • Bladder cancer
  • Head and neck cancer (but not if a tumor is in a confined space)
  • Leukemia
  • Melanoma
  • Multiple myeloma
  • Renal cancer
  • Sarcoma (osteo-muscular)

Gurdev Parmar, ND, FABNO, and Tina Kaczor, ND, FABNO

Parmar G, Kaczor T. Textbook of Naturopathic Oncology: A Desktop Guide of Integrative Cancer Care. 1st edition. Medicatrix Holdings Ltd. 2020.

This book provides information on the treatment of 24 cancers, plus the most effective treatments of the most common symptoms affecting cancer patients while they undergo chemotherapy, radiotherapy, or surgery.

Other assessments or authorizations

Mistletoe Therapy Webinar from Believe Big

Viscum album is listed in the Homeopathic Pharmacopoeia of the United States, which is the officially recognized compendium for homeopathic drugs in the US.2Mistletoe Extracts (PDQ®)–Health Professional Version. National Cancer Institute. March 17, 2021. Viewed October 25, 2021.

This 2014 book by integrative medicine experts and CancerChoices advisors states that mistletoe is used as part of an anthroposophic medicine approach to oncology care for improving quality of life as well as promoting tumor remission and better survival with some uses.

The Moss Reports conclude that mistletoe has anticancer properties. Mistletoe is listed in their “Green Light Treatments: Well Researched Approaches.”3Moss R. The Moss Report on Breast Cancer. 2017-2.0. p. 1. 

Traditional medicine

Mistletoe is used in traditional Chinese medicine and traditional Korean medicine.4dela Cruz JF, Kim YS, Lumbera WM, Hwang SG. Viscum album var hot water extract mediates anti-cancer effects through G1 phase cell cycle arrest in SK-Hep1 human hepatocarcinoma cells. Asian Pacific Journal of Cancer Prevention. 2015;16(15):6417-21.

Learn more about traditional medicine and how to find practitioners.

Dosing

Dosage has not been standardized for use in cancer care, but recommendations are available from these sources.

See the studies cited in How can mistletoe help me? What the research says › for doses used in clinical trials.

General information about dosing

Find general dosing guidelines regarding natural products and supplements.

Expert commentary

According to CancerChoices advisor Gunver Kienle, MD, about half of all cancer patients in Germany use mistletoe. Breast cancer patients represent more than half of those using it. Anyone can purchase it in the pharmacy, but Dr. Kienle says having a doctor to prescribe and monitor it is much better. About half of doctors prescribe it and appreciate it. Some physicians are very experienced and knowledgeable, using very sophisticated methods of applying mistletoe, such as directly injected into the tumor, or by intravenous (IV) administration. According to Dr. Kienle, “High-dose IV or intralesional use is considered off-label and should be restricted to and monitored by experienced physicians.”5Abrams DI, Weil AT. Integrative Oncology, 2nd Edition. New York, NY: Oxford University Press. 2014, p. 576.

Resources

Mistletoe and the Emerging Future of Integrative Oncology

By Steven Johnson, Nasha Winters, Adam Blanning, Marion Debus, Paul Faust, Mark Hancock, and Peter Hinderberger

Access the book

Keep reading about mistletoe

Author

Nancy Hepp, MS

Lead Researcher and Program Manager
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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, program manager, and writer for CancerChoices. 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.

Nancy Hepp, MS Lead Researcher and Program Manager

Reviewers

Laura Pole, RN, MSN, OCNS

Senior Clinical Consultant
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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.

Laura Pole, RN, MSN, OCNS Senior Clinical Consultant

Gunver Sophia Kienle, MD

Physician, medical researcher, and CancerChoices advisor
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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.

Gunver Sophia Kienle, MD Physician, medical researcher, and CancerChoices advisor

Last update: October 7, 2022

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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