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 can mistletoe help me? What the research says

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

Learn more about how we research and rate therapies and practices.

Preclinical evidencetesting a drug, a procedure, or another medical treatment in isolated cells or in animals; preclinical evidence is considered only an initial indication of possible effects in people is summarized in Are you a health professional? ›

Improving treatment outcomes

Is mistletoe linked to improved survival? Is it linked to less cancer growth or metastasis? Does it enhance the anticancer action of other treatments or therapies? We present the evidence.

Cancer as a whole

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

Advanced cancer

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

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of tumor response among people with with advanced hepatocellular carcinoma treated with Viscum fraxini

Breast cancer

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 better survival among people with breast cancer treated with mistletoe

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 treated with mistletoe during chemotherapy in a preliminary study

Gynecological cancers

Insufficient (conflicting) evidence of clinical benefit among people with gynecological cancers treated with mistletoe

Optimizing your body terrain

Does mistletoe promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.

Immune function

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 markers of immune function among people with tumors and healthy volunteers treated with mistletoe extracts

Managing side effects and promoting wellness

Is mistletoe linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being? We present the evidence.

Side effects as a whole

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 with cancer treated with mistletoe

Anxiety

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

Blood-related side effects

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 fewer reductions in white blood cells from chemotherapy, surgery, and/or radiotherapy among people treated with mistletoe

Body composition or cachexia

Preliminary evidence of better weight gain among people with metastatic pancreatic cancer receiving no conventional treatment and treated with mistletoe extract

Changes in appetite

Modest evidence of better appetite among people with cancer treated with mistletoe

Fatigue

Modest evidence of less fatigue among people with cancer treated with mistletoe

Gastrointestinal symptoms

Preliminary evidence of less diarrhea during oral chemotherapy among people undergoing treated with mistletoe

Quality of life

Modest evidence 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

Pain

Preliminary evidence of less pain during cancer treatment among people with breast cancer treated with mistletoe

Preliminary evidence of less pain among people with locally advanced or metastatic pancreatic cancer treated with mistletoe

Sleep disruption

Preliminary evidence of less insomnia among people with advanced or metastatic pancreatic cancer treated with mistletoe extract

Other side effects and symptoms

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of less fluid in the abdomen (ascites) among people with advanced cancer treated with mistletoe

Reducing cancer risk

Is mistletoe linked to lower risks of developing cancer or of recurrence? We present the evidence.

Cancer as a whole

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

Bladder cancer

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

Resources related to evidence

Believe Big: Panel Discussion on Mistletoe Therapy

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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