Nancy Hepp, MS, BCCT Project Manager
Laura Pole, RN, MSN, OCNS, BCCT Senior Researcher
Last updated February 9, 2021.
Also known by these names
Mistletoe is a woody plant, with different species found in many places. Three main types of mistletoe are noted:
- European mistletoe (Viscum album)
- Korean mistletoe (Viscum album var. coloratum)
- American mistletoe (Phoradendron leucarpum)
This summary focuses on European mistletoe.
While the raw mistletoe plant and berries are toxic, sterile extracts can be beneficial when injected or infused. Mistletoe preparations are most commonly administered as asubcutaneous, intramuscular, or intrapleural injections, or as an intravenous infusion.1
Mistletoe contains a variety of biologically active compounds, of which lectin is the most studied. Mistletoe is both toxic to cancer cells and stimulating to the immune system; each of these properties contributes to anticancer activity.2
Clinical Practice Guidelines
- Grade C recommendation for co-administering mistletoe with conventional treatment for improving quality of life in those with breast cancer. Grade C "recommends selectively offering or providing this service to individual patients based on professional judgment and patient preferences (there is at least moderate certainty that the net benefit is small)." See more about recommendation levels on Clinical Practice Guidelines and Standards of Care.
- Insufficient evidence to recommend using it for neutropenia/leukopenia in breast cancer.
Treating the Cancer
Working against cancer growth or spread, improving survival, or working with other treatments or therapies to improve their anticancer action
Reviews of Multiple Cancer Types
Head and Neck Cancers
Ovarian and Other Gynecologic Cancers
Lab and Animal Evidence
Managing Side Effects and Promoting Wellness
Managing or relieving side effects or symptoms, reducing treatment toxicity, supporting quality of life or promoting general well-being
Quality of Life and Psychological Benefits
Managing Symptoms and Reducing Side Effects
Reducing the risk of developing cancer or the risk of recurrence
High-dose Viscum album (European mistletoe) treatment may have interrupted frequently recurring tumors in individual patients with recurrent bladder cancer in a small study.39 A small earlier study showed that treatment with mistletoe was comparable in reducing recurrence rates to that of local historical controls treated with adjuvant Bacillus Calmette-Guerin (BCG).40
Optimizing Your Terrain
Mistletoe extracts stimulate the immune system.41 Mistletoe supports the immune system by increasing the number and activity of various types of white blood cells, particularly natural killer (NK) cells.42
Mistletoe is widely available in Germany. Considered a drug, it is regulated by the German drug agency, which also regulates herbs.
Mistletoe is available in Canada: Order from Canada Nature's Source, 1-866-502-6789 or firstname.lastname@example.org.
In the US, the legal status of mistletoe is in limbo. The FDA previously approved the formulation Iscar for homeopathic use, but has since reversed that approval until it reviews the manufacturing plant in Sweden. People with cancer considered to have no other legal treatment options can apply to the FDA for compassionate use of mistletoe. As we find further information, we'll update this page regarding legal access in the United States.
Several cautions, contraindications, adverse events and herb-drug interactions are described in the Centre for Health Innovation monograph, Mistletoe (Viscum album). BCCT urges you to read this monograph for details about cautions. Reviews note that side effects are rare and typically mild but can depend on the dose.43
BCCT does not recommend therapies or doses, but only provides information for patients and providers to consider as part of a complete treatment plan. Patients should discuss therapies with their physicians, as contraindications, interactions and side effects must be evaluated.
Dosage recommendations are available from these sources:
- Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010.
- McKinney N. Naturopathic Oncology, 3rd Edition. Victoria, BC, Canada: Liaison Press. 2016.
- Moss Reports (purchase required): Select from the list of cancers down the left side of the page for a report describing uses of conventional, complementary, alternative and integrative therapies related to that cancer. Ralph Moss is among the most knowledgeable and balanced researchers of integrative cancer therapies. The cost of his Moss Reports is not negligible, but many patients find them of considerable value. Moss is also available for consultations.
- Natural Medicines Database (requires purchase)
Integrative Programs, Protocols and Medical Systems
|For more information about programs and protocols, see our Integrative Programs and Protocols page.|
- Programs and protocols
- Alschuler & Gazella complementary approaches49
- McKinney protocols50
- 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.
- 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)
- Multiple myeloma
- Renal cancer
- Sarcoma (osteo-muscular)
- Parmar & Kazcor treatment plans51
- Traditional systems
According to BCCT 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."52
Safety and Side Effects
More from Our Resources Database
Enter your comments or questions below.
My integrative care physician in Philadelphia was able to write me a prescription for Iscador. I e-mailed the prescription to a recommended drug store in Germany and they filled it for me. They will ship the drug to me in refrigerated containers and I will take the drug to my doctor so that he can show me how to self-administer and make sure that I'm familiar with side effects and risks. It's a bit convoluted but not that hard to obtain!