Mistletoe (European)
Authors
 Nancy Hepp, MS, BCCT Project Manager
Read more Ms. Hepp is a science researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. View profile.
 Laura Pole, RN, MSN, OCNS, BCCT Senior Researcher
Read more Ms. Pole is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation and education services for more than 30 years. View profile. Last updated December 20, 2020.
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Also known by these names
- ABNOBA viscum
- Abnoba-viscum
- All-heal
- Birdlime
- Cefalektin
- Eurixor
- Helixor
- Iscador
- Iscador Qu
- Lektinol
- Quercus
- Viscum
- Viscum album
- White-berry mistletoe
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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.
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.
Key Points
- Before using this therapy, consult your oncology team about interactions with other treatments and therapies. Also make sure this therapy is safe for use with any other medical conditions you may have.
- Mistletoe preparations are typically administered as a subcutaneous, intramuscular or intrapleural injection, or as an intravenous infusion.
- Mistletoe is toxic to cancer cells and stimulating to the immune system, which both contribute to its anticancer activity.
- Mistletoe may support improved survival for some cancer types when used as a supplemental (adjuvant) treatment.
- Mistletoe may reduce side effects and symptoms and improve quality of life when used as a supplemental (adjuvant) treatment, though one 2019 study found no effect.
- In the US, the legal status of mistletoe is in limbo.
- Several cautions, contraindications, adverse events and herb-drug interactions have been described.
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Clinical Practice Guidelines
The 2017 Society for Integrative Oncology clinical practice guidelines for breast cancer give these recommendations:
- 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
Clinical Evidence
Reviews of Multiple Cancer Types
Read more
A 2012 review of studies involving several cancer types found improved survival with adjuvant Iscador treatment (used in addition to other therapies or treatments). A similar 2009 review found with slightly better results in lung cancer than in other cancer types.
A 2003 review of 16 controlled studies involving several cancer sites (breast, lung, stomach, colon, rectum, head and neck, kidney, bladder, melanoma, glioma, and genital) found these results, although the authors noted that none of the studies had strong methodology:
- Significantly improved survival in eight studies and trends for improved survival in eight studies
- Significant tumor remission in one study and trends toward remission in two studies
- Trend for disease-free-survival in one study
Breast Cancer
Read more
- Improved survival and prolonged relapse intervals in breast cancer, and a nonsignificant trend toward longer survival in another study
- Improved tumor response and reduction with chemotherapy
Colorectal Cancer
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A nonsignificant trend toward longer disease-free survival of people with colorectal cancer.
Head and Neck Cancers
Read more
Lung Cancer
Read more
Improved one-year and three-year overall survival rates among people with stage 4 non-small cell lung cancer with Viscum album L. (European mistletoe) along with chemotherapy compared to chemotherapy alone
Melanoma
Read more
- No improved survival with melanoma in a systematic review
- Fewer lung metastases and lower adjusted hazard ratio for brain metastases, as well as significantly longer tumor-related survival, overall survival, disease-free survival and brain metastases-free survival of primary intermediate- to high-risk malignant melanoma patients without distant metastases following surgery in a large cohort study
Ovarian and Other Gynecologic Cancers
- Improved overall survival ovarian cancer patients with distant metastases but not in patients without distant metastases with use of mistletoe extracts such as Iscador.
- Improved survival with gynecological (ovarian, endometrial, cervical, vaginal, vulval, and fallopian cancers) across 46 clinical studies involving almost 10,000 combined patients; positive results were not as strong for incidence of remission or time to relapse.
Pancreatic Cancer
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Improved overall survival in people with pancreatic carcinoma when Iscador treatment was added to adjuvant chemotherapy with gemcitabine after surgery
Lab and Animal Evidence
Read more
Mistletoe extracts show toxic effects against breast cancer cells in lab and animal studies.
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
Read more
Reported results in patients with breast cancer:
- Mistletoe improved health-related quality of life.
- A combined analysis in 2010 found improved psychosomatic self-regulation as a measure of autonomous coping with the disease.
- Patients with early stage breast cancer undergoing chemotherapy with six cycles of cyclophosphamide, adriamycin, and 5-fluorouracil (CAF) reported better quality of life with mistletoe compared to those without mistletoe.
- Of patients undergoing CMF (cyclophosphamide, methotrexate, fluorouracil) chemotherapy, those receiving adjuvant mistletoe extract reported significantly higher quality of life than those not receiving mistletoe.
In a 2009 review of European mistletoe use in gynecologic (ovarian, uterine, vulvar or cervical) and breast cancers, the majority of studies assessing quality of life and tolerability of chemotherapy, radiotherapy or surgery reported a statistically significant positive result; the others (three studies) showed either a positive trend, no difference, or mixed results.
A 2008 meta-analysis found generally favorable benefits on quality of life, psychological measures, performance index, symptom scales or the reduction of adverse effects of chemotherapy. Separate reviews found improved quality of life with of Viscum album, even across different formulations of extracts. A 2003 review of 16 controlled studies involving several cancer sites (breast, lung, stomach, colon, rectum, head and neck, kidney, bladder, melanoma, glioma, and genital) found improved overall quality of life in three studies and improved quality of life in relation to side effects during cytoreductive therapy in three studies.
Managing Symptoms and Reducing Side Effects
Read more
Effects in breast cancer patients:
- A randomized controlled trial of undergoing surgery and adjuvant chemotherapy found those also taking mistletoe showed significantly improved pain and appetite loss scores and a trend toward less neutropenia.
- Patients treted with standardized mistletoe extracts for approximately five years after completing standard therapies reported significantly fewer complaints of disease/therapy-related sign/symptoms (such as mucositis, fatigue, pain or headache), which correlated with a significantly improved quality of life.
- Patients had reduced side effects from treatment: nausea, gastro-intestinal tract symptoms, depression, fatigue, and mental symptoms.
- Mistletoe may have reduced side effects of cytoreductive therapies (chemotherapy, radiation and surgery).
A group of patients with non-metastasized colorectal cancer undergoing chemo- or radio-chemotherapy after surgery were supported by mistletoe. Their incidence of cancer-related fatigue was far lower than in patients not receiving mistletoe. A controlled, retrospective, observational cohort study of nonmetastatic colorectal cancer patients found fewer adjuvant therapy-related adverse reactions and fewer persisting symptoms in patients administered Iscador.
A 2018 observational study of patients with various types of cancer (breast, digestive/gastrointestinal [stomach, esophageal, gallbladder, pancreatic, colorectal or anal] respiratory/thoracic, hematologic/blood [leukemia, lymphoma, and multiple myeloma] and others) found that those administered mistletoe showed fewer adverse events—such as nausea and vomiting or pain—and lower rates of discontinuination of standard oncological treatment.
One review listed benefits in coping, fatigue, sleep, exhaustion, energy, nausea, vomiting, appetite, depression, anxiety, ability to work, and emotional and functional well-being and, less consistently, in regard to pain, diarrhea, general performance, and other side effects of conventional treatments.
A 2019 review and meta-analysis found no significant effect in improving quality of life across all cancer types.
A small, nonrandomized study found that installation of Iscador M into the peritoneal cavity may reduce the need for repeated punctures with ascites in advanced cancer.
Preliminary evidence shows reduced incidence of febrile neutropenia in solid tumor malignancies.
Reducing Risk
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. 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).
Optimizing Your Terrain
Mistletoe extracts stimulate the immune system. Mistletoe supports the immune system by increasing the number and activity of various types of white blood cells, particularly natural killer (NK) cells.
Access
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 helixor@natures-source.com.
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.
Cautions
Several cautions, contraindications, adverse events and herb-drug interactions are described in the Ottawa Integrative Cancer Centre monograph. Professional Resource: Mistletoe. 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.
Read more
Incidence and severity of side effects from subcutaneous mistletoe use are reported in a 2014 study. The most common:
- Fever
- Local reaction
- Injection site erythema (redness of the skin)
- Urticaria (hives)
- Chills
A few high-risk malignant melanoma patients experienced adverse drug reactions, requiring therapy termination in fewer than 2 percent of patients receiving mistletoe.
A few cases of anaphylactic shock have been reported with use. Higher doses of mistletoe (2000 mg) increase risk for allergic reactions, fever and other side effects.
According to Neil McKinney, ND, mistletoe should not be used with a fever greater than 100.4°F (38°C), nor with ascites (abdominal fluid) or in-brain tumors or other tumors in tight compartments where an immune response can cause initial inflammatory edema (swelling) and subsequent compression of vital structures. Dr. McKinney says mistletoe may activate a hidden focus of infection, such as dental abscess. He also cautions that increased cytokine release may aggravate cachexia (wasting). He considers mistletoe to be contraindicated in pregnancy, breastfeeding, tuberculosis, biliary stenosis, liver failure, heart failure, kidney failure, hyperthyroidism, and with interferon or interleukin therapies.
BCCT strongly advises anyone thinking about using mistletoe to consult a physician knowledgeable and experienced in its use to prescribe it and monitor your response.
Dosing
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
- Programs and protocols
- 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."
- Evidence-Based Monographs: Professional Resource: Mistletoe. Ottawa Integrative Cancer Centre. Viewed May 22, 2019.
- Evidence-Based Monographs:
- Professional Resource: Mistletoe. Ottawa Integrative Cancer Centre. Viewed May 22, 2019.
- Greenlee H, DuPont-Reyes MJ et al. Clinical practice guidelines on the evidence-based use of integrative therapies during and after breast cancer treatment. CA: A Cancer Journal for Clinicians. 2017 May 6;67(3):194-232.
- Ostermann T, Büssing A. Retrolective studies on the survival of cancer patients treated with mistletoe extracts: a meta-analysis. Explore (NY). 2012 Sep-Oct;8(5):277-81.
- Ostermann T, Raak C, Büssing A. Survival of cancer patients treated with mistletoe extract (Iscador): a systematic literature review. BMC Cancer. 2009 Dec 18;9:451.
- Kienle GS, Berrino F et al. Mistletoe in cancer—a systematic review on controlled clinical trials. European Journal of Medical Research. 2003 Mar 27;8(3):109-19.
- Marvibaigi M, Supriyanto E, Amini N, Abdul Majid FA, Jaganathan SK. Preclinical and clinical effects of mistletoe against breast cancer. Biomed Research International. 2014;2014:785479; Kienle GS, Glockmann A, Schink M, Kiene H. Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research. Journal of Experimental & Clinical Cancer Research. 2009 Jun 11;28:79.
- Ziegler R, Grossarth-Maticek R. Individual patient data meta-analysis of survival and psychosomatic self-regulation from published prospective controlled cohort studies for long-term therapy of breast cancer patients with a mistletoe preparation (Iscador). Evidence-based Complementary and Alternative Medicine. 2010 Jun;7(2):157-66.
- Marvibaigi M, Supriyanto E, Amini N, Abdul Majid FA, Jaganathan SK. Preclinical and clinical effects of mistletoe against breast cancer. Biomed Research International. 2014;2014:785479.
- Friedel WE, Matthes H, Bock PR, Zänker KS. Systematic evaluation of the clinical effects of supportive mistletoe treatment within chemo- and/or radiotherapy protocols and long-term mistletoe application in nonmetastatic colorectal carcinoma: multicenter, controlled, observational cohort study. Journal of the Society for Integrative Oncology. 2009 Fall;7(4):137-45.
- Horneber MA, Bueschel G, Huber R, Linde K, Rostock M. Mistletoe therapy in oncology. Cochrane Database of Systematic Reviews. 2008 Apr 16;(2):CD003297.
- Schad F, Thronicke A et al. Overall survival of stage IV non-small cell lung cancer patients treated with Viscum album L. in addition to chemotherapy, a real-world observational multicenter analysis. PLoS One. 2018 Aug 27;13(8).
- Horneber MA, Bueschel G, Huber R, Linde K, Rostock M. Mistletoe therapy in oncology. Cochrane Database of Systematic Reviews. 2008 Apr 16;(2):CD003297.
- Augustin M, Bock PR, Hanisch J, Karasmann M, Schneider B. Safety and efficacy of the long-term adjuvant treatment of primary intermediate- to high-risk malignant melanoma (UICC/AJCC stage II and III) with a standardized fermented European mistletoe (Viscum album L.) extract. Results from a multicenter, comparative, epidemiological cohort study in Germany and Switzerland. Arzneimittelforschung. 2005;55(1):38-49.
- Grossarth-Maticek R, Ziegler R. Prospective controlled cohort studies on long-term therapy of ovairian cancer patients with mistletoe (Viscum album L.) extracts iscador. Arzneimittelforschung. 2007;57(10):665-78.
- Kienle GS, Glockmann A, Schink M, Kiene H. Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research. Journal of Experimental & Clinical Cancer Research. 2009 Jun 11;28:79.
- Matthes H, Friedel WE, Bock PR, Zänker KS. Molecular mistletoe therapy: friend or foe in established anti-tumor protocols? A multicenter, controlled, retrospective pharmaco-epidemiological study in pancreas cancer. Current Molecular Medicine. 2010 Jun;10(4):430-9.
- Marvibaigi M, Supriyanto E, Amini N, Abdul Majid FA, Jaganathan SK. Preclinical and clinical effects of mistletoe against breast cancer. Biomed Research International. 2014;2014:785479.
- Marvibaigi M, Supriyanto E, Amini N, Abdul Majid FA, Jaganathan SK. Preclinical and clinical effects of mistletoe against breast cancer. Biomed Research International. 2014;2014:785479; Kienle GS , Kiene H. Complementary cancer therapy: a systematic review of prospective clinical trials on anthroposophic mistletoe extracts. European Journal of Medical Research. 2007 Mar 26;12(3):103-19; Eisenbraun J, Scheer R, Kröz M, Schad F, Huber R. Quality of life in breast cancer patients during chemotherapy and concurrent therapy with a mistletoe extract. Phytomedicine. 2011 Jan 15;18(2-3):151-7.
- Ziegler R, Grossarth-Maticek R. Individual patient data meta-analysis of survival and psychosomatic self-regulation from published prospective controlled cohort studies for long-term therapy of breast cancer patients with a mistletoe preparation (Iscador). Evidence-based Complementary and Alternative Medicine. 2010 Jun;7(2):157-66.
- Tröger W, Jezdić S, Zdrale Z, Tišma N, Hamre HJ, Matijašević M. Quality of life and neutropenia in patients with early stage breast cancer: a randomized pilot study comparing additional treatment with mistletoe extract to chemotherapy alone. Breast Cancer (Auckl). 2009 Jul 6;3:35-45.
- Semiglazov VF, Stepula VV, Dudov A, Schnitker J, Mengs U. Quality of life is improved in breast cancer patients by Standardised Mistletoe Extract PS76A2 during chemotherapy and follow-up: a randomised, placebo-controlled, double-blind, multicentre clinical trial. Anticancer Research. 2006 Mar-Apr;26(2B):1519-29.
- Kienle GS, Glockmann A, Schink M, Kiene H. Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research. Journal of Experimental & Clinical Cancer Research. 2009 Jun 11;28:79.
- Horneber MA, Bueschel G, Huber R, Linde K, Rostock M. Mistletoe therapy in oncology. Cochrane Database of Systematic Reviews. 2008 Apr 16;(2):CD00329.
- Kienle GS, Kiene H. Review article: Influence of Viscum album L (European mistletoe) extracts on quality of life in cancer patients: a systematic review of controlled clinical studies. Integrative Cancer Therapies. 2010 Jun;9(2):142-57.
- Melzer J, Iten F, Hostanska K, Saller R. Efficacy and safety of mistletoe preparations (Viscum album) for patients with cancer diseases. A systematic review. Forschende Komplementarmedizin. 2009 Aug;16(4):217-26.
- Kienle GS, Berrino F et al. Mistletoe in cancer—a systematic review on controlled clinical trials. European Journal of Medical Research. 2003 Mar 27;8(3):109-19.
- Pelzer F, Tröger W, Nat DR. Complementary treatment with mistletoe extracts during chemotherapy: safety, neutropenia, fever, and quality of life assessed in a randomized study. Journal of Alternative and Complementary Medicine. 2018 Sep/Oct;24(9-10):954-961.
- Beuth J, Schneider B, Schierholz JM. Impact of complementary treatment of breast cancer patients with standardized mistletoe extract during aftercare: a controlled multicenter comparative epidemiological cohort study. Anticancer Research. 2008 Jan-Feb;28(1B):523-7.
- Schumacher K , Schneider B et al. Influence of postoperative complementary treatment with lectin-standardized mistletoe extract on breast cancer patients. A controlled epidemiological multicentric retrolective cohort study. Anticancer Research. 2003 Nov-Dec;23(6D):5081-7.
- Kienle GS , Kiene H. Complementary cancer therapy: a systematic review of prospective clinical trials on anthroposophic mistletoe extracts. European Journal of Medical Research. 2007 Mar 26;12(3):103-19.
- Bock PR, Hanisch J, Matthes H, Zänker KS. Targeting inflammation in cancer-related-fatigue: a rationale for mistletoe therapy as supportive care in colorectal cancer patients. Inflammation & Allergy Drug Targets. 2014;13(2):105-11.
- Friedel WE, Matthes H, Bock PR, Zänker KS. Systematic evaluation of the clinical effects of supportive mistletoe treatment within chemo- and/or radiotherapy protocols and long-term mistletoe application in nonmetastatic colorectal carcinoma: multicenter, controlled, observational cohort study. Journal of the Society for Integrative Oncology. 2009 Fall;7(4):137-45.
- Thronicke A, Oei SL, Merkle A, Matthes H, Schad F. Clinical safety of combined targeted and Viscum album L. therapy in oncological patients. Medicines (Basel). 2018 Sep 6;5(3). pii: E100.
- Kienle GS, Kiene H. Review article: Influence of Viscum album L (European mistletoe) extracts on quality of life in cancer patients: a systematic review of controlled clinical studies. Integrative Cancer Therapies. 2010 Jun;9(2):142-57.
- Freuding M, Keinki C et al. Mistletoe in oncological treatment: a systematic review: part 2: quality of life and toxicity of cancer treatment. Journal of Cancer Research and Clinical Oncology. 2019 Apr;145(4):927-939.
- Bar-Sela G, Goldberg H, Beck D, Amit A, Kuten A. Reducing malignant ascites accumulation by repeated intraperitoneal administrations of a Viscum album extract. Anticancer Research. 2006 Jan-Feb;26(1B):709-13.
- von Schoen-Angerer T, Wilkens J, Kienle GS, Kiene H, Vagedes J. High-dose Viscum album extract treatment in the prevention of recurrent bladder cancer: a retrospective case series. Permanente Journal. 2015 Fall;19(4):76-83.
- Elsässer-Beile U, Leiber C et al. Adjuvant intravesical treatment with a standardized mistletoe extract to prevent recurrence of superficial urinary bladder cancer. Anticancer Research. 2005 Nov-Dec;25(6C):4733-6.
- Marvibaigi M, Supriyanto E, Amini N, Abdul Majid FA, Jaganathan SK. Preclinical and clinical effects of mistletoe against breast cancer. Biomed Research International. 2014;2014:785479.
- Hamprecht K, Handgretinger R, Voetsch W, Anderer FA. Mediation of human NK-activity by components in extracts of Viscum album. International Journal of Immunopharmacology. 1987;9(2):199-209; Mueller EA, Anderer FA. Chemical specificity of effector cell/tumor cell bridging by a Viscum album rhamnogalacturonan enhancing cytotoxicity of human NK cells. Immunopharmacology. 1990 Jan-Feb;19(1):69-77; Mueller EA, Hamprecht K, Anderer FA. Biochemical characterization of a component in extracts of Viscum album enhancing human NK cytotoxicity. Immunopharmacology. 1989 Jan-Feb;17(1):11-8
- Evidence-Based Monographs: Professional Resource: Mistletoe. Ottawa Integrative Cancer Centre. Viewed May 22, 2019; Horneber MA, Bueschel G, Huber R, Linde K, Rostock M. Mistletoe therapy in oncology. Cochrane Database of Systematic Reviews. 2008 Apr 16;(2):CD003297.
- Steele ML, Axtner J et al. Adverse drug reactions and expected effects to therapy with subcutaneous mistletoe extracts (Viscum album L.) in cancer patients. Evidence-Based Complementary and Alternative Medicine. 2014;2014:724258.
- Augustin M, Bock PR, Hanisch J, Karasmann M, Schneider B. Safety and efficacy of the long-term adjuvant treatment of primary intermediate- to high-risk malignant melanoma (UICC/AJCC stage II and III) with a standardized fermented European mistletoe (Viscum album L.) extract. Results from a multicenter, comparative, epidemiological cohort study in Germany and Switzerland. Arzneimittelforschung. 2005;55(1):38-49.
- Hutt N, Kopferschmitt-Kubler M et al. Anaphylactic reactions after therapeutic injection of mistletoe (Viscum album L.). Allergologia et Immunopathologia (Madr). 2001 Sep-Oct;29(5):201-3.
- Huber R, Schlodder D, Effertz C, Rieger S, Tröger W. Safety of intravenously applied mistletoe extract—results from a phase I dose escalation study in patients with advanced cancer. BMC Complementary and Alternative Medicine. 2017 Sep 18;17(1):465; Kienle GS, Grugel R, Kiene H. Safety of higher dosages of Viscum album L. in animals and humans--systematic review of immune changes and safety parameters. BMC Complementary and Alternative Medicine. 2011 Aug 28;11:72.
- McKinney N. Naturopathic Oncology, 3rd Edition. Victoria, BC, Canada: Liaison Press. 2016.
- Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010; Alschuler LN, Gazella KA. The Definitive Guide to Thriving after Cancer: A Five-Step Integrative Plan to Reduce the Risk of Recurrence and Build Lifelong Health. Berkeley, California: Ten Speed Press. 2013.
- McKinney N. Naturopathic Oncology, 3rd Edition. Victoria, BC, Canada: Liaison Press. 2016.
- Parmar G, Kaczor T. Textbook of Naturopathic Oncology: A Desktop Guide of Integrative Cancer Care. 1st edition. Canada: Medicatrix Holdings Ltd. 2020.
- Abrams DI, Weil AT. Integrative Oncology, 2nd Edition. New York, NY: Oxford University Press. 2014, p. 576.
View All References
More Information
- Ottawa Integrative Cancer Centre Evidence-Based Monographs:
- National Cancer Institute PDQ® Cancer Information Summaries:
- About Herbs: Mistletoe (European)
- CAM-Cancer: Mistletoe (Viscum album)
- Anthroposophische Medizin: Cancer disease, mistletoe treatment
- 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.
- TRC Natural Medicines: Mistletoe (subscription required): in-depth information, ratings of effectiveness and safety and evaluation of specific mistletoe products
Treatment Effects
- Scientific Reports: Quantitative analysis of receptor-mediated uptake and pro-apoptotic activity of mistletoe lectin-1 by high content imaging (includes four short videos on mistletoe lectins inducing cell death (apoptosis( in cancer cells at the end of the article)
- Werthmann PG, Saltzwedel G, Kienle GS. Minor regression and long-time survival (56 months) in a patient with malignant pleural mesothelioma under Viscum album and Helleborus niger extracts—a case report. Journal of Thoracic Disease. 2017;9(12):E1064-E1070.
- Weissenstein U, Kunz M, Urech K, Baumgartner S. Interaction of standardized mistletoe (Viscum album) extracts with chemotherapeutic drugs regarding cytostatic and cytotoxic effects in vitro. BMC Complementary and Alternative Medicine. 2014 Jan 8;14:6.
- Reynel M, Villegas Y, Kiene H, Werthmann PG, Kienle GS. Intralesional and subcutaneous application of Viscum album L. (European mistletoe) extract in cervical carcinoma in situ: a CARE compliant case report. Medicine (Baltimore). 2018 Nov;97(48):e13420.
- Werthmann PG, Kempenich R, Kienle GS. Long-term tumor-free survival in a patient with stage iv epithelial ovarian cancer undergoing high-dose chemotherapy and viscum album extract treatment: a case report. Permanente Journal. 2018;23:18-025.
- Lee YG, Jung I et al. Efficacy and safety of Viscum album extract (Helixor-M) to treat malignant pleural effusion in patients with lung cancer. Support Care Cancer. 2019 May;27(5):1945-1949.
- Gutsch J, Werthmann PG, Rosenwald A, Kienle GS. Complete remission and long-term survival of a patient with a diffuse large b-cell lymphoma under Viscum album extracts after resistance to R-CHOP: a case report. Anticancer Research. 2018 Sep;38(9):5363-5369.
Safety and Side Effects
- Schad F, Axtner J, Kroz M, Matthes H, Steele ML. Safety of combined treatment with monoclonal antibodies and Viscum album L preparations. Integrative Cancer Therapies. 2018;17:41-51.
- Steele ML, Axtner J et al. Use and safety of intratumoral application of European mistletoe (Viscum album L) preparations in oncology. Integrative Cancer Therapies. 2015;14:140-8.
- Steele ML, Axtner J et al. Safety of intravenous application of mistletoe (Viscum album L.) preparations in oncology: an observational study. Evidence-Based Complementary and Alternative Medicine. 2014;2014:236310.
- Thronicke A, Steele ML, Grah C, Matthes B, Schad F. Clinical safety of combined therapy of immune checkpoint inhibitors and Viscum album L. therapy in patients with advanced or metastatic cancer. BMC Complementary and Alternative Medicine. 2017;17:534.
- Schad F, Thronicke A, Merkle A, Matthes H, Steele ML. Immune-related and adverse drug reactions to low versus high initial doses of Viscum album L. in cancer patients. Phytomedicine. 2017 Dec 1;36:54-58.
- Zuzak TJ, Wasmuth A, Bernitzki S, Schwermer M, Längler A. Safety of high-dose intravenous mistletoe therapy in pediatric cancer patients: a case series. Complementary Therapies in Medicine. 2018 Oct;40:198-202.
Clinical Trials
More from Our Resources Database
- Gurdev Parmar and Tina Kaczor: Textbook of Naturopathic Oncology
- Dr. Deirdre Orceyre: Naturopathic and Integrative Cancer Care
- Barbara MacDonald, ND, LAc: The Breast Cancer Companion: A Complementary Care Manual: Third Edition
- September 2018 Issue of the Journal of Alternative and Complementary Medicine
- National Cancer Institute at the National Institutes of Health: PDQ® Cancer Information Summaries
- Raymond Chang, MD: Beyond the Magic Bullet: The Anti-Cancer Cocktail
- Donald I. Abrams, MD, and Andrew T. Weil, MD: Integrative Oncology, 2nd Edition
- Neil McKinney, BSc, ND: Naturopathic Oncology, 3rd Edition
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Danielle Rice:
Nov 08, 2018 at 10:21 AM
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!