Cancer Care | Mistletoe Therapy

MistletoeViscum album L. (VA), has a long traditional history of about 100 years as an integrative therapy (add-on therapy) in cancer treatment in German-speaking countries. In other words, it has been used alongside conventional therapy. Studies have demonstrated improvements in health-related quality of life and reduction of adverse events from treatment with chemotherapy and radiation. It is also sometimes used to diminish tumor-related pain.

Various immune-modulating activities have been described in clinical research. Other mechanisms, such as attenuating angiogenesis, have been looked at pre-clinically. Systematic reviews of clinical trials have shown a benefit of mistletoe treatment on quality of life across a range of cancer types. With an excellent safety profile and the potential benefit for improved quality of life, many patients inquire about mistletoe as an integrative strategy alongside their conventional cancer plan.

Studies on Mistletoe

Studies on tumour responses, cancer recurrence, remission and survival have been inconclusive or mixed. This means that some studies document a benefit, some show no effect and some have mixed results. While, a small number of studies have shown the potential for a survival benefit, additional clinical research is needed. The first clinical trial in the United States using intravenous mistletoe is currently underway at Johns Hopkins University School of Medicine.

A pooled analysis of multiple clinical studies suggested that the adjuvant treatment of cancer patients with the mistletoe was associated with a better survival.

A randomized phase III trial concluded that mistletoe treatment showed a significant and clinically relevant prolongation of overall survival and less disease-related symptoms for patients with locally advanced or metastatic pancreatic cancer. (Eur J Cancer. 2013 Dec;49(18):3788-97)

A qualitative interview study reported the addition of mistletoe therapy to a patients cancer care plan may improve long ­term disease stability and improvements in patients’ general condition, vitality, strength, thermal comfort, appetite, sleep, pain from bone metastases, dyspnea in pulmonary lymphangitis carcinomatosa, fatigue, and cachexia; chemotherapy was better tolerated. (

A multicenter comparative study involving 686 patients with malignant melanoma (329 treated with mistletoe vs. 357 controls) suggested that the addition of mistletoe therapy was safe and, was associated with a improved overall survival and disease-free survival. (Arzneimittelforschung. 2005;55(1):38-49.)

A randomised, multicentre, double-blind clinical trial looked at the therapeutic value of mistletoe treatment (vs placebo), on quality of life in breast cancer patients undergoing treatment with chemotherapy. The authors summarized the results of the study to say mistletoe therapy “improved the QoL in patients with breast cancer receiving adjuvant CMF standard therapy (chemo), and during follow-up without chemotherapy. It is important to stress that not only general well-being, but also the typical side-effects of chemotherapy improved significantly. Clinical studies with another standardized mistletoe extract preparation in patients with advanced breast or colorectal cancer supported the results of this study.” (Anticancer Res. 2006 Mar-Apr;26(2B):1519-29)

In a randomized phase II study with 72 advanced lung cancer patients, it was observed that there were less chemotherapy dose reductions, grade 3-4 non-haematological side effects, and hospitalizations in patients treated with add-on mistletoe therapy. (Eur J Cancer. 2013 Mar;49(5):1058-64.)

In a study looking at chemo/radiation-induced fatigue (CRF) in patients with colorectal cancer, only 16/181 patients (8.8%) were diagnosed with CRF in the supportive care group and 86/143 (60.1%) in the chemo-or radio-chemotherapy group without supportive mistletoe medication. There were no discernable toxicities from the mistletoe treatment. (Inflamm Allergy Drug Targets. 2014;13(2):105-11.)

In a systemic review of controlled clinical studies, 26 randomized controlled trials (RCTs) and 10 non-RCTs looking at mistletoe and quality of life (QOL) in malignant (cancer) diseases. “Among the 26 RCTs, 22 reported a QoL benefit, 3 indicated no difference, and 1 did not report any result. All non-RCTs assessed reported a QoL benefit. Of the studies with higher methodological quality, most reported a benefit, whereas 1 found no difference. Improvements were mainly in regard to coping, fatigue, sleep, exhaustion, energy, nausea, vomiting, appetite, depression, anxiety, ability to work, and emotional and functional well-being in general and, less consistently, in regard to pain, diarrhea, general performance, and side effects of conventional treatments. VAEs were well tolerated.” (Integr Cancer Ther. 2010 Jun;9(2):142-57.)

A study with patients with breast cancer undergoing chemotherapy, concluded that mistletoe extracts were safe. “This result suggests that mistletoe extracts had no adverse interactions with the anticancer agents used in this study. Furthermore, certain side effects of chemotherapy decreased under this complementary treatment in breast cancer patients.” (

This randomized phase III study concluded that concomitant mistletoe application with checkpoint inhibitor therapy (immunotherapy) may not increase or alter immune related side effects in patients with advanced or metastatic cancer (BMC Complement Altern Med. 2017; 17: 534.)

This retrospective study demonstrated a nearly 5 times lower odds of experiencing an adverse response to treatment with a monoclonal antibody drug with concurrent mistletoe therapy, compared to monoclonal antibody therapy alone. The authors concluded that the combined treatment was safe. (Integr Cancer Ther. 2018 Mar;17(1):41-51.)

A retrospective analysis on pediatric patients treated with “intravenous high-dose mistletoe therapy for a period of two years… demonstrated safety and feasibility of high-dose mistletoe infusion in children with advanced stages of cancer. It also showed noteworthy antineoplastic effects.” ( *Please note: Dr. Moore currently only works with patients 18yo or older

In a case study with a 47-year-old woman with stage IVB ovarian cancer, chemotherapy was discontinued due to toxicity and acute kidney injury with infection. The patient opted for adjuvant treatment with mistletoe extract and achieved good health without progression of her cancer or ascites over 42 months since the 1st diagnosis and 24 months since the last relapse when she was on chemotherapy.  Click here to access the study 

In a case study case of a patient with laryngeal carcinoma, he was documented to make a full recovery following mistletoe therapy, despite failing to respond to chemoradiotherapy and salvage laryngectomy. (J Laryngol Otol. 2014 Mar;128(3):302-6)

In a case study of a 65-year-old patient with a diffuse large B-cell lymphoma and resistance to R-CHOP, a complete remission and long-term survival was observed with the addition of Viscum album Extracts (Mistletoe therapy). ” Five months after termination of chemotherapy – under continued VAE therapy in increasing dosage- regression of paraaortal lesions was found. The patient fully recovered under continuous VAE application and is in ongoing complete remission and in a good state of health 17 years after the initial diagnosis.”  (Anticancer Res. 2018 Sep;38(9):5363-5369. )

Dr. Jessica Moore, ND - Vancouver, BC
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Antitumoral properties

Immunomodulatory characteristics

Quality of life-promoting activity

May reduce side effects of modern conventional anticancer therapies


This information on this page should not be interpreted as medical advice nor should it replace the advice of a qualified health care provider. Mistletoe is a medical supervised therapy. Mistletoe is administered subcutaneously and intravenously, at a frequency and dose determined by the prescribing doctor. If you have questions about mistletoe therapy, you can talk with Dr. Moore about this during your consultation.

Additional References: Evid Based Complement Alternat Med. 2019 Apr 17;2019; Br J Pharmacol. 2011 Jan;162(2):349-64