If you or someone close to you is facing cancer, you might be exploring various alternative and natural therapies aimed at potentially enhancing treatment results and improving overall well-being and quality of life. However, it is crucial to note that many natural products promoting anticancer or immune-boosting advantages lack substantial research to validate their efficacy. In some cases, these remedies can even pose risks to health. Mistletoe, known as Viscum album, is one such alternative therapy utilized in various regions across the globe. This article delves into the nature of mistletoe and examines its effectiveness in improving the quality of life, treatment outcomes, and alleviating symptoms for individuals battling cancer.

What is Mistletoe?

European mistletoe (Viscum album L.) is a notable medicinal herb that has been utilized for over a century in cancer treatment. This evergreen semiparasitic plant thrives on specific trees, extracting moisture and nutrients for its growth. It is indigenous to regions of Europe and Asia, showcasing its adaptability across diverse climates. Extracts derived from mistletoe are employed to address various health conditions, particularly cancer. The concept of using mistletoe extract as a potential remedy for cancer was first introduced by Austrian philosopher Rudolph Steiner in 1920, although it was Dutch physician Ita Wegman who pioneered its application in a patient battling cancer.

In India, mistletoe is known by different names depending on the region and the species. Some common Indian names for mistletoe species include:

1. Dendrophthoe falcata (Indian Mistletoe)
   • Hindi:  (Bandar Bel), (Hadjod)
   • Sanskrit: (Vand?ki),  (Bandh?ka)
   • Tamil: (Pandak?rai)
   • Malayalam:  (K?vinakudi)
   • Kannada:  (Bantikare)
   • Marathi: (Vandaki)
   • Bengali: (Bandar Lata)
2. Viscum articulatum (Himalayan Mistletoe)
   • Sanskrit:(Vand?ki)
   • Hindi: (Hadjod)
   • Nepali:(Gurjo)

These plants are often used in traditional Ayurvedic medicine. Mistletoe in India is found in various species, primarily belonging to the Loranthaceae and Viscaceae families. Unlike the European mistletoe (Viscum album), which is commonly associated with Christmas traditions, Indian mistletoes are mostly parasitic plants found growing on host trees.

Common Mistletoe Species in India

1. Viscum album – Found in the Himalayan region, but less common in India.
2. Viscum articulatum – Found in India, China, and Southeast Asia, often growing on tree hosts.
3. Dendrophthoe falcata (Common Indian Mistletoe) – A parasitic plant found on mango, neem, and other trees, used in traditional medicine.
4. Taxillus tomentosus – A mistletoe species growing in parts of the Western Ghats and Northeast India.

Uses of Mistletoe in India

• Traditional Medicine: Used in Ayurveda and folk remedies for treating hypertension, diabetes, and inflammation.
• Ecological Role: Supports bird species by providing food and habitat.
• Potential Toxicity: Some species contain toxic alkaloids that can be harmful if ingested in large amounts.

Oral formulations of mistletoe are available as dietary supplements, but the majority of research studying its impact on cancer outcomes primarily concentrates on injection or intravenous administration, methods that are often prescribed in specific European nations.

Typically, mistletoe extract is administered through subcutaneous injections 2 to 3 times per week, with treatment durations potentially extending from several weeks to even years. Despite its widespread use as an alternative cancer therapy in Europe, mistletoe extract has not received approval from the United States Food and Drug Administration (FDA), rendering prescription mistletoe products unavailable in the U.S.

In contrast, European countries frequently prescribe mistletoe extracts as part of cancer treatment regimens, particularly in German-speaking regions where it is most commonly utilized. The characteristics of mistletoe products can vary significantly based on the host tree species, the specific mistletoe variety, and the seasonal timing of its harvest. Mistletoe extracts are typically prepared in either water-based solutions or a combination of water and alcohol.

These extracts are often employed as adjuvant therapies for individuals with cancer, indicating their use following initial conventional cancer treatments such as chemotherapy. Commercially available formulations of European mistletoe extracts encompass brands like Helixor, Iscador, Iscador Qu, Lektinol, Cefalektin, Eurixor, ABNOBAviscum, and Abnoba-viscum Quercus. In certain European countries, these mistletoe extracts are routinely prescribed to cancer patients, often in conjunction with standard cancer therapies, enhancing the overall treatment strategy.

What Makes Mistletoe a Candidate for Cancer Treatment?

Mistletoe (Viscum album) is rich in various compounds that present promising therapeutic possibilities, such as lectins, viscotoxins, flavonoids, oligo- and polysaccharides, membrane lipids, and alkaloids, among others. The intricate blend of these substances contributes to its potential efficacy in cancer care.  While the precise mechanisms behind mistletoe’s anticancer properties remain elusive to researchers, it is widely believed that the concentration of lectins in mistletoe plays a crucial role in modulating the immune response. This could enhance the body's defenses while mitigating adverse effects associated with conventional cancer treatments.

Lectins are unique molecules that consist of both carbohydrate and protein components, enabling them to bind to and influence cellular functions. Another significant compound in mistletoe is viscotoxins, which are thought to exhibit anticancer effects. Interesting findings reveal that the complete extract of mistletoe may provide more robust anticancer benefits compared to its isolated components. This indicates that all constituents, not just lectins and viscotoxins, work synergistically to enhance its therapeutic impact.

Research indicates that mistletoe influences the immune system in various beneficial ways, particularly in cancer treatment and alleviating treatment-related side effects. For instance, clinical studies have demonstrated that administration of mistletoe extract can significantly elevate the levels of natural killer (NK) cells—immune cells that are essential for combating cancer. Moreover, mistletoe exhibits anti-inflammatory properties, with some studies suggesting its role as an antiangiogenesis agent. This implies that it might impede cancer progression by inhibiting the formation of new blood vessels, thereby cutting off the nutrient supply to tumors.

The diverse array of biologically active compounds found in mistletoe bestows it with potent immune-modulating effects, potentially making it an effective adjunct in cancer therapies.

Is it Effective?

Mistletoe extract, unlike many other complementary treatments for cancer, has undergone extensive research involving human subjects. To date, over 50 clinical trials have been conducted to evaluate the effects of mistletoe extract on individuals diagnosed with cancer. Some studies indicate that mistletoe may provide benefits such as enhanced quality of life, reduced side effects from conventional treatments, prolonged survival, and symptom improvement in patients with specific types of cancer. For instance, certain research suggests positive outcomes related to pain management and nausea.

However, it's important to note that not every study demonstrates these benefits. Some scientists have raised concerns regarding the quality of the evidence available. A comprehensive review of 26 studies found that patients using mistletoe extract experienced notable improvements in quality of life, particularly in terms of pain and nausea, compared to those receiving placebo treatments. Nonetheless, the researchers highlighted a significant risk of bias in the studies reviewed.

Conversely, a two-part review analyzing 28 studies concluded that well-structured research showed minimal to no advantage of mistletoe treatment concerning quality of life or survival rates among individuals with various cancers, including colorectal, lung, and breast cancers. Another analysis looked into the impact of the mistletoe extract product known as Iscador on cancer survival. This review encompassed 32 studies and determined that when utilized as an adjunct treatment, Iscador contributed to improved survival rates, particularly in patients suffering from cervical cancer.

A randomized controlled trial conducted in 2013 also indicated favorable outcomes associated with Iscador. This study involved 220 individuals diagnosed with advanced metastatic pancreatic cancer who were receiving only supportive care. The findings revealed that participants treated with Iscador had an average survival extension of two months compared to the placebo group, along with a reduction in disease-related symptoms such as pain, nausea, diarrhea, anxiety, and fatigue.

In a separate study involving 319 women with nonmetastasized breast cancer, researchers compared those who received only standard cancer treatment (chemotherapy) with those who underwent standard treatment in conjunction with mistletoe extract. At the 12-month mark, the individuals receiving the combination of mistletoe and standard treatment reported improvements in symptoms like fatigue, insomnia, and overall physical functioning, whereas the standard treatment group experienced a deterioration in their symptoms.

A trial conducted in the U.S. investigated Iscar, a mistletoe extract product, in combination with the chemotherapy drug Gemcitabine in 2007. However, the results of this study have yet to be released. This unpublished trial focused on patients with non-small cell lung cancer who had not benefited from an initial round of chemotherapy.

While some of these findings imply that mistletoe may hold promise in the treatment of certain cancers, researchers caution that many of the completed studies have considerable flaws, rendering their findings potentially unreliable. Therefore, the need for more high-quality studies is crucial to fully comprehend the effects of mistletoe extract on cancer patients and to ascertain if it should be considered as an alternative therapy.

If you are facing a cancer diagnosis and wish to explore the potential of mistletoe in your treatment plan, it is essential to consult with your oncology team. These medical professionals possess in-depth knowledge of your specific diagnosis and treatment options and can guide you in determining whether alternative and complementary therapies like mistletoe are applicable in your individual case.

In summary, while some research indicates that mistletoe extract might be advantageous in enhancing quality of life, survival rates, and symptom management in cancer patients, researchers express concerns about the reliability and variability of the existing studies.

Precautions and Side Effects

Generally speaking, the side effects associated with mistletoe extracts, as documented in clinical studies, have been relatively minor and non-life-threatening. Most individuals using mistletoe have reported experiencing a few common side effects, which include:

• Headache
• Fever
• Chills
• Inflammation and soreness at injection sites
• Elevated white cell count

Nevertheless, there have been instances of severe allergic reactions to mistletoe, including cases of anaphylactic shock. A small-scale study conducted in 2019 indicated that treatment with mistletoe extract products, such as Iscador and Helixor, was safe and did not result in adverse effects among cancer patients with pre-existing autoimmune conditions, like Hashimoto’s thyroiditis and ulcerative colitis.

However, consuming mistletoe dietary supplements, including teas, in excessive amounts can lead to severe side effects and potentially fatal outcomes. It is important to note that these products differ significantly from commercially available formulations such as Iscador, which are prescribed by healthcare professionals. Moreover, while mistletoe extract is not commonly linked to many adverse effects in clinical settings, it is crucial to remember that mistletoe plants and berries are toxic to humans and should be strictly avoided.

As previously mentioned, although mistletoe extract is frequently used in cancer treatments across various regions in Europe, prescription injectable mistletoe products like Iscador have not received FDA approval and are unavailable in the United States. Mistletoe has the potential to interact with certain medications, leading to additional, less common side effects, such as low blood pressure and a slow heart rate. Therefore, it is imperative to consult your oncology team before beginning any mistletoe treatments. Your oncology team can assist you in determining the most suitable treatment plan tailored to your individual needs and provide guidance on appropriate evidence-based complementary therapies.

Research findings suggest that prescription mistletoe products are generally safe. However, if you are undergoing cancer treatment, it is essential to discuss any changes in medication or supplements with your oncology team to ensure your safety.

The Bottom Line

Mistletoe extract is recognized as one of the most extensively researched complementary and alternative therapies for cancer, frequently recommended to cancer patients in various European nations. In contrast, prescription mistletoe products lack approval for cancer treatment within the United States. Several studies indicate that when utilized as an adjuvant therapy, mistletoe extract could enhance the quality of life, alleviate symptoms, and potentially improve survival rates for individuals diagnosed with specific types of cancer. Nonetheless, the body of research is not uniformly positive, and some scientists have raised concerns about the reliability of the existing evidence surrounding its efficacy. If you are considering mistletoe or any other alternative cancer treatment, it is essential to consult with your oncology team prior to using any pharmaceutical or dietary supplement that claims to benefit those with cancer.