Mistletoe (Viscum album) is a biologic therapy with broad applications in the field of oncology. It is among the most well studied and evidence-based, complementary therapies recommended for cancer patients. It has demonstrated consistent safety when used in concordance with the established treatment protocols. Mistletoe extract acts on many levels: boosting the immune system, triggering apoptosis (programmed cell death) in cancer cells, as well as protecting DNA of immune cells and other healthy cells against damage caused by cytostatic drugs. As a result, side effects of chemotherapy can be reduced.
Mistletoe (Viscum album) delivered via intravenous route can avoid local reactions and allow for faster dose escalation and greater maintenance dose. This may lead to increased tumor-specific response and pain control in widespread disease. There are some case studies published showing partial and complete responses of breast and pancreatic cancers using IV Mistletoe in combination with Intra-lesional Mistletoe (i.e., injecting it into a tumor). Mistletoe is also administered by subcutaneous injection (injection into the fatty tissue), and can also be applied topically to cancerous and precancerous spots, as well as over and around tumor sites. Your healthcare provider at The Woodlands Institute for Health and Wellness will determine any and all forms of mistletoe that will benefit you the most.
o Has shown to activate the immune system and the production of defense cells.
o Has shown to stimulate “programmed cell death” (apoptosis), particularly in tumor cells, which have lost this ability and thus multiply uncontrollably.
o Has shown to protect the DNA of healthy cells against damage caused by cytostatic drugs, so the side effects of chemotherapy are reduced.
o Has shown to decrease fatigue, particularly during and after chemotherapy, noting less severe fatigue. o Has shown to reduce nausea during chemotherapy.
o Has shown to help stimulate the appetite, the body gains new energy.
o Has shown to improve sleep.
o Mistletoe products raise patients’ body temperatures slightly, warming their bodies through. Many cancer patients have a low average body temperature and easily feel cold.
o Has shown to reduce sensitivity to pain, so fewer painkillers and sedatives are needed.
Clinical Indication for use:
o All types of cancer (all sites and histological types)
o All cancer stages
o At any point in the course of cancer
o After cancer cure for prophylaxis of relapse or of secondary cancer
o Tumor response in patients on 2nd line or beyond conventional treatment protocols
o Palliative treatment of metastatic disease (especially bone mets) for pain control and other quality of life measures
o Primary treatment in patients who have refused conventional care. There are no guarantees for cure or halt of progression of cancer.
*Mistletoe is not aimed at the tumor directly but at the host organism by:
- Activating the potencies of resistance, self-healing and regulation
- Protecting the organism from adverse effects of standard therapies
- Significantly enhancing quality of life
Contraindication for use
o Allergy to mistletoe products: Please note that people with a known allergy (not sensitivity) to chestnuts or latex or certain tropical fruits such as kiwi, banana, or avocado may have a cross-reaction to mistletoe and should have a smaller test dose. PLEASE NOTIFY YOUR PROVIDER AND NURSE IF YOU HAVE A KNOWN ALLERGY TO ANY OF THESE.
o Acute inflammatory disease, high fever
o Acute hyperthyroidism with tachycardia
o Chronic granulomatous and autoimmune diseases (if uncontrolled or treated with immunosuppressants)
o Tumor location where significant swelling (100-200% of pretreatment size) might lead to dangerous complications. Examples include:
o Head and neck tumors
o Prostate tumors
o Lung tumors
o Patients where strong immune stimulation may lead to a worsening of comorbid conditions or may lead to allergic type reactions
o Patients with Auto-immune conditions
o Atopic Patients (severe allergies, eczema, asthma)
Potential side effects of Mistletoe include:
o Pain and tenderness at site of infusion or injection; irritation of skin with topical use
o Fever and chills
o Allergic reaction
o Cytokine Release Syndrome (aka CRS) – Signs and symptoms similar to allergy, but this should have been ruled out by prior provocation testing. Treatment protocols are in place should this occur.
o Tumor Swelling and Pain – this is caused by combination of moderate tumor lysis (i.e. cancer cell death) and a tumor-specific immune response leading to tumor inflammation.
Treatment for side effects:
Mild – Moderate – patient to use current painkiller if already prescribed or use Tylenol/Advil as needed.
Severe – referral to Emergency Department for assessment for tumor lysis syndrome and for more significant pain control likely need for temporary opiates as pain of treatment origin should subside within 2-3 days.
Phlebitis (inflammation of blood vessel) – rates of phlebitis in Mistletoe infusions seem higher in patients who also experience a CRS when compared with other infusions.
Discontinuation of infusion and re-initiated at alternate site. We can apply heat or cold depending on comfort and offer hamamaelis/aesulus/pau d’arco cream to apply to area for 5-7 days.
Pre-treatment Sensitivity Evaluation
o Patient to be given Mistletoe intra-dermally at least 72 hours prior to first intravenous treatment. The injection site will be marked with 2” diameter circle and you’ll be asked to observe for the development of a skin reaction (redness) outside of this circle or a hive-like reaction.
o If you develop redness outside the 2-inch mark we will escalate your dose at a 50% of the normal schedule.
o If you develop hives– this indicates a hypersensitivity to Mistletoe and you’re not a candidate for Mistletoe therapy.