Does Mistletoe Help Cancer Patients?
The pharmacokinetics in healthy adults has been determined. Data are limited.
Use of mistletoe extracts in patients with primary or secondary brain tumors, leukemia, or malignant lymphoma is contraindicated. Local reactions following injection include redness, itching, inflammation, and induration at the injection site. Systemic reactions include mild fever or flu-like symptoms.
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Anaphylaxis has been reported. Poison centers report toxicity of the whole plant, but especially mistletoe berries.
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The family Viscaceae Christmas Mistletoe family contains 5 genera and more than 50 different mistletoe species. Synonyms include Phoradendron flavescens, Phoradendron serotinum, and Viscum coloratum.
Mistletoe is a hemiparasitic plant that grows on a wide variety of host trees such as pine, oak, birch, and apple. The term hemiparasitic indicates that the mistletoe plant carries out photosynthesis independently but obtains its water and minerals from the host. There are several subspecies and varieties of mistletoe, which are defined by the host that they parasitize. European mistletoe is dioecious, with male and female flowers on separate plants. They are pollinated by insects and bear small white berries on evergreen foliage.
Other varieties bear red berries. Mistletoe preparations have been used medicinally in Europe for centuries to treat epilepsy, infertility, hypertension, and arthritis. The Celtic priests, known as Druids, revered the oak tree and the mistletoe that grew upon it, according to Roman author and naturalist Gaius Plinius Secundus also known as Pliny the Elder. At the winter celebration of Samhain, the sacred oaks were bare except for the green boughs of mistletoe. This was taken as a sign of eternal fertility. The Celts placed a sprig of mistletoe above the door of their houses.
Its sacred nature prohibited fighting beneath it. This evolved over centuries into the custom of kissing underneath mistletoe at Christmas. The most distinctive constituents of V.
Four viscotoxins A1, A2, A3, and B have been isolated and sequenced. The 3-dimensional structure of viscotoxin A3 has been elucidated by nuclear magnetic resonance methods. The viscotoxin profile of subspecies album did not vary appreciably with 7 different hosts. The American species P.
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Viscumin, a toxic lectin, was isolated from V. The water-soluble polysaccharides of V.
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A highly esterified galactouronan and a complex arabinogalactan were identified, with the corresponding polysaccharides from Iscador having lower molecular weights compared with those of the native, unfermented extract. The phenylpropanoids syringin, syringenin-apiosylglucoside, and eleutheroside E have been found in V. They are thought to play a role in osmotic balance. Because of the potential toxicity of mistletoe, many studies have been done in vitro.
Methodology of clinical trials is generally poor. Despite a plethora of experiments to determine a mechanism of action for mistletoe, no clear pathway has been identified. Proposed mechanisms generally focus on direct cytotoxic action apoptosis induction or immunomodulation eg, enhanced natural killer cell activity, increased production of interleukins and tumor necrosis factor-alpha, activation of mononuclear cells, stimulation of granulocyte phagocytosis.
Several systematic reviews of clinical trials have been published. No evidence of effect can be shown. A positive and negative trend were found for trials included in the reviews. Data analyzed from survivors found statistically and clinically significant improvement in quality of life parameters with administration of subcutaneous mistletoe 3 times weekly for up to 1 year compared with those receiving only best supportive care.
Mistletoe extract was initiated at 0. In European folk medicine, a primary use of mistletoe is for its cardiovascular properties. However, clinical trials to support this use are lacking. Viscotoxins have been shown to induce reflex bradycardia and possess negative inotropic effects in the isolated animal cardiac muscle, as well as vasoconstriction at higher doses. Iscador has not been approved for use in the United States.
Mistletoe contains toxic constituents. Avoid use during pregnancy or lactation.
follow url Mistletoe is considered to be a toxic plant, and its content of toxic lectins lends support to this. Outcome data were extracted and expressed as hazard ratios HR using standard formulas. Fifty-two publications on the clinical effects of Iscador use and survival were found. Eight of these papers cited the same data and were excluded. Another 4 studies were excluded because they utilized 2 different mistletoe extracts, Helixor and Iscador. The oldest study was published in and the most recent Participants Overall 3, patents were treated with Iscador and 7, served as controls.
Key Findings The medical use of mistletoe can be traced back to Druid ritual.
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Rudolf Steiner popularized the use of mistletoe preparations in his system of anthroposophical medicine. That this therapy was derived from such an esoteric source may be why research results have been inconsistent. The bias that researchers bring to their study of mistletoe may be difficult to overcome. Results may be swayed by patient belief, and non-randomized studies are inherently suspect. This paper is the most comprehensive and yields the most positive meta-analysis to date. There have been similar attempts at pooling data over recent years in order to gain more insight into whether mistletoe offers benefit, but those studies have not yielded such encouraging results.
In , Ernst, et al, attempted to review the randomized clinical trials but concluded that statistical pooling was not possible because the primary studies varied so much and instead simply wrote a narration of results. Rigorous trials of mistletoe extracts fail to demonstrate efficacy of this therapy. Despite obvious limitations, and strong hints for a publication bias which limits the evidence found in this meta-analysis, one cannot ignore the fact that studies with positive effects of VA-E [viscum alba extract] on survival of cancer patients are accumulating.
Instead they will point to other reviews that were unable to show benefit, and there is no shortage of these. For more research involving integrative oncology, click here. He is recognized as a fellow by the American Board of Naturopathic Oncology. Mistletoe for cancer?