An exploratory study on quality of life and individual coping of cancer patients during mistletoe therapy

Abstract

Question: Mistletoe (Viscum album) preparations are the most often used CAM-therapy in the treatment of cancer and several clinical studies have shown that mistletoe—often in combination with standard treatments—can improve patients’ QoL. In clinical studies, QoL is usually estimated by questionnaires, which represent a possibility to objectively quantify it in a high number of patients, but lack the subjective dimension of each patient's QoL perception. Methods: This exploratory, prospective, cohort-study comprised 25 patients with different types of malignant diseases and conventional therapies, which were followed during their treatment with subcutaneous applications of mistletoe-preparations. The study included among others the EORTC QLQ-C30 (Version 3.0) questionnaire on QoL, which was filled in at the beginning of the mistletoe therapy (MT, n = 25) and approximately three months later (n = 21). When the patients agreed, they were interviewed by the researchers at both occasions (n = 17); the interviews were transcribed verbatim and submitted to a qualitative content analysis (n = 12). Results: All patients made use of conventional therapies either prior or in addition to the MT, some also of other CAM-therapies. Analysis of the EORTC QLQ-C30 questionnaire showed an improvement in defined functional (including global quality-of-life) and symptoms scales. In particular the scores of the role and emotional functioning scales were improved, whereas the most marked decrease in a symptom scale concerned fatigue. The qualitative interviews’ analysis indicated that psychosocial considerations and personal opinions were seen by the patients as relevant to QoL. The patients adopted the MT often with a supportive goal, rather than as an anti-tumor therapy. After three months of MT, most interviewed patients mentioned that they felt higher vitality and autonomy, and reported concrete personal achievements such as changes in the private and/or in the professional environment. These changes had often the goal of reducing stress, can be seen as a positive personality development and are likely to have improved coping with the disease. Conclusion: Taken together, our results show that the patients adopted the MT with a supportive goal and perceived an improvement of QoL during MT. MT seemed to offer a platform for an integrative coping with the disease, which might be important to reconcile the perceived shock of an existential disease with a good QoL, by releasing forces of motivational origin.