An integrative approach of cancer treatment with mistletoe therapy, surgery, irradiation and chemotherapy in CAM settings

Abstract

Introduction Cancer treatment with mistletoe extract (Viscum album L., VA) is among the most widely spread CAM therapies in Germany and is especially popular in anthroposophic medicine (AM). However, relatively little is known about the particular cancer types and stages treated, frequency, duration and route of administration or co-medication used routinely in hospitals or outpatient settings. Therefore it is also difficult to determine possible risks and benefits of VA application in routine care that have been described in clinical studies. Materials To determine how VA is routinely used and if it is predominantly administered instead of or concurrent with radiotherapy, chemotherapy or surgery, data were analysed from the German arm of the Network Oncology (NO) that operates in several European countries, including Switzerland, Italy and Great Britain. Data were used from patients visiting one of the 4 participating hospitals and 7 outpatient/GP-surgeries in 2006–2008. Results Of the 6648 patients included, 4522 (68%) received VA treatment (4387 sc, 311 iv and 119 il). Gender ratio was 68% female and most common entities were breast (31.1%), pulmonary (10.6%), colon (7.3%), rectum (4.2%) and pancreatic (3.7%) cancer. Gender and entity distribution did not significantly differ between patients treated with VA or not. 16.2% received conventional therapy and 11.4% VA only, whereas 70.4% received both. However, this rate varied significantly between participating centres (54.9–88.2%). An average (o) time of application was 89.0 days (d) (±228.6) with a maximum of 1851 d. Two distinct groups (0–200 and 365–2100 d) became apparent, with averages of 37.8 and 1043.1 d. iv and il treatments were predominantly short term and hospital based, whereas sc application was mainly used in long-term treatment (o 94 apps in o 240 d). Conclusion In the settings investigated, an integrative approach was predominantly chosen when VA was administered. VA is used on a large variety of entities, predominantly by sc application. It is possible to differentiate between short- and long-term users but no data are yet available if there is a correlation between the length of treatment and either a curative use or the intention to improve quality. These data will provide a solid basis for the comparison of clinical trial data with routine use. Acknowledgements This project was supported by Weleda AG, Helixor GmbH, and Abnoba GmbH.