Impact of mistletoe therapy on the quality-of-life of cancer patients

Abstract

Quality-of-life (QoL) of cancer patients is an issue both in conventional and in complementary/alternative medicine (CAM). In clinical studies, QoL is usually estimated by questionnaires, which represent a possibility to objectively quantify it in a wide number of patients, but lack the subjective dimension of each patient's QoL perception. Mistletoe (Viscum album) preparations are often used in the adjuvant setting and several clinical studies have shown that mistletoe – often in combination with standard treatments – can improve QoL [1]. In our previous work, we have detected a tendency for an improvement of the patients’ QoL as detected by various questionnaires (EORTC QLQ-C30 Version 3.0 [2], SELT-M [3] and HLQ Version 2.5 [4]), in a cohort of 25 patients with different types of malignant diseases during treatment with subcutaneous applications of mistletoe preparations [5]. This cohort study, which was authorized by the ethical commission of the canton Zurich, included an additional questionnaire focusing on the therapies used (mistletoe, conventional and others) and on their impact on the QoL as perceived by the patient. The patients filled in the questionnaire at the beginning of the mistletoe therapy (n=25), and approximately 3 months later (n=21), to document the evolution during this time period. When the patients agreed, they were interviewed by the researchers at both occasions (n=12). For comparison reasons, only the questionnaires data of the patients, which were as well interviewed, are considered in the present analysis. The analysis of the questionnaires showed that the patients had most expectations concerning the improvement of QoL on the mistletoe therapy. Furthermore, they perceived the mistletoe therapy as the one leading to an improvement of QoL and to a better coping – including dimensions like positive thinking and a conscious lifestyle – with the disease. These results were supported by those of the interviews’ analysis, which further revealed that the successful coping with a cancer disease is associated with secondary (indirect) but effective components of the QoL, such as the interpretation of the disease (both of the patient and of the loved ones), the perceived sense or meaning of the disease, the received treatment (preferences, concept, setting) and the personal world's view. The coping with the disease was in some cases associated with changes in the private (psychosocial) space and in other cases in the professional space. Taken together, our results show that the patients adopt the mistletoe therapy with a supportive goal rather then as an anti-tumour therapy. Mistletoe therapy seems 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.