Frequently asked questions and answers

Here you will find a summary of the most important questions and answers on mistletoe therapy for cancer. Click on the grey fields below to view the individual questions. The answers are based on the clinical and practical experience of physicians experienced in mistletoe therapy. If your doctor's recommendation differs from the statements made here, you should talk to him about it.

There are three major issues at stake: 

  1. Onset and course of therapy
  2. Side effects
  3. Injections


Last update: January 4th, 2022/AT

Onset and course of therapy

When should mistletoe therapy begin?
Mistletoe therapy can be start early, even immediately after diagnosis or before surgery, if this is planned. Since mistletoe therapy activates the immune system and thus promote resistance, the body will be well prepared for the stress that surgery causes to the organism. But a later start is also possible.

Can mistletoe therapy also be performed during chemo- and/or radiotherapy?
Yes, because mistletoe therapy can reduce the adverse effects of chemo- radio-, hormone or antibody therapy. However, it is essential to ensure that the injection is given outside the radiation field, otherwise the skin can become highly inflamed.

Does mistletoe interfere with the effects of other drugs?
No, so far there are no known negative interactions with other drugs. The studies available so far show that mistletoe therapy can be well combined with conventional treatment methods like chemo- radio-, hormone or antibody therapy. It can also reduce some of their undesirable effects. 

How long does the treatment take?
Mistletoe therapy is often a long-term therapy but needs to be accompanied by a health professional. How long the therapy lasts in individual cases depends on how the disease develops and how the organism reacts to the therapy.

Do blood levels need to be measured? 
In most cases the blood levels are determined once at the beginning of mistletoe therapy and monitored repeatedly at longer intervals during the course of the treatment. However, such laboratory controls are not absolutely necessary. Each doctor decides which examinations are necessary in the individual case on the basis of the disease situation.

Does mistletoe therapy influence tumour markers?
The tumour markers change depending on the course of the disease. If the general condition improves or the tumour size reduces as a result of mistletoe therapy, the tumour markers may also decrease again.

Is mistletoe therapy useful if metastases are already present? 
Yes, because mistletoe therapy can improve quality of life and strengthen the immune system, which may be manifested, for example, in an increase in appetite and weight, normalization of sleep quality and stimulation of the vital spirits revive. 

Can mistletoe therapy relieve pain?
Mistletoe therapy may reduce the need for analgesics. Pain intensity depends on the tumour growth, your general condition and physical strength. As your condition improves and energy returns, yours pain also decreases.

Which mistletoe preparation is the appropriate one? 
There is no "right" or "wrong" mistletoe preparation. The most important aspects in the selection of the mistletoe preparation are the type and stage of the tumour, the patients's individual symptoms and situation of the patient and above all, the question of what is to be achieved with mistletoe therapy. Considering these factors, the doctor needs to find the most suitable preparation. People who are sensitive to drugs may initially be given a rather low-dose mistletoe preparation – some manufacturers offer special preparation series with particularly low initial concentrations for this purpose.

Who can prescribe mistletoe preparations? 
Every doctor, and in Germany, also non-medical practitioners, can prescribe mistletoe preparations.

Where can I find a doctor who is experienced in mistletoe therapy? 
You can ask the Society of Anthroposophic Doctors in Germany for a doctor experienced in mistletoe therapy near your home. The citizens' and patients' association GESUNDHEIT AKTIV has also set up a doctors' hotline where you can ask for a mistletoe specialist: phone +49-1803-30 50 55 (Monday to Friday 9-12 a.m., Monday to Thursday 2-4 p.m; 9 cents/minute from a German landline, mobile maximum 42 cents/minute).


Last update: January 4th, 2022/AT

Side effects

Is the reddening of the skin an allergy? 
No, redness at the injection site up to 5 cm in diameter is a sign that the immune system reacts to mistletoe therapy. 

The red spot itches – is that an indication of an allergic reaction? 
No, this is not an indication of an allergy either. The itching can occur when the mild local inflammation caused by the mistletoe extract subsides. 

Is it dangerous if mistletoe therapy causes fever? 
An increased temperature of up to 38 °C is desired because the organism is stimulated to regulate the body temperature. This ability is often weakened in cancer patients. Many cancer patients who are always shivering feel comfortably warmed up following subcutaneous mistletoe therapy. If temperatures exceed 38° C and persist for more than 3 days, an infectious process or tumour fever should also be considered.

If higher fever develops during mistletoe infusion (up to 39.5 °C), this may be therapeutically useful. However, this therapy variant is an off-label application and should therefore always be under medical supervision. If the body temperature remains above 38 °C for more than three days, you should consult your doctor. 

Can mistletoe stimulate tumour proliferation? 
Neither laboratory experiments nor more than 150 clinical studies have found evidence that mistletoe therapy could stimulate tumour proliferation. 


Last update: December 14th, 2020/AT1


Should mistletoe preparations always be injected? 
Mistletoe therapy is approved for subcutaneous application. In the form of an oral application, the protein-containing mistletoe extracts would be "digested" in the stomach and made ineffective.  

Do the injections hurt? 
No, the injection can only be felt as a small prick. It may be as well slightly painful if injection has been given intracutaneously or when a nerve end has been striked by mistake, being however harmless. The needle used for injection is extremely fine and thin. You can look for a place to inject where your body is as insensitive as possible (abdomen, thighs). At the beginning you should be instructed how to inject by a professional, because there are a few tricks and tips on how to inject painlessly.

Hardenings form at the injection site. Why? 
The hardening is called induration and it is caused by the migration of white blood cells into this region. This induration disappears within a few days, usually the day after the injection. 

At what time should injection take place? 
If it is important to stimulate the activity of the organism, it is useful to perform the injection during the rising of the body temperature, i.e. in the morning (between 7 and 9 a.m.). If the warming aspect of mistletoe is to be preferred, it is advisable to inject it at the time of maximum body temperature, i.e. in the evening (between 5 and 6 p.m.). In principle a change of both methods is possible.

If the next injection is due but the redness has not yet subsided, what can be done? 
Normally you do not inject into the same place again. Nevertheless, you should wait with the next injection until the redness of the previous injection has completely subsided, because otherwise the redness that still exists could intensify to such an extent that a strong and painful inflammatory reaction develops. A redness that does not disappear within two days is often greater than five centimetres, indicating that the dose of mistletoe extract is too high or that the injection was wrong.


Last update: December 14th, 2020/AT1

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