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Editorials

Mistletoe as a treatment for cancer

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.39055.493958.80 (Published 21 December 2006) Cite this as: BMJ 2006;333:1282

Effect of Mistletoe on Cervical cancer (n =1)

I am certainly not a fan of the so-called complementary 'unproven'
treatments. (1). I certainly concur with the author about the 'absence of
evidence' regarding mistletoe treatment for cancer. (2)(3)(4).

I wish to report on a patient who seems to have 'benefited' from
mistletoe therapy. A 57 yr old woman presented with vaginal bleeding and
a biopsy showed cervical cancer in March 2002. A subsequent MRI scan
showed a 3cm cervical cancer with lateral spread to right parametrium.
Chemoradiation was recommended, but the patient refused radiotherapy and
chemotherapy. She elected to have 'mistletoe injection therapy only' even
after she was made aware of the risks. She then continued on regular
medical follow up.

A year later, she had vaginal bleeding for which she agreed to have a
single fraction of radiotherapy. I was expecting rapid tumour progression
and possibly metastatic disease at this stage. However, I was surprised
when the repeat MRI scan in December 2003 showed no significant tumour
progression. The treatment options were discussed with her again and this
time she agreed to have the 'full radical course of radiotherapy'. A
repeat MRI scan in June 2004 after radiotherapy showed complete tumour
response. Another MRI scan in March 2007 has confirmed that she is
completely free of tumour. The patient continues on subcutaneous Mistletoe
(ISCADOR®) injections.

The most likely explanation for non-progression of cancer for more
than year without treatment is that the patient's cervical cancer was a
'slow growing' tumour. (5). But I have to admit that I could not rule out
an effect (direct or indirect) of mistletoe on cervical cancer.

Ref:

1. Sundar S. It's either a proven therapy or an unproven therapy.
http://www.bmj.com/cgi/eletters/333/7578/1129#150613.

2. Ernst E. Mistletoe as a treatment for cancer. Has no proved
benefit and can cause harm. BMJ 2006; 333: 1282-1283.

3. Ernst E, Schmidt K, Steuer-Vogt MK. Mistletoe for cancer? A
systematic review of randomised clinical trials. Int J Cancer
2003;107(2):262-267.

4. Mistletoe Extracts (PDQ®).
http://www.cancer.gov/cancertopics/pdq/cam/mistletoe/HealthProfessional/...

5. Symonds P, Bolger B, Hole D, Mao JH, Cooke T. Advanced-stage
cervix cancer: rapid tumour growth rather than late diagnosis. Br J Cancer
2000; 83: 566-568

Competing interests:

1. A healthy scepticism of unproven therapy

2. Manuscript draft shown to patient for factual accuracy check and consent for publication

Editorial note
The patient whose case is described has given her signed informed consent to publication.

Competing interests: No competing interests

16 July 2007
S Sundar
Consultant Oncologist
Dept of Oncology, University Hospitals of Nottingham, NG5 1PB