MAB: Mistletoe and Breast Cancer

Mistletoe and Breast Cancer (MAB), led by Professor Gene Feder and Dr Alyson Huntley, is a two-site pilot study for a randomized controlled trial investigating the feasibility of a mistletoe treatment for women who have been diagnosed with early breast cancer.

In Europe, Viscum album L (mistletoe) is the most commonly used complementary therapy by patients with cancer and is integrated into conventional oncology treatment programmes in Germany, Switzerland and Holland.  Despite this use of mistletoe therapy, it is only in the past 15 years that this treatment has been the subject of randomised controlled trials (RCTs), although most of these have been poorly designed and reported.

Nevertheless, a relatively consistent finding of these trials measuring the effects of mistletoe on the adverse effects of chemotherapy and radiotherapy was a reduction of these effects and/or improvement of quality of life (QOL). The magnitude of these effects cannot be reliably estimated from current trials and were not pooled in a Cochrane review. These trials recruited patients with a range of solid tumours and chemo/radiotherapeutic regimes and most had substantial methodological weaknesses.

The potential recruitment of cancer patients into RCTs of mistletoe on mainland Europe is limited by the popularity of the treatment. In the United Kingdom, whilst mistletoe can be prescribed in the NHS, uncertainty about its effectiveness makes it a controversial treatment, despite its potential to improve the patient experience of cancer care, a major priority of the NHS cancer plan.

The rationale for piloting before conducting a full trial is the need to assess the feasibility of recruitment and the logistics of repeated treatments, as well as the success or otherwise of blinding of patients to treatment allocation, which proved difficult in the previous trials.  This will be the first trial of mistletoe in the United Kingdom.

Evans, MA, Bryant, SB, Huntley, AL & Feder, GS, 2016, ‘Cancer patients’ experiences of using mistletoe (Viscum album): A qualitative systematic review and synthesis’. Journal of Alternative and Complementary Medicine, vol 22., pp. 134-144