Mistletoe therapy is a complementary therapy for breast cancer treatment used by some cancer patients to support the immune system and improve quality of life during their mainstream cancer treatment. It involves injecting extracts from the mistletoe plant under the skin. While it is widely used in cancer care in parts of Europe and has a long history of safety, it is not currently part of standard care in the UK and is accessed mainly through private community-based practice.
This pilot trial was designed to test the practicalities of delivering mistletoe therapy in an NHS hospital setting, rather than to measure its effectiveness.
Fifteen patients were recruited from an NHS oncology centre and randomly assigned to receive either mistletoe or a placebo injection. They were asked to keep diaries and answer quality-of-life questionnaires. The trial was designed to be double-blind, meaning neither the patients nor the researchers knew who received the mistletoe therapy over placebo.
Alongside the clinical trial, the team also conducted interviews to understand patients’ and health professionals’ experiences and attitudes toward mistletoe therapy.
Key findings
- The trial design was successfully implemented in an NHS setting, showing that a larger study is possible.
- There were some difficulties recruiting to the trial, partly due the COVID pandemic, but none of the difficulties were specific to mistletoe therapy.
- Patients were generally open to trying mistletoe therapy and valued the holistic approach. Oncology professionals were supportive.
- Diaries and interviews indicated that most participants struggled with injections and skin reactions. Yet 12 of the 15 participants completed the full trial therapy, a further two participants completed the majority of the trial therapy, and one participant withdrew early due to the Covid-19 pandemic.
- Diary and questionnaire completion was good across the 14 participants who received the study therapy.
- It was not possible be confident of blinding and future trials will need to address this.
Gene Feder, Professor of Primary Care at the Centre for Academic Primary Care, said: “This pilot trial shows that it’s feasible to test mistletoe therapy in NHS secondary care."
Dr Alyson Huntley, Senior Research Fellow in Evidence-Based Primary Health Care at the Centre for Academic Primary Care, said: “The participants in the MAB Study show that cancer patients are keen to be involved in their care and well-being during treatment. It is important we support that.”
Paper: The Mistletoe and Breast Cancer (MAB) Study: A UK Mixed-Phase, Pilot, Placebo-Controlled, Double-Blind, Randomised Controlled Trial by Lorna Duncan et al. Published in Cancers. September 2025.