Download Mistletoe Therapy for Cancer – General Information for Patients

In harmony with
nature
Mistletoe Therapy for Cancer –
General Information for Patients
Imprint
Mistletoe Therapy for Cancer –
General Information for Patients
1st Edition 08/2009
Art.-No. 50 603 600
Publisher
Weleda AG
Corporate Medical Department
Postfach 13 20
D-73503 Schwäbisch Gmünd
Germany
Photographic Source
Weleda Archive Schwäbisch Gmünd
© Weleda AG 2009
All rights reserved. No part of this brochure “Mistletoe Therapy
for Cancer - General Information for Patients” may be reproduced,
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Note
Extenisve care has been taken to ensure that the information and
recommendations given in this brochure are accurate and up to
date. Misprints and errors excepted; guarantee or liability claims
excluded.
Mistletoe Therapy for Cancer –
General Information for Patients
4
Table of Contents
• Foreword
6
• Standard therapies in oncology
8
• Complementary cancer therapy with mistletoe
11
• The phytology of mistletoe
13
• Mistletoe substances and their effects
15
• Clinical studies
18
• Practical use of mistletoe preparations
22
• Sources and references
28
• Weleda representatives list
29
5
Foreword
Dear reader,
In our modern world of medical advancements, many forms
of cancer can now be cured. Nevertheless, a cancer diagnosis
comes as a great shock for the afflicted individual. Fear, along
with fright, arise in its wake. Moreover, patients and their
relatives have practical questions for which they often do not find
answers: What does this disease mean for me? What conventional therapeutic possibilities are available? What else can I do
for myself? How shall I manage my life? Can I be cured?
Surgery, chemo-, radiotherapy and in some cases, hormone therapies, are established standard therapies for treating cancer.
To support these conventional forms of treatment, many patients
also opt for so-called complementary measures (= supplementary
treatment measures). The most frequently used is mistletoe therapy, which supports the body‘s own defences during oncological
treatment. This can mean, for example, that the tumour is attacked
more effectively or the side effects of the chemotherapy or radiotherapy can be reduced. The earlier a complementary therapy is
initiated, the more successful it will be.
6
With this brochure, we would like to give you a helping hand, empower you to cope better with your cancer. Furthermore, we would
like to show you how the therapeutic success of the tried-andtested standard treatments can be improved with complementary
measures, in particular mistletoe therapy.
With best wishes
Yours,
Dr. Bettina Arnold-von Versen
7
Standard therapies in oncology
The main objectives of conventional cancer treatment are to destroy the tumour and prevent it from spreading further. The three
„standard pillars“ are steel (scalpel), rays (irradiation, radiation)
and chemotherapy. Worldwide, decades of experience have
already been amassed with these methods of tumour destruction.
In conventional cancer treatment, the tumour is initially attacked
in these three ways, which are often combined together, used in
pairs or used at staggered intervals one after the other.
• Surgery
During an operation, the cancerous tumour is surgically removed.
Complete removal of the tumour is especially important to
prevent further spread. For this reason often a substantial amount
of healthy tissue is resected along with the tumour. Neighbouring lymph nodes are also removed if cancerous cells have
metastasised. However, often lymph nodes close to the tumour
are removed as preventative measure.
In some cases, it is helpful, to initially reduce the size of the
tumour by way of chemo- or radiotherapy in order to operate on
it afterwards. Conversely, a tumour, which cannot be completely
removed in an operation, can initially be reduced in size surgically
so that a secondary course of chemo- or radiotherapy has greater
chances of success.
8
• Radiotherapy
During radiotherapy, high-energy rays are directed at the tumour.
The intention is to destroy the malignant cells by damaging the
genetic material (DNA). With radiation, it is important to measure
the tumour as precisely and as completely as possible. Only then
can the effect on surrounding healthy tissue be minimized. In contrast to chemotherapy, in which the drug is dispersed throughout
the entire body, most forms of radiotherapy are locally effective.
This means that a therapeutic effect only occurs in the area of the
body subjected to radiation. Radiotherapy not only affects tumour
cells, but also neighboring healthy tissue. Therefore, some side
effects from the treatment may occur. Most of these side effects
subside after the treatment is completed.
• Chemotherapy
The aim of chemotherapy is to prevent the proliferation of cancer cells. Chemotherapy drugs, known as cytostatics, can destroy
the different tumour cells by influencing their metabolism and/or
stopping or substantially slowing down their ability to multiply. To
do this, many cytostatic drugs attack the genetic material. Others
block important metabolic processes involved in cell division. As
these are essential processes, almost all cytotoxins also affect
healthy cells.
9
For this reason all tissue which regenerates quickly is impaired to
varying degrees. Typical side effects of many cytostatics are temporary damage to blood cell formation as well as hair loss. Nausea
and vomiting are also typical side effects from chemotherapy.
In addition to these tumour-destructive treatments, (anti-)
hormone therapies are also utilised with tumours sensitive to them.
This is because many hormones control important processes in
the body at a cellular level, such as lowering the blood sugar level,
reproduction and growth. Many tumours also show an increased
growth rate under the influence of hormones. This hormonal
dependency of cancer cells is the starting point for the (anti-)
hormone treatments: hormones produced naturally in the body are
deactivated in order to inhibit the spread of a tumour.
10
Complementary cancer therapy
with mistletoe
Conventional cancer treatment aims to remove or destroy a diagnosed tumour. However, the side effects which occur can substantially impair quality of life. This in turn can have a negative effect
on the success of the treatment.
Mistletoe preparations have been used in cancer treatment since
the beginning of the last century. In addition to fighting cancer,
the use of mistletoe preparations improves the patient’s quality
of life: most patients quickly experience an improvement in their
general condition and sleep, appetite as well as performance.
Mistletoe can also relieve pain caused by tumours, strengthen
the immune system and reduce the side effects from chemo- and
radiotherapy.
All mistletoe preparations are complete extracts from the twigs,
leaves and berries from the white-berry European mistletoe
(Viscum album L.). Summer and winter extracts are mixed for anthroposophic preparations.
11
Chemo- / Radiotherapy
Surgery
Optimal
cancer
therapy
Therapy with
mistletoe extract
12
The phytology of mistletoe
The white-berry mistletoe grows on deciduous trees and conifers.
It occurs very frequently on poplars and apple trees. Only very rarely is it found on elm and oak trees. Of the conifers, it prefers pines
and fir trees. It is found throughout Europe. In terms of growth,
development and propagation, the mistletoe displays many characteristics which make it very different to „normal plants“, so
that Rudolf Steiner, the founder of anthroposophy, had cause to
recommend the mistletoe as a medicinal plant in cancer treatment,
already since the beginning of the 20th century.
The mistletoe is a dioecious plant, meaning that male and
female flowers are growing on separate plants. Mistletoes are
very slow-growing plants. It is only in the second year of growth
that two small leaves appear, whereas the mistletoe flowers
emerge first between the fifth and seventh year of growth. Its
inflorescence secretes a type of nectar with an aroma similar
to orange; this attracts ants and flies which help to ensure pollination. After pollination, the female inflorescence rests until
the end of June. The fruits then slowly develop with the green
embryo lying within, reaching full maturity in winter when they
emerge as white berries. Similarily to humans, it takes a total of
nine months for the flower to fully mature.
13
However, the embryo already fully developed in the mistletoe
berry cannot force its own way out, rather it is dependent on
the coriaceous berry shell being ripped open by a bird. Mistletoe
seedlings are very durable and remain germinable for months –
provided that they receive sufficient light.
14
Mistletoe substances and their
effects
Mistletoe extracts exhibit complex effects. For instance, the immune system is stimulated, the toxic effects of the tumour cells
are reduced, the psyche is positively influenced and genetic material (DNA) is protected.
The effect is due to a number of different biologically active
substances. Mistletoe extracts contain approximately 600 different proteins. The most important typical mistletoe proteins are the
sugar-containing mistletoe lectins and the viscotoxins, which are
among the important active pharmaceutical ingredients of mistletoe. In addition, they also contain numerous enzymes, sulphurous
compounds, fats and plant pigments (flavonoids).
Thus, lectins are sugar-containing proteins which only occur in
this form in mistletoe. They are very similar to the lectin of the
castor-oil plant. Lectins inhibit the growth of cancer cells or kill
them, meaning they have a “cytostatic” and “cytotoxic” effect,
and they affect the immune system (immunomodulation).
15
A distinction can be drawn between three different groups of
mistletoe lectins: mistletoe lectin I, II and III with a total of more
than 20 different individual components (isolectins). All lectins
can stimulate cancer cells to „self-destruction“. „Apoptosis“ of
this nature is possible and necessary for all healthy cells. This is
because new cells are continually being produced and old cells
are continually dying. Cell death and cell division are thus balanced out. Cancer cells have lost this ability and for this reason
they reproduce unregulated and begin to proliferate. If the capability for apoptosis in cancer cells is reactivated or restored, the
tumour growth can be restricted.
Viscotoxins are protein-containing compounds which in terms of
their chemical structure are similar to snake venom, in particular
cobra venom. The effects of viscotoxins individually are not yet as
well researched as the effects of lectins. It is known that viscotoxins destroy cancer cells by breaking up their cell walls (cytotoxic
effect). In addition, they can also stimulate the immune system in
the same way as lectins. In particular, they increase the activity
of natural killer cells and granulocytes (subtype of the white blood
cells) so that these can destroy bacteria and, presumably, tumour
cells in a much more efficient manner.
16
The mood-brightening and pain-reducing effect can be attributed to an increased release of beta-endorphins (substances
similar to morphine) which itself is attributable to the mistletoe
extract.
The type of host tree as well as the time of harvesting also have
a formative effect on the substances contained in the mistletoe.
For instance, the oak mistletoe contains more mistletoe lectins
than apple tree mistletoe, which in turn contains more than pine
mistletoe. In summer, the mistletoe plant has a high content of
viscotoxins in contrast to winter, when the content of mistletoe
lectins is particularly high.
Only the whole extract of the mistletoe deploys the full spectrum
of activity in cancer treatment.
17
Clinical studies
Currently, well over 100 clinical studies have been carried out
with regard to the use of mistletoe extracts with different types
of tumours. Mistletoe preparations are thus the best and most
extensively researched medicines used in complementary cancer
treatment.
In the final analysis, the studies predominantly indicate that mistletoe therapy is of benefit. The best documented effects are the
reduction in the side effects of conventional treatments such as
surgery, chemotherapy and radiotherapy and an improvement in
quality of life. In some cases, the appearance of metastases can
be delayed and survival time can be prolonged.
• Breast cancer
A study by Bock et al. (2004) demonstrated the safety and efficacy of a mistletoe preparation in patients with breast cancer.
It compared the medical data of women with breast cancer who
only received basic oncological treatment after the surgery with
the data of patients who also received injections of mistletoe
extract. When compared with the control group, the women in
the mistletoe group showed substantially fewer side effects
caused by conventional treatments (radiotherapy, chemotherapy
and hormone therapy) and a longer survival time. The tolerance of
the mistletoe therapy was assesed good to very good.
18
• Malignant melanoma
Study results from Augustin et al. (2005) show that mistletoe
therapy can also be regarded as safe and effective in cases of
malignant melanoma. Furthermore, it was determined that skin
cancer patients treated with mistletoe extract survived for a clearly
longer period of time. In general, the treatment was well tolerated;
neither serious side effects nor an increase in tumour growth were
observed. In contrast, the incidence rates of metastases were
significantly lower in the mistletoe group as compared to control.
19
• Intestinal and pancreatic cancer
Current study results are now also demonstrating the efficacy
and safety of mistletoe extracts in patients with intestinal
(colorectal) cancer and pancreatic cancer. The patients in the
mistletoe group showed considerably fewer side effects caused
by conventional treatments than those in the control group. For
example, in the mistletoe group, only approximately 19% of the
colorectal cancer patients and only 14% of the pancreatic cancer
patients developed side effects caused by chemotherapy and/or
radiotherapy, whereas in both control groups almost 50% suffered from these side effects. Likewise, disease- and therapyrelated symptoms, such as nausea, vomiting, loss of appetite,
depression, fatigue, sleep disturbances and back pain occurred
at a much lower frequency than in the control group, the physical
performance of the patients was better, they spent much less
time in hospital and survived longer with a better quality of life
at the same time.
The mistletoe therapy was also well tolerated. Only very few of
the patients reacted to the mistletoe extract with side effects
such as dizziness, fatigue, depression, slight fever or itching.
With almost a quarter of the patients, so-called local reactions
occurred at the injection site; these were always slight to medium in terms of intensity and subsequently subsided completely.
No major side effects were observed (Bock et al. 2007, Matthes
et al. 2007).
20
21
Practical use of
mistletoe preparations
The mistletoe extract is administered by injection, as the sensitive
natural substances would be destroyed by the digestive juices of
the human intestine.
It is easy to learn how to inject beneath one’s own skin (subcutaneously). However, please ensure that the first self-injection is
carried out together with the doctor treating you. Your doctor can
show you exactly where to inject and what you have to do. Always
adhere strictly to the treatment plan given to you by your doctor.
Generally, the mistletoe preparation is injected three times per
week, preferably in the morning.
What factors must you be aware of when self-injecting?
The application of mistletoe extracts requires a strictly subcutaneous injection technique.
Suitable injection sites are:
• abdomen region
• upper side of the thigh
Change the injection site regularly in order to prevent tissue
irritation.
22
If cool storage is needed, the ampoule should be warmed up to
room temperature before administration. It is recommended to
remove it early enough from refrigeration or warm the ampoule in
the hands.
Reddening around the injection site (maximum 5 cm in diameter)
can occur temporarily and is not a cause for concern, but rather
indicates a normal reaction to exogenous substances. In general,
this local reaction should have faded away by the time of the next
injection. Change the injection site for the next injection.
For each injection you need the following utensils:
•
•
•
•
•
an ampoule of mistletoe extract
a small syringe (2 ml)
a short, fine-gauged needle (0.4 mm x 20 mm, no. 27 G1/2)
disinfectant and swab
a small band-aid (if required)
23
Injection technique
Preparation
Lay out the utensils required! Place the needle (canula) with cap
on the syringe.
Opening the ampoule
First of all, the neck of the ampoule is opened under the coloured
dot. While holding the coloured dot upwards, bend the ampoule
backwards by applying slight pressure.
Drawing up the injection liquid
The mistletoe preparation is now drawn up into the syringe via the
needle (remove cap beforehand) (see photograph). Next, remove
the air still present in the syringe: hold the syringe vertically with
the needle upwards. Air bubbles at the side or at the bottom of the
syringe can be moved upwards by gently tapping the syringe and
then removed by slowly pressing the plunger.
Subcutaneous injection
Your doctor will indicate the best sites for injection.
24
Open the ampoule
Draw up injection fluid
Subcutaneous injection (under the skin)
25
Checklist for self-injection
• Before injection, the ampoule has to be brought to room
temperature.
• Before injecting, ensure that there are no air bubbles
remaining in the syringe.
•Disinfect the injection site with an alcohol swab.
• Take a fold of skin between two fingers of one hand and lift this away from the muscle.
•Hold the syringe at a 45° angle, and rapidly insert the
needle into the skin and underlying adipose tissue.
•Retract the plunger of the syringe a little to ensure that you
have not hit a blood vessel (which would be indicated by
blood in the syringe).
• If you have hit a vessel, select an alternative
injection site and use a new needle.
• Inject the contents of the syringe slowly and steadily.
• Once the syringe is empty, hold the alcohol swab at the injection site and remove the needle from the skin.
• Press the swab on the injection site for a few
seconds.
•Replace the needle’s protective cap on the syringe so that
nobody can be injured and discard properly.
26
Reactions
General reactions
After injecting a mistletoe preparation, the body temperature may rise
to approx. 38°C (100.4°F) especially
when mistletoe therapy is first begun;
it generally returns to normal within
24 hours. The reaction signals the
Visible reddening of the skin
stimulation of the body’s own defence
directly following injection
mechanisms.
Local inflammation
There may be slight inflammation
around the injection site, with unsharply delimited redness and possible
itching.
Typical local reaction 4 hours
After
following injection
about 4 hours, the border of the
local reaction will become smoother,
but itching may reappear.
The edge of the local reaction has
become flatter after 10 hours and disappears slowly. The redness, however,
may still extend further.
Typical local reaction 10 hours
following injection
27
Sources and references
•Augustin M et al: Safety and efficacy of the long-term
adjuvant treatment of primary intermediate- to high-risk
malignant melanoma (UICC/AJJC stages II and III) with a
fermented European mistletoe (Viscum album L.) extract.
Arzneim.-Forsch. / Drug Res. 55 (1), 38 – 49 (2005).
•Bock PR et al: Treatment with a fermented mistletoe (Viscum
album L.) extract as part of long-term supportive care in
patients with primary non-metastatic colorectal carcinoma.
Phytomedicine 14 (2), 43 (2007).
•Bock PR et al: Efficacy and safety of long-term complementary treatment with European mistletoe extract (Viscum
album L.) in addition to the conventional adjuvant oncological therapy in patients with primary non-metastatic breast
cancer. Arzneim.-Forsch. / Drug Res. 54 (8), 456 – 466 (2004).
•Bopp A: Die Mistel – Heilpflanze in der Krebstherapie. Rüffer
& Rub Sachbuchverlag, Zürich, 1. Auflage 2006.
•Kienle GS, Kiene H: Die Mistel in der Onkologie. Schattauer
Verlag Stuttgart, 1. Auflage 2003.
•Matthes H et al: Improvement of the palliative supportive
care in pancreatic carcinoma patients with a fermented
mistletoe (Viscum album L.) extract treatment. Phytomedicine
14 (2), 54 (2007).
•Overstolz A: Mistletoe preparations in anthroposophically
extended cancer treatment. Verlag für Ganzheitsmedizin
Basel / Schweiz, 1st edition 2003.
28
Weleda representatives list
For further information
• Argentina
Weleda S.A.
+54 11 4702-1166, [email protected]
• Australia
Weleda Australien Pty Limited
+61 3 9918-0911, [email protected]
• Austria
Weleda Ges.m.b.H&Co.KG
+43 1 256-6060, [email protected]
• Belgium
Weleda N.V.
+32 16 4066-24. [email protected]
• Brazil
Weleda do Brasil
+55 11 3641-4122, [email protected]
• Czech Republic
Weleda spol s.r.o.
+420 257 315-888, [email protected]
• Denmark
A/S Tødin
+45 74 6244-88, [email protected]
• France
Weleda S.A.
+33 389 69-6800, [email protected]
• Georgia
NaturaPharm Ltd.
+995 32 322760, [email protected]
• Germany
Weleda AG
+49 7171 919-414, [email protected]
29
• India
Navneet Homoeo Pharmacy
+91 11 2644-6067, [email protected]
• Israel
Bar Ilan Pharmacy
+972 9 744-3579, [email protected]
• Italy
WELEDA Italia S.r.l.
+39 02 4877-051, [email protected]
• Netherlands
Weleda Nederland NV
+31 79 363-1313, [email protected]
• New Zealand
Weleda New Zealand Ltd.
+64 6 872-8700, [email protected]
• Poland
PZA S.A. Multi Pharme
+48 86 2167481-86, [email protected]
• Spain
Weleda S.A.
+34 91 358-0358, [email protected]
• Sweden
WELEDA AB
+46 8 522-96100, [email protected]
• Switzerland
Weleda AG
+41 61 705-2121, [email protected]
• United Kingdom
Weleda U.K., Ltd.
+44 115 944-8222, [email protected]
• USA
Weleda North America.
+1 800 241-1030, [email protected]
30
For further information about mistletoe therapy or on the use of mistletoe preparations, consult your doctor
or contact your local Weleda (see list
pages 29/30).
Another helpful address is the web
site: www.mistel-therapie.de
In harmony with
nature
Weleda AG, Möhlerstraße 3, 73525 Schwäbisch Gmünd
www.weleda.de