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MISTLETOE
Naturopathic healers have used European mistletoe to shrink tumors and treat cancer for years. Now, researchers at Johns Hopkins are putting this plant to the test.

Mistletoe, long a symbol of holiday cheer, might have a secret superpower: fighting cancer.

Cutting-edge technology has become synonymous with cancer treatment. Think chemical pills and injections, high-tech radiation, and machinery that test the limits of scientific invention. But for those seeking a more holistic approach, medicinal mistletoe may take contemporary oncology back to its roots.

Mistletoe first grew in popularity as a cancer treatment in Europe during the 1920s. In more recent history, naturopathic healers and their patients claim mistletoe injections shrink tumors, boost the immune system, and treat cancer symptoms like pain and exhaustion. Now, researchers at Johns Hopkins Kimmel Cancer Center are putting these claims to the test in the first rigorous clinical trial studying mistletoe and cancer.

Mistletoe was popular among ancient healers throughout Greece, Rome, and northern Europe to treat ailments like headaches and seizure disorders. Symbolically, mistletoe represented fertility, virility, and the renewal of life—a fitting association, given the evergreen plant’s ability to thrive even in icy winter temperatures.

In the United States, European mistletoe is most commonly used by naturopathic healers to treat cancer. Naturopaths—heavily influenced by traditional folk medicine—utilize natural, plant-based remedies to treat and heal ailments. Patients often turn to naturopaths when looking for complementary or alternative treatment methods, especially when trying to avoid the adverse side effects of chemotherapy or radiation.

Mistletoe is perhaps the gentlest option for cancer patients. Most do not experience any severe side effects commonly associated with chemotherapy and radiation, like hair loss, nausea, and weakness. When used in conjunction with conventional treatments, mistletoe can boost the efficacy of things like chemotherapy while keeping patients feeling healthy.

For patients facing a difficult diagnosis, mistletoe offers something chemotherapy cannot: a treatment option that makes them feel better, rather than sicker.

“The side effects are quite minimal,” says Dr. Channing Paller, assistant professor of oncology at Johns Hopkins and a lead researcher on the organization’s clinical trial. “Even immunotherapy isn’t perfectly harmless. It can cause rashes, diarrhea, or autoimmune phenomenon for about one-third of patients.”

For patients facing a difficult diagnosis, mistletoe offers something chemotherapy cannot: a treatment option that makes them feel better, rather than sicker.

“With chemotherapy, I felt like I’d be burning down the whole forest for one rotten tree,” says Ivelisse Page, a colon cancer survivor and founder of Believe Big, a nonprofit organization bridging the gap between conventional and complementary medicine. “It would’ve done more harm than good.”

A week after being diagnosed with stage IV colon cancer, Page underwent surgery to remove 15 inches of her colon and 28 lymph nodes. Facing an 8 percent survival rate, Page chose to pursue mistletoe treatments rather than chemotherapy, which can damage healthy cells in addition to cancerous ones. In her case, chemotherapy would only increase her survival chances by 10 percent. Her biggest concern was being able to spend valuable time with her husband and four children. “If I only had six months, I wasn’t going to spend them sick and in bed. I could either live in fear, or I could live by faith and fight,” Page says.

A week into immunotherapy and five weeks post-surgery, Page’s doctor discovered the cancer had spread to her liver and that additional surgery was required. Doctors removed 20 percent of Page’s liver, and she continued receiving mistletoe injections and taking supplements for her health. Five weeks after surgery, Page’s doctor delivered the shocking news: there was no visible cancer in her body. As of December 2018, Page is celebrating ten years cancer-free. Page still receives small, monthly maintenance doses of mistletoe, which she says cost her less than $200 and give her more energy than she would have without it. She is not receiving any conventional treatments. These days, Page says she feels healthy and strong and credits mistletoe injections for her victory and vitality.

Inspired by her seemingly miraculous recovery, Page founded Believe Big in 2011 with a twofold mission: to provide faith-based community and support for those dealing with a cancer diagnosis, and to advocate for mistletoe therapy. She knows her success story is not alone among mistletoe users, many of whom claim higher energy levels and reduced side effects from chemotherapy. However, these results were largely anecdotal or case reports rather than the official data needed for FDA approval.

“There have been trials that looked at mistletoe as an anti-cancer treatment, and there have been trials that looked at improving quality of life. Many trials show benefit in both survival and quality of life, but those trials were not at the FDA gold standard with placebo controls,” Paller says.

Mistletoe’s low-risk, high-reward reputation piqued Paller’s interest. Because patients—including Page—reported tumor shrinkage, higher energy levels, and significantly reduced pain, Paller knew there was more to be done.

“I was seeing and hearing about impressive results from my patients seeing naturopathic providers. I wanted to start to dissect what component of that [success] was the mistletoe and what component was other variables,” she says.

The clinical trial, the first of its kind in the United States, began in March 2017 and included 12 patients. In 2013, Believe Big launched a fundraising campaign which raised the $500,000 needed to fund the clinical trial. Through community efforts, the organization is fully funding the clinical trial, something Page credits to patients “paying it forward.” At Johns Hopkins, researchers are looking for results in tumor shrinkage, toxicity levels, and changes in quality of life to document official results rigorously, Paller says. The study is open to patients with stage IV metastatic solid tumor cancer who have previously been treated with at least one FDA-approved therapy, such as chemotherapy, immunotherapy, or hormonal therapy.

Rigorously studying natural products is not new; it's us going back to our roots of oncology drug development.

Mistletoe can be administered via IV or subcutaneous injection. Injections are typically more popular with naturopaths because this method uses lower doses and functions somewhat like a vaccine, Paller says. By contrast, IV delivery uses higher doses and typically has more  impressive results when it comes to tumor shrinkage and inducing cell death in cancer cells. Mistletoe is useful because it contains two essential proteins: viscotoxins, which boost the immune system and kill cells, and lectins, which can bind to cancer cells, causing biochemical changes.

For those who consider this study a departure from conventional medicine, Paller says a history lesson is due. “A little-known fact is that one of our first chemotherapy methods, Taxol, actually came from the yew tree. It started as a natural product. So rigorously studying natural products is not new; it’s us going back to our roots of oncology drug development,” she says.

This shift to naturally derived methods holds potential for widespread appeal. By bridging the gap between synthesized conventional medicine and more natural, holistic practices, researchers hope to give patients more opportunities to find treatments that are a good fit.

“Your quality of life is so important, and realizing that it removes the pain and helps a person have the energy they need is crucial. Mistletoe feels so empowering because it feels like you’re healing yourself,” Page says.

For now, the Johns Hopkins study remains active. According to Paller, it will likely take up to two more years to complete phase one, as FDA requirements mandate a 30-day period between each patient. In the meantime, organizations like Believe Big continue to advocate for mistletoe use as complementary medicine, keeping hope alive for cancer patients.

“Mistletoe improved my energy, outlook, and strength,” says Page. “It does so much more than kill cancer cells.”

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