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Frequently asked questions about mistletoe therapy

General questions
How important is mistletoe therapy in the concept of integrative oncology?

Mistletoe therapy is an essential component of a holistic, i.e. integrative cancer therapy and is intended as an addition to conventional therapy. Surgery, chemo-, radio- and/or (anti-)hormone therapies are established standard methods for the treatment of cancer, which can be supplemented by complementary measures such as mistletoe therapy. The aim of mistletoe therapy is primarily to improve the patient's quality of life.

Since when have mistletoe preparations been available?

Mistletoe preparations have been used in cancer therapy for 100 years now. Today, they are one of the most prescribed complementary drugs in cancer medicine. More than half of all tumour patients in the German-speaking countries use mistletoe therapy.

Is mistletoe therapy scientifically proven?

To date, about 140 clinical studies on the use of anthroposophic mistletoe preparations in various types of tumours are available. Mistletoe preparations are therefore the best and most extensively investigated drugs in complementary cancer therapy. As a result, almost all studies show an advantage for mistletoe therapy. The alleviation of the side effects of conventional therapies such as chemo- and radiotherapy and an improvement in the quality of life are well documented. In some cases, the occurrence of metastases can also be delayed and an increase in survival time can be observed.

What active substances does mistletoe contain?

The mistletoe contains a large number of active substances. For some, such as mistletoe lectins or viscotoxins, the effect in cancer therapy is well documented. However, according to today's knowledge, the actual effect only develops in the form of a total extract of mistletoe plant, as the effects in a total extract are mutually reinforcing.

What are the effects of mistletoe therapy?

Mistletoe therapy leads to an improvement of the general condition. This manifests itself, for example, in an appetite and weight gain, normalization of sleep, improvement of the feeling of warmth and performance as well as mental well-being. The mood is rising again, you have more courage and the ability to take initiative increases. In addition, the tumour-related pain can be reduced. Thereby, therapy with mistletoe extracts leads to an improved quality of life for tumour patients. Recent study results also indicate an increase in survival time under mistletoe therapy. In cell experiments, mistletoe preparations also inhibit the growth of malignant cells without affecting healthy tissue and can reduce the risk of relapse. The body's own immune defence system is also strengthened, thus reducing the susceptibility to infections.

How does mistletoe therapy affect surgery or chemo-/radiotherapy?

Since mistletoe therapy has an immunomodulatory effect, it can be assumed that by administering mistletoe 14 days prior to surgery, the procedure is better tolerated than usual, because activation of the immune system in the preoperative treatment leads to a good and faster recovery. After surgery, mistletoe therapy inhibits the development of metastases and prevents relapses.

Mistletoe therapy can be used in addition to chemo-/radiation therapy, as it reduces the side effects and these therapies are therefore better tolerated.

Why are mistletoe preparations from different host trees used?

Mistletoe differs in its ingredients according to the host tree on which it has grown. In this way, mistletoe extracts from different host trees are used in cancer therapy to achieve the best effect with the best possible tolerability, depending on the type of tumour.

Are there differences between the individual mistletoe preparations?

Yes, they differ in the pharmaceutical processes used by the individual manufacturers and therefore in composition. This means that mistletoe preparations from different manufacturers are not directly comparable with each other. If you want to change to another mistletoe preparation, you must proceed in the same way as for a new setting.

Application
How are mistletoe preparations administered?

Mistletoe preparations are injected under the skin (subcutaneous) because when applied in the form of drops, the protein compounds contained in the extract can be digested via the gastrointestinal tract. The injection is similar to the injection of insulin. It can be carried out by the patient according to the doctor's instructions.

Which needle/cannula and which syringe is suitable for injection?

A cannula of 0.4 x 19 mm and a 2ml syringe have proven their worth. However, it is also possible to ask the therapist which cannula was used.

Is there an ideal time to start therapy?

Depending on the objective, mistletoe preparations can be administered at different times in a treatment concept and at different stages of the disease. In principle, however, the earlier you start, the better the effect. Thus, one starts as soon as possible after the diagnosis.

What injection frequency/intervals are recommended?

As a rule, mistletoe preparations are injected two to three times a week. An individual adjustment is made by the doctor. Especially in the first years of treatment, however, an injection rhythm of three times a week has proven its worth (e.g. Monday, Wednesday, Friday).

What are the characteristics of an effective dosage?

A reddening of the skin (also with hardening, itching, swelling or overheating) can occur up to a maximum of 5 cm in diameter around the injection site, or an increase in temperature to up to 38°C. Furthermore, an improvement in the general condition can be observed, which is accompanied by an increase in appetite and weight, a normalisation of sleep, a feeling of warmth and an enhanced performance, a lower susceptibility to infections, a brightening of the mood and an increase in courage to face life, in self-regulation and in the ability to take initiative. It is to be expected that the local reactions will weaken or disappear in the course of mistletoe therapy.

How long is a mistletoe preparation injected for?

Mistletoe therapy is continued as long as the tumour disease persists. In addition, it has also proved its worth to continue the therapy depending on the risk of relapse. In most cases, this means a continuation of the therapy for about five years from the time of diagnosis or after surgery or for a longer period of time (e.g. breast or colon carcinoma).

Side effects
Are there side effects, and if so, which ones?

Side effects are not excluded. Under mistletoe therapy, however, rarely any significant adverse effects have been observed under intended use. If the dosage is too high, so-called excessive local reactions with a diameter of more than 5 cm may occur. In this case, treatment should only be continued after symptoms have subsided and in a reduced dose (next lower dose). The same applies to strong general reactions such as an increase in body temperature to over 38°C. A medical examination by the doctor is recommended.

How can local reactions be distinguished from side effects?

A slight reddening and itching at the injection site as well as a certain increase in body temperature are expected reactions. Local inflammatory reactions at the subcutaneous injection site up to a maximum diameter of 5 cm and an increase in temperature up to 38°C are considered "normal".

However, if the reactions exceed these values or the patient does not tolerate them, this is considered a side effect and a dose reduction after the symptoms have subsided is appropriate.

Are there any interactions with other therapies or drugs?

So far, no clear interactions are known. Mistletoe therapy can also be performed during chemo-, radiotherapy or (anti-)hormone therapy. In laboratory experiments on tumour cells and in practice, no negative influence by mistletoe preparations could be found in the usual chemo- and (anti)hormone therapeutics, and no impairment of the efficacy of chemotherapeutics has been known to date in clinical applications.

Storage
How should mistletoe preparations be stored?

Since herbal medicinal products can react sensitively to temperature fluctuations, they must be stored in the refrigerator at 2°C to 8°C. For transport (from the pharmacy to home or during the holiday) it is possible to deviate from these temperature specifications at short notice if the total duration of the transport is less than 8 days. The temperature must not be below 2°C or above 30°C.

What happens if the mistletoe preparation has been stored outside the refrigerator for too long?

The quality of the active substance up to its expiry date cannot be guaranteed.

Can mistletoe preparations be used beyond the expiry date?

No, mistletoe preparations can only be used up to the expiry date. After that, the quality of the active substance can no longer be guaranteed.

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