Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep 29;17(19):3169.
doi: 10.3390/cancers17193169.

The Mistletoe and Breast Cancer (MAB) Study: A UK Mixed-Phase, Pilot, Placebo-Controlled, Double-Blind, Randomised Controlled Trial

Lorna J Duncan  1 , Susan Bryant  1 , Gene Feder  1 , Maria Gresham  2 , Poppy Gibson  2 , Debbie Sharp  1 , Jeremy P Braybrooke  2   3 , Alyson L Huntley  1
Affiliations

The Mistletoe and Breast Cancer (MAB) Study: A UK Mixed-Phase, Pilot, Placebo-Controlled, Double-Blind, Randomised Controlled Trial

Lorna J Duncan et al. Cancers (Basel). .

Abstract

Background/objective: To test the feasibility of a mixed-phase, pilot, placebo-controlled, double-blind trial of mistletoe therapy (MT) with an embedded qualitative study in the UK National Health Service (NHS) setting.

Methods: The aim was to recruit 45 patients via an NHS oncology centre with a diagnosis of early or locally advanced breast cancer. Participants were allocated to Iscador® Malus, Iscador® Pinus, or physiological saline (placebo). Diaries and quality-of-life questionnaires were administered. Qualitative interviews were conducted with participants, oncologists, and nurses. Feasibility was assessed by recruitment, retention, adherence, blinding, and safety.

Results: Sixty-seven patients were approached between August 2019 and March 2020, 15 gave consent, 14 participants were randomised, and 2 withdrew during the trial. Ten participants and five staff were interviewed. Barriers to recruitment were the additional treatments/time, extra injections, and the possibility of placebo allocation. Adherence was very good whilst the participants were on the study therapy. Diaries and interviews indicated that 11/14 participants struggled with injections and skin reactions. There were 22 adverse events due to the MT, related to the injections or skin reactions.

Conclusion: This pilot study examined the feasibility of conducting a randomised placebo-controlled, double-blind trial of mistletoe therapy for breast cancer patients within the UK NHS. The results describe the challenges and achievements of recruitment, retention, adherence, blinding, and safety in this context.

Keywords: Viscum album; breast cancer; feasibility; mistletoe; pilot randomised controlled trial; quality of life.

PubMed Disclaimer

Conflict of interest statement

Both S.B. and L.J.D. received salary funding from the Verein für Krebsforschung (Society for Cancer Research), Arlesheim, Switzerland, and the Camphill Wellbeing Trust. A.L.H. received salary funding from the Camphill Wellbeing Trust. The authors declare no further conflicts of interest.

Figures

Figure 1
Figure 1
Screening and recruiting for the MAB study.
Figure 2
Figure 2
Consort diagram.
See this image and copyright information in PMC

References

    1. Mistletoe Therapy: Information for Doctors. [(accessed on 1 June 2025)]. Available online: https://www.mistletoe-therapy.org/information-for-doctors.
    1. EMA Report on Mistletoe Therapy. [(accessed on 1 June 2025)]. Available online: https://www.ema.europa.eu/en/documents/herbal-report/final-assessment-re....
    1. FDA Report on Mistletoe Therapy. [(accessed on 1 June 2025)]; Available online: https://www.cancer.gov/about-cancer/treatment/cam/patient/mistletoe-pdq.
    1. Schnell-Inderst P., Steigenberger C., Mertz M., Otto I., Flatscher-Thöni M., Siebert U. Additional treatment with mistletoe extracts for patients with breast cancer compared to conventional cancer therapy Alone—Efficacy and safety, costs and cost-effectiveness, patients and social aspects, and ethical assessment. Ger. Med. Sci. 2022;20:Doc10. doi: 10.3205/000312. - DOI - PMC - PubMed
    1. Mistletoe Centres in the UK. [(accessed on 1 June 2025)]. Available online: https://www.mistletoetherapy.org.uk/centres/

LinkOut - more resources