WHAT IS MISTLETOE LECTINS THERAPY OR VAE?

 

 

Lectins are the bioactive plant derivatives of the plant Viscum Album Extract (European Mistletoe), also known as VAE, extensively studied for their potent anti-cancer activity and widely used in Europe as a traditional plant medicine for cancer treatment. European Mistletoe lectins, also known as Iscador, VAE, or Helixor, has been extensively studied in Germany and large studies have proven it increases survival time and reduces the risk of recurrence in cancer patients. [1]

 

Iscador and Helixor are among the many evidence-based cancer supportive treatments offered to patients seeking integrative cancer care at various practices in Canada.

HOW DO MISTLETOE LECTINS WORK AGAINST CANCER?

Mistletoe use in cancer began in the early 1900’s with professor Rudolf Steiner, Ph.D. and founder of the Society for Cancer Research in Arlesheim, Switzerland. At that time, the plant’s mechanism of action in cancer was largely unknown.

In recent years, several studies have determined that the presumed anti-cancer component in mistletoe may, in fact, be the powerful lectins contained in the plant. [1]

The mechanism by which mistletoe lectins may be an important anti-cancer drug, is thought to be in part due to the ability of certain lectins to disrupt the action of enzymes involved in the transport of calcium and magnesium into the cell’s nucleus, thereby reactivating the programmed cell death (apoptosis) mechanism that cancer cells manage to override in order to achieve continuous, sustained growth and division (unlike normal, healthy cells which are programmed to die after a certain number of cell divisions).

Research also demonstrates that mistletoe lectins have the ability to specifically target cancer cells while sparing normal, healthy cells – a significant advantage over most conventional drug therapies – making it a very useful and promising adjunctive treatment in cancer. [2,3]

A thorough review of its safety, tolerability, and effectiveness by a large body of evidence supports its use in oncology – either alone or in conjunction with other therapies. [4]

WHAT IS THE EVIDENCE FOR VISCUM ALBUM EXTRACT / MISTLETOE LECTINS THERAPY?

Most studies have been conducted in Europe, primarily in Germany and Austria. However, in 2002, the National Center for Complementary and Alternative Medicine in cooperation with the National Cancer Institute (NCI) began accruing patients to a phase I trial (NCCAM-02-AT-260) of mistletoe (Helixor A) and gemcitabine in patients with advanced solid tumors. The Helixor A and gemcitabine combination showed minimal toxicity with clinical benefit in 48% of patients.[5]

Most of the recent randomized controlled clinical trials looked at outcomes such as survival, tumor response, tumor recurrence and quality of life. All of the outcomes showed a positive response to mistletoe therapy. A systematic review of all controlled clinical studies of mistletoe found consistent improvement in chemotherapy-associated fatigue as well as other quality-of-life measures.[6]

A nonrandomized, case-control study of long-term mistletoe extract for patients with melanoma, showed a survival advantage among patients with high-risk disease.[7]

A large cohort study on the effectiveness of Iscador as a treatment for people with rectal cancer, colon cancer, breast cancer, stomach cancer, or lung cancer, found that the treatment can produce a clinically significant increase in survival in cancer patients.[8]

The use of Iscador as an adjuvant treatment has been examined in several studies involving many types of cancer, including stage I-III colorectal cancer, bladder cancer, and malignant melanoma. In these studies, Iscador proved safe and effective and also showed a significant survival advantage over untreated controls. [9,10,11,12]

In a three-arm (Helixor, chemotherapy or control) randomized trial of breast cancer patients, survival was equivalent between the group treated with Helixor and the group treated with chemotherapy, but the Helixor group reported better quality of life owing to fewer side effects of therapy. [13]

Another three-arm randomized trial of colorectal cancer patients reviewed the outcome of chemotherapy alone or with chemotherapy and Helixor in combination. The mean survival time of those treated with Helixor and chemotherapy in combination was almost twice that of patients treated with chemotherapy alone. [14]

There are numerous other studies have demonstrated a significant positive effect of Helixor or Iscador in various types of cancers, including breast, lung, lymphomas, ovarian, pancreatic and colorectal. [15, 16,17,18]

A study in 2006 looking at the outcome of long-term Iscador therapy in breast cancer patients in Germany, found the treatment had a clinically relevant effect on breast tumor progression as measured by overall survival as well as by the time to recurrences, lymphatic or distant metastases (spread). The study also found that, in the short term, there were distinct and significant psychological benefits noted in the women who used Iscador therapy in conjunction with their chemotherapy regimen, than with conventional therapy alone. [19]

To summarize, mistletoe lectin therapy has clinically and scientifically demonstrated to have the following health-promoting and anti-cancer actions:

 

• Inhibit metastasis and reduce tumor size

• Induces apoptosis (cancer cell death)

  • Enhances the activity of immune cells (such as T-helper cells and natural killer cells), thereby engaging and supporting the body’s own immune system to target and destroy cancerous cells

  • Improve survival for most types of cancer

• Improved quality of life in patients with cancer tumors including improved mood, sleep, endurance, appetite, chemotherapy tolerability and decreased fatigue and pain

  • Counteracts some side-effects of chemotherapy and radiation

  • Increases survival in some cancers when used in combination with chemotherapy

  • Lowers the risk for cancer recurrence

Iscador is most commonly administered as a subcutaneous injection. Helixor is given either by injection or intravenously.

Mistletoe lectin therapy is best used in combination with other cancer therapies such as IV vitamin C, as well as other therapies that are often given in the form of oral supplementation. Recommendations are always made on an individual, case-by-case basis.

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REFERENCES:

1. Grossarth-Maticek R, Kiene H, Baumgartner SM, et al.: Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomized and randomized matched-pair studies nested within a cohort study. Altern Ther Health Med 7 (3): 57-66, 68-72, 74-6 passim, 2001 May-Jun.  [PUBMED Abstract]

2. Fu LL, Zhou CC, Yao S, Yu JY, et al.: Plant lectins: targeting programmed cell death pathways as antitumor agents. Int J Biochem Cell Biol. 43(10):1442-9, 2011. [PUBMED Abstract]

3. Liu B, Bian HJ, Bao JK: Plant lectins: potential antineoplastic drugs from bench to clinic. Cancer Lett. 287(1):1-12, 2010. [PUBMED Abstract]

4. Horneber MA, Bueschel G, Huber R, et al.: Mistletoe therapy in oncology. Cochrane Database Syst Rev (2): CD003297, 2008.  [PUBMED Abstract]

5. Mansky PJ, Wallerstedt DB, Sannes T, et al.: NCCAM/NCI phase I study of mistletoe extract and gemcitabine in patients with advanced solid tumors. [Abstract] J Clin Oncol 28 (Suppl 15): A-2559, 2010. Abstract

6. Kienle GS, Kiene H: Review article: Influence of Viscum album L (European mistletoe) extracts on quality of life in cancer patients: a systematic review of controlled clinical studies. Integr Cancer Ther 9 (2): 142-57, 2010.  [PUBMED Abstract]

7. Augustin M, Bock PR, Hanisch J, et al.: Safety and efficacy of the long-term adjuvant treatment of primary intermediate- to high-risk malignant melanoma (UICC/AJCC stage II and III) with a standardized fermented European mistletoe (Viscum album L.) extract. Results from a multicenter, comparative, epidemiological cohort study in Germany and Switzerland. Arzneimittelforschung 55 (1): 38-49, 2005.  [PUBMED Abstract]

8. Grossarth-Maticek R, Kiene H, Baumgartner SM, et al.: Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomized and randomized matched-pair studies nested within a cohort study. Altern Ther Health Med 7 (3): 57-66, 68-72, 74-6 passim, 2001 May-Jun.  [PUBMED Abstract]

9. Elsässer-Beile U, Leiber C, Wetterauer U, et al.: Adjuvant intravesical treatment with a standardized mistletoe extract to prevent recurrence of superficial urinary bladder cancer. Anticancer Res 25 (6C): 4733-6, 2005 Nov-Dec.  [PUBMED Abstract]

10. Elsässer-Beile U, Leiber C, Wolf P, et al.: Adjuvant intravesical treatment of superficial bladder cancer with a standardized mistletoe extract. J Urol 174 (1): 76-9, 2005.  [PUBMED Abstract]

11. Bock PR, Friedel WE, Hanisch J, et al.: Retrolective, comparative, epidemiological cohort study with parallel groups design for evaluation of efficacy and safety of drugs with “well-established use”. Forsch Komplementarmed Klass Naturheilkd 11 (Suppl 1): 23-9, 2004.  [PUBMED Abstract]

12. Bock PR, Friedel WE, Hanisch J, et al.: [Efficacy and safety of long-term complementary treatment with standardized European mistletoe extract (Viscum album L.) in addition to the conventional adjuvant oncologic therapy in patients with primary non-metastasized mammary carcinoma. Results of a multi-center, comparative, epidemiological cohort study in Germany and Switzerland] Arzneimittelforschung 54 (8): 456-66, 2004.  [PUBMED Abstract]

13. Gutsch J, Berger H, Scholz G, et al.: [Prospective study in radically operated breast cancer with polychemotherapy, Helixor® and untreated controls]. Dtsch Z Onkol 21: 94-101, 1988.

14. Douwes FR, Wolfrum DI, Migeod F: [Results of a prospective randomized study: chemotherapy versus chemotherapy plus “biological response modifier” in metastasizing colorectal carcinoma]. Dtsch Z Onkol 18 (6): 155-64, 1986.

15. Piao BK, Wang YX, Xie GR, et al.: Impact of complementary mistletoe extract treatment on quality of life in breast, ovarian and non-small cell lung cancer patients. A prospective randomized controlled clinical trial. Anticancer Res 24 (1): 303-9, 2004 Jan-Feb.  [PUBMED Abstract]

16. Auerbach L, Dostal V, Václavik-Fleck I, et al.: Signifikant höherer anteil aktivierter NK-Zellen durch additive misteltherapie bei chemotherapierten mamma-Ca-patientinnen in einer prospektiven randomisierten doppelblinden studie. In: Scheer R, Bauer R, Becker H, et al.: Fortschritte in der Misteltherapie. Aktueller Stand der Forschung und klinischen Anwendung. Essen, Germany: KCV-Verlag, 2005, pp 543-54.

17. Matthes HF, Schad F, Buchwald D, et al.: Endoscopic ultrasound-guided fine-needle Injection of Viscum album L. (mistletoe; Helixor M) in the therapy of primary inoperable pancreas cancer: a pilot study. [Abstract] Gastroenterology 128 (Suppl 2): A-T988, A433-A434, 2005.

18. Beuth J, Schneider B, Schierholz JM: Impact of complementary treatment of breast cancer patients with standardized mistletoe extract during aftercare: a controlled multicenter comparative epidemiological cohort study. Anticancer Res 28 (1B): 523-7, 2008 Jan-Feb.  [PUBMED Abstract]

19. Grossarth-Maticek R, Ziegler R: Prospective controlled cohort studies on long-term therapy of breast cancer patients with a mistletoe preparation (Iscador). Forsch Komplementmed 13 (5): 285-92, 2006.  [PUBMED Abstract]