Iscador, helixor, and eurixor (Viscum album)
The primary use of mistletoe is as a palliative cancer therapy. Iscador is a fermented aqueous extract of Viscum album that is marketed as IscadorM (from apple trees), IscadorP (from pine trees), IscadorQ (from oak trees), and IscadorU (from elm trees). Helixor is an unfermented aqueous extract of V. album L. that is standardized through its biological effects on human leukemia cells in vitro; it is marketed as HelixorA (from spruce trees), HelixorM (from apple trees), and HelixorP (from pine trees). Eurixor is an unfermented aqueous extract of V. album L. that is harvested from poplar trees (V. album). These extracts are administered parenterally and may cause inflammation at injection sites. The antineoplastic activity of V. album, Helixor, and Iscador is documented in vitro and in vivo, and mistletoe preparations have proved effective in fighting solid tumors in eight of ten animal studies (seven in mice, three in rats); in two studies, they significantly inhibited metastasis and reduced tumor volume. In two negative studies, ML did not inhibit chemically induced bladder cancer.
Iscador is an injectable extract of mistletoe (SC 0.045 mg/kg equivalent to lectin concentration of 3.5ng/kg). Although Iscador is regarded as a complementary cancer therapy, it is the most commonly used oncologic drug in Germany. A prospective, nonrandomized and randomized, matched-pair study nested within a cohort study was conducted in Germany. A total of 10,226 human patients with cancer were involved in a prospective, long-term, epidemiologic cohort study that included 1668 patients treated with Iscador and 8475 who had taken neither Iscador nor any other mistletoe product (control patients). In the nonrandomized, matched-pair study, the survival times of patients treated with Iscador were longer for all types of cancer studied. In the pool of 396 matched pairs, mean survival times in the Iscador groups (4.23 years) were roughly 40% longer than in control groups. Iscador treatment can achieve a clinically relevant prolongation of survival time for patients with cancer and appears to stimulate self-regulation.
Helixor has been in use since 1968. A number of components with different possible effects have been isolated, including lectins, viscotoxins, and alkaloids. Contraindications include pregnancy, hyperthyroidism, and intolerance. Depending on the type and stage of the tumor, treatment in humans is based on a specific schedule that can be lifelong. Local inflammatory reactions may occur. Fever is desirable.
A multicentric, randomized, open, prospective clinical trial was conducted in China. A total of 224 patients with breast, ovarian, and non-small cell lung cancer fulfilled the requirements for final analysis (n = 115 treated with Helixor A; n = 109 control group treated with Lentinan). All patients were provided with standard tumor destructive treatment schedules and were treated with standardized mistletoe extract or Lentinan during chemotherapy. The study showed that complementary treatment with Helixor can reduce the adverse effects of chemotherapy in patients with cancer, thereby improving quality of life.
An off-label veterinary protocol has been proposed by Dr. Chris Piper (New Zealand), who prefers to use HelixorP because it produces fever and local swelling at a level somewhere between the stronger HelixorM and the weaker HelixorA. Clinical effects include pyrexia, leukocytosis, and inhibition of tumor growth. It can be combined with chemotherapy with anecdotal evidence of enhanced well-being, reduced adverse effects of chemotherapy and increased survival times.
The cancer treatment first popularized by Harry M. Hoxsey (1901-1974) is controversial, popular, and one of the longest-lived unconventional herbal therapies for cancer. Depending on the type and stage of cancer, and the individual patient’s condition, Hoxsey would add to a basic solution of cascara (Rhamnus purshiana) and potassium iodide one or more of the following plant substances: poke root (Phytolacca americana), burdock root (Arctium lappa), barberry or berberis root (Berberis vulgaris), buckthorn bark (Rhamnus frangula), Stillingia root (Stillingia sylvatica), or prickly ash bark (Zanthoxylum americanum).
Studies on individual herbs leave no doubt that Hoxsey’s formula contains many plant constituents with potential therapeutic activity. Research has identified antitumor activity of one sort or another in all but three of Hoxsey’s plants, and two of these three are purgatives; one of them (Rhamnus purshiana) contains the anthraquinone glycoside structure now recognized as predictive of antitumor properties. Whether Hoxsey’s particular formula has therapeutic merit is still unsubstantiated by clinical data, despite provocative findings of antitumor properties in many of the individual herbs that he used. However, anecdotal evidence from veterinarians who have used various versions of the formula indicates that it improves quality of life and may inhibit growth of tumors in animals. It is difficult to evaluate the benefits of the traditional approach of detoxification through laxative effects, liver support, improved nutrition, and so forth, all of which may strengthen the immune system and favorably affect the cancer status of a human patient; Hoxsey proposed that this was how the formula worked.
A prospective study with no controls evaluated survival for 39 patients with a variety of histologically verified cancers treated at a Mexican clinic. Cancer types for six long-term survivors were lung, melanoma, recurrent bladder cancer and one labial vulva cancer. Twenty three patients were lost to follow-up, and 10 died after an average of 15.4 months. Six remained disease-free with an average follow-up of 48 months. A retrospective cohort study followed new cancer patients (n = 149) registered at the same clinic during the first quarter of 1992. At the end of 5 years, 17 (11.4%) were alive, 68 (45.6%) deceased and the status of 64 (43%) unknown. The large proportion lost to follow-up (45.6%) made comparison of the survival of this cohort to the survival of other cohorts of cancer patients reported in the literature impossible.
Various versions of Hoxsey-like formulas are available commercially. The original formula contained an herb identified as Cascara amarga (Honduran bark), which is apparently not available in commerce. Most companies substitute Cascara sagrada or another alterative in its place.
A Hoxsey-like formula for constitutional cleansing and cancer support is made up of the following:
|Licorice root (Glycyrrhiza glabra)||6oz|
|Red clover (Trifolium pratense)||6oz|
|Burdock root (Arctium lappa)||3oz|
|Queen’s root (Stillingia sylvatica)||2oz|
|Oregon grape root (Berberis aquifolium)||3oz|
|Poke root (Phytolacca decandra) (toxic)||2oz|
|Cascara sagrada bark (Rhamnus purshiana)||2oz|
|Buckthorn bark (Rhamnus frangula) (toxic)||2oz|
|Prickly ash bark (Zanthoxylum americanum)||1oz|
|Baptisia (Baptisia tinctoria)||2oz|
Human dose: From 30 drops 2x per day to 1 tsp 3x per day
Caution on Phytolacca: This herb, used alone, can raise the white blood cell count, mimicking leukemia. Another recipe (source unknown), per 5mL:
|Potassium iodide||150 mg|
|Licorice (Glycyrrhiza glabra)||20 mg|
|Red clover (Trifolium pratense)||20 mg|
|Burdock root (Arctium lappa)||10 mg|
|Stillingia root (Stillingia sylvatica)||10 mg|
|Barberry (Berberis vulgaris)||10 mg|
|Cascara (Cascara sagrada)||5 mg|
|Prickly ash bark (Zanthoxylum americanum)||5 mg|
|Buckthorn bark (Rhamnus catharticus)||20 mg|
|Pokeroot (Phytolacca americana)||10 mg|
Note (BF): We do not include potassium iodide in our practice formula.
Another controversial “unproven” herbal remedy is Essiac. Various formulas have been prepared on the basis of four herbs:
- Burdock root (Arctium lappa)
- Sheep sorrel (Rumex acetosa)
- Turkey rhubarb (Rheum palmatum)
- Slippery elm (Ulmus fulva)
Many commercial products consist of varying proportions of these herbs. The powdered formula is decocted over minutes to hours, depending on the supplier.
As with the Hoxsey formula, no controlled trials have substantiated the efficacy of Essiac; however, studies on the herb constituents support antineoplastic activity. In the early 1980s, the Canadian Bureau of Human Prescription Drugs conducted a retrospective review physician summaries about Caisse’s patients. Eighty six patient histories were submitted. All had previously received conventional therapy. Of the 86 patients, 1 showed subjective improvement, 5 required fewer analgesics, and 3 remained stable (Office of Technology Assessment). In a survey of North American consumers of one brand of essiac, 50.6% of respondents reported improvement in their symptoms. 6.6 percent reported adverse events of nausea, vomiting and diarrhea, but 11.8% had exceeded the daily recommended dose.
Antitumor activity has been demonstrated in vivo with burdock, with various fractions inhibiting induced sarcoma by as much as 61% in mice. Burdock seed contains a number of ligands, including arctigenin, which has been shown to induce differentiation in mouse myeloid leukemia cells. Arctigenin has also demonstrated potent cytoxic effects against a human leukemia cell line, while showing no toxicity toward normal lymphocytes. Sheep sorrel contains emodin, which has antitumor activity; its polysaccharides have displayed antitumor activity in mice implanted with sarcoma. Some constituents of rhubarb (aloe, emodin, catechin, and rhein) have shown antitumor activity. Rhein has antitumor activity in vivo, increasing survival time in leukemia-bearing mice in one study, and inhibiting melanoma in mice by 76% in another.
Other traditional cancer formulas include Scudder’s alterative (equal parts of corydalis tubers [Corydalis yanhusuo], black tag alder [Alnus serrulata], figwort [Scrophularia nodosa], and yellow dock [Rumex crispus]) and Compound Syrup of Scrophulara (figwort leaves and roots, Phytolacca root, Rumex crispus root, Celastrus scandens bark and root, Corydalis formosa root, Podophyllum root, juniper berries, prickly ash berries, and guaiacum wood). The recipes for these formulas are found in Eli Jones’ classic, Cancer: Its Causes, Symptoms and Treatment, first published in 1911 and recently reprinted.