The Growing Trend of Mistletoe Therapy as an Integral Part of Individualized Integrative Cancer Care: New mistletoe options and the emerging role of Helleborus niger

by Steven M Johnson, DO

The global occurrence of cancer is still increasing and is the leading cause of death in Western countries. For two decades now about half of all cancer patients in North America and Europe have used some form of integrative cancer care (ICC).  Viscum album (mistletoe) remains the most studied and prescribed medicine within integrative medicine in the Western World.  Mistletoe was first introduced in the 1920s by Dr. Rudolf Steiner, has been and further researched within anthroposophic clinics across Europe. Later studies expanded into mainstream medicine, including a current study at John Hopkins School of Medicine in Baltimore, MD.

With the founding of the Society of Integrative Oncology in 2003, the ICC concept was established on a national level within mainstream medicine. The society was created by leading researchers from some of the top cancer treatment centers in North America. These include the Dana Farber Cancer Center in Boston, MA; MD Anderson Cancer Center in Texas; and Sloan Kettering Cancer Centers in New York. Since the umbrella term (ICC) refers to the integration of conventional and complementary therapies and emphasis on the self-healing capacities with an individualized holistic philosophy, a great deal of research in this area is flowing into the professional and public domain. There are more than 7,000 published scientific studies on these topics. Thus, therapeutic elements such as complementary/naturopathic medicines, viscum album (mistletoe), nutrition, sleep, stress, relationships, work, creativity, and faith are all being evaluated as part of the ICC model. This is leading to more public acceptance of ICC. Yet, while many complimentary therapies are recognized as playing a positive role in cancer treatment, not one treatment is universally recognized or FDA-approved for cancer treatment, including mistletoe therapy.  Fortunately, thousands of patients and a growing community of clinicians are making a case for this lack of inclusion to finally change.

Anthroposophic Medicine (AM) was the first integrative and collaborative model to provide integrative cancer care in the Western world, and it is now practiced in more than 80 countries. It is one of the few models practiced in specialized cancer centers and hospitals as well as outpatient clinics and practices in the world today. In North America there has been a large growth in anthroposophic medicine-based ICC in large part due to the increased incidence of positive mistletoe research publications (now more than 100 studies (see These studies have established mistletoe as safe, and demonstrate many quality-of-life improvements, as well as improvements in life expectancy for several types of cancer. Patients are also sharing many positive experiences with mistletoe. A well-known example of patient advocacy is Ivelisse Paige, who founded the successful non-profit organization Believe Big ( This website grew out of her personal healing journey with mistletoe and ICC.

In the U.S., mistletoe therapy is provided mainly by AM-trained clinicians and naturopaths. Recently, the naturopathic physicians have formed an oncology sub-specialty organization called the Oncology Association of Naturopathic Physicians (OncANP), which includes their own ICC model. Expert anthroposophical doctors and naturopaths are now teaming up to form standards of training and treatment in the use of mistletoe in multi-disciplinary ICC models. The first “Best Practices” course will be in Baltimore, June 2019 ( This will also include oncology physicians from Europe.

There are a few new developments in mistletoe therapy worth mentioning.  European studies and clinical case studies show that Helixor mistletoe preparations can be injected and infused at much higher doses than had been thought possible earlier. With the current availability of several types of mistletoe, it is also increasingly common to use fermented and non-fermented products in varying rhythms to improve therapeutic reactions and possibly decrease long-term tumor sensitivity to mistletoe. There is also more experience now with rapid induction protocols versus slower dosing protocols. This means a rapid high dose is given earlier in the treatment protocol. A well-trained clinician can determine the best options for individual patient situations.  Also, research is further delineating which types of mistletoe might be more appropriate for specific solid tumor types, as well as lymphomas and leukemias. Further, there is growing clinical experience with combining mistletoe with other adjuvant ICC medical treatments to improve outcomes. Vitamin C infusions, Helleborus niger therapy, and hyperthermia are a few common examples out of many others.  

Helleborus niger is an anthroposophic medical therapy that may potentially  improve mistletoe symptom outcomes in advanced disease situations such as lymphoma and leukemia, to name a few. Paracelsus and ancient Greek physicians used Helleborus niger to prolong life and stimulate thinking. Rudolf Steiner suggested that it has similar properties to mistletoe. Dr. Samuel Hahnemann, creator of homeopathy, and subsequent homeopaths have used it for edema, and brain and kidney diseases, as well as developmental disorders of early childhood. Studies also show that suppression of pro-inflammatory cytokines supports the well-known anti-inflammatory and anti-rheumatic effects of Helleborus, which is now an increasing anthroposophic indication for therapy. In the chart below some of the studied active constituents are summarized. It is available from Helixor through Uriel pharmacy(

Clinical research is lagging in all these areas of therapies, including for other remedies combined with Helleborus niger. It is important that case studies are shared in the clinical community so larger research trials can be organized. The Physicians’ Association for Anthroposophic Medicine (PAAM) is reaching out to facilitate cooperation among MDs, DOs, NDs, and NPs to further improve our levels of expertise, experience, and standards of care for our patients. In many ways it is an exciting opportunity to extend our professional community and learn from each other.  

It is important to mention that in many of the best-reported cancer treatment outcomes in clinics and practices across the world,   anthroposophic remedies provided by Uriel, Weleda, True Botanica, and others play an important role in achieving these therapeutic results; and these need to be considered in a comprehensive therapeutic approach. To support further anthroposophic pharmacy research and education, consider joining the following non-profit organizations:

Anthroposophia Foundation:

Kolisko Institute:

PAAM Friends:

As mistletoe and Helleborus therapy evolved out of AM, practitioners trained in AM can often offer a unique perspective to these therapies.

An anthroposophic clinician can be an MD, DO, ND, NP, or PA.  Their extended training includes a very specific picture of the healthy human being as a balanced integration of spirit, soul, and body. They spend many additional years studying plants, minerals, embryology, physiology, the developmental impact of the differing phases of life, and further, training their faculties of creative and intuitive diagnosis and treatment. This allows the anthroposophic clinician to treat a patient as an individual connecting them with remedies unique to their illness and biographical context.

 It is often difficult to reconcile the constraints of professional standards of care with intuitive knowledge and individualized medicine. It is sometimes important that patients give their AM doctor (and other holistic clinicians as well) permission to heal out of their deepest intuitive healing capacities. Their inner training, experience with the being of illness, and deep study of nature allow the AM clinician access to a broad range of uniquely individual therapies that is hard to find anywhere else. Patients should feel encouraged to challenge their AM physician’s emerging intuitive gifts that can only develop because of these many years of inner discipline, training, and experience with illness.

AM is a path of striving to heal out of the deepest depths of the universe and humanity while respecting that ultimately science and spirit need to lead to a common reality. Integrative cancer care can become extremely profound and effective in this light. The healing relationship between physician and patient is a sacred one. It is only in our mutual recognition of each other that the universal powers of healing can be willed into existence. 


Dr. Stephen Johnson is president of the Physicians’ Association for Anthroposophic Medicine (PAAM). He is currently in practice with Kathleen Lazare-Derosa, DO, and Cathy Sims-O’Neil, DO, at Collaborative Medical Arts in Chatham, NY. Visit  or call 518-721-8417. Their practice specializes in cancer support, neurological/musculoskeletal disorders, regenerative joint therapies, pediatrics, and early childhood development.  


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