misteltoe as cancer remedy

in anthroposophic medicine, mistletoe is used not as christmas decoration but to heal, treat or alleviate the symptoms of cancer (and thus supposedly assist in a conventional cancer treatment scheme). The Quackometer blog has a new post on mistletoe treatment in the UK, apparently supported by the NHS (that is, through the social welfare system). In Sweden, I am unsure whether these mistletoe therapies are subsidised by state authorities. The anthroposophic hospital, Vidarkliniken, is supported, however.

According to Rudolf Steiner, cancer tumors appear

primarily from the actual enmity of certain processes within the physical body, against the action of the etheric body; these processes rebel as it were, so that the etheric body ceases to act in certain regions of the physical body.

By helping natural forces or processes, the tumor can be “overcome” through the “very great powers of regeneration” of the etheric body once the

counteracting physical processes which oppose the etheric body [has been removed], so that the etheric body may once more extend its working to the region where it had temporarily receded.

According to Steiner, the use of mistletoe as a cancer remedy is due to its manner of parasitic growing on other plants;

an area in the physical body of man which revolts against the whole access of the etheric forces, so that the latter are, as it were, dammed up and stopped and thus what appears to be a “neoplasm” is formed; and the mistletoe counteracts this “pocketing” which has been formed and draws the forces again to the area which they do not want to enter.

Steiner claims that mistletoe therapy will eventually replace conventional cancer treatments, since it

provides, beyond question, a means which — when given in potencies — should enable us to dispense with the surgical removal of tumours.

(All quotes above: Steiner, R. The Invisible Man Within Us. Lecture February 11, 1923.)

The latter optimistic assertion is clearly incorrect; research has shown mistletoe to be utterly useless for curing cancer. Even anthroposophic practitioners usually make more fuzzy claims these days; for example, that mistletoe helps the body’s natural healing processes or that it assists conventional treatment or helps alleviate the side-effects of such conventional treatments. They don’t usually claim to cure the actual cancer. Nevertheless, mistletoe can’t be regarded as anything other than a treatment given to clients for spiritual reasons, not for medical ones. Thus it will be primarily of interest to anthroposophic patients, who buy the whole spiritual-philosophic framework anthroposophy provides. It won’t treat any actual disease, but if you believe in reincarnation, it may have long-term effects that aren’t considered in conventional medical therapies, I suppose.

The Quackometer’s blog post summarizes the current state of evidence on mistletoe therapy. Quoting Edzard Ernst:

Mistletoe has been tested extensively as a treatment for cancer, but the most reliable randomised controlled trials fail to show benefit, and some reports show considerable potential for harm. The costs of regular mistletoe injections are high. I therefore recommend mistletoe as a Christmas decoration and for kissing under but not as an anticancer drug. At the risk of upsetting many proponents of alternative medicine, I also contend that intuition is no substitute for evidence. (Original source.)

Studies have concluded, writes the Quackometer:

The current Cochrane review of the evidence (2010) shows that despite there being many studies of mistletoe therapy, the trials tend to be of poor quality with lack of randomisation, and poor reporting quality.

A review by Ostermann, Raak and Büssing (2009), despite coming to a fairly positive but qualified [conclusion] about mistletoe,  found evidence of significant publication bias by looking at funnel plots. Funnel plots are graphs of the treatment effects found in studies plotted against study size. If researchers are fairly publishing their results it should have a symmetrical shape. If it is skewed, it suggests researchers are withholding less favourable results from publication and, hence, reviews of all studies may conclude that there is a stronger effect than there really is. This is what Osterman saw in the studies of mistletoe.

So: it doesn’t work. But efficacy has never been paramount to anthroposophic therapies. That is, efficacy from a “materialistic” viewpoint. Anthroposophists’ use of mistletoe in treatments is wholly based on spiritual values. It is meaningless to say mistletoe has been shown ineffective — for anthroposophists such a rejection of the spiritual-scientific (“scientific”, nota bene) remedies indicates mainly one thing: the inadequacy of materialistic science. On the other hand, spiritually based interventions shouldn’t be tax-funded. That’s a waste of public money on something belonging to the private sphere of religion and spirituality; the sort of things people can spend their money on if they should fancy doing so. As long as the folks who sell these magic potions don’t commit any fraudulent acts on their costumers or put them in harms way by providing unsafe products, they can perhaps be allowed to peddle their spiritual trickery like any faith-based operation. A complicating factor is that anthroposophic medical practitioners are registered MDs, which lends them credibility and a certain client base which is seeking real medical advice but is also inclined towards quack medicine and woo (that is, to accepting alterantive “treatments” as something positive and natural, thus more beneficial (to the whole human being or to repeated incarnations or whatever happens to be the individuals woo focus) than ordinary cures). Depending on the particular doctor, there could potentially be dangerous situations where a patient abstains from real and effective treatments, relying instead solely on the alternative options made available by some practitioner who in theory provides both alternative and conventional medicine, but for personal and spiritual reasons prefer the former to the latter.