New research shows that palliative patients with pancreatic cancer neither live longer nor experience improved quality of life when taking mistletoe extract in addition to standard cancer treatment, compared to placebo. The study is published in the journal Palliative Medicine.
“Previous research has shown promising results for mistletoe extract as a complementary treatment for this patient group, but our findings indicate that it has no effect on either survival or patients’ quality of life,” says Kathrin Wode, researcher and specialist physician in oncology and palliative medicine, Ph.D. at the Department of Diagnostics and Intervention, Umeå University.
Mistletoe extract is one of the most widely used plant-based medicinal products in Europe, but scientific evidence for its effectiveness against cancer remains limited. The MISTRAL study was conducted between 2016 and 2022 at Umeå University and nine Swedish oncology clinics and investigated the effectiveness of mistletoe extract as an adjunct treatment for patients receiving palliative care for pancreatic cancer. The researchers examined, among other outcomes, patient survival, quality of life, weight loss, and the use of corticosteroids.
“This is a patient group with a poor prognosis and a heavy symptom burden. There is a great need for gentle treatment options, which is why we wanted to investigate whether mistletoe extract could be helpful as an adjunct therapy,” says Per Fransson, Professor at the Department of Nursing, Umeå University.
“The study is quite unique because it focuses on complementary medicine rather than standard cancer treatment. It is also the first placebo-controlled study of mistletoe extract to examine both survival and quality of life,” says Roger Henriksson, Senior Professor at the Department of Diagnostics and Intervention, Umeå University.
The study included 290 patients with pancreatic cancer, who were randomized to receive either injections of a mistletoe preparation or placebo. The study was double-blind, meaning that neither the patients nor the researchers knew who received mistletoe extract and who received placebo. Previous results in 2024 showed no improvements in survival in the group receiving mistletoe extract compared to the placebo group. The new results showed that there were also no improvements in survival or quality of life.
“Based on our study results, there is no clinical reason to recommend adding mistletoe extract in the treatment of pancreatic cancer,” says Wode.
More information
Kathrin Wode et al, Mistletoe extract in patients with advanced pancreatic cancer: Health-related quality of life in a double-blind, randomized, placebo-controlled trial (MISTRAL), Palliative Medicine (2026). DOI: 10.1177/02692163261437609
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