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Mistletoe – not just for Christmas


21 November 2023

Mistletoe has been a feature of Christmas for hundreds of years. But this semi-parasitic plant has some rather surprising properties: in mainland Europe, it has been used alongside chemotherapy to support cancer patients for more than a century.

Dr Lorna Duncan, Research Fellow at the University of Bristol’s Centre for Academic Primary Care, is part of a team who recently completed the first randomised controlled trial of Mistletoe Therapy for cancer patients receiving NHS chemotherapy treatment in the UK. 

A variety of effects 

Mistletoe contains a variety of unusual substances which may be beneficial when integrated into conventional oncology treatment programmes. Mistletoe Therapy has been shown to affect biological processes, for example stimulating the immune system, as well as improving patients’ quality of life. 

However, there has been little investigation into mistletoe therapy in the UK where it is relatively unknown; and patients’ experiences of this treatment have also been less studied. Lorna Duncan undertook qualitative interviews with patients for the Mistletoe And Breast cancer trial, which was part-funded by Camphill Wellbeing Trust and the Swiss Association for Cancer Research (VfK). 

“It was important to understand the experiences of participants in this feasibility trial, both to find any barriers to a larger trial and to understand patients’ broader perspectives on the therapy, rather than just focussing on clinical measurements,” said Dr Duncan. “I interviewed patients attending Bristol Haematology and Oncology Centre both during and after they had finished their trial treatment.” 

Patients were intrigued 

“We found they were enthusiastic about mistletoe therapy, despite having to self-administer it sub-cutaneously. They liked the idea of having a ‘natural’, if surprising, treatment alongside their chemotherapy and also that it was an accepted therapy in countries such as Germany and Switzerland.” 

A subsequent grant from the Elizabeth Blackwell Institute’s COVID-19 Support Scheme for Early Career Researchers enabled Lorna to conduct a number of interviews with clinicians offering mistletoe therapy, as well as with an importer and a pharmacist, to better understand current UK provision, which is largely private. 


“The trial findings have now been submitted for publication” continued Lorna, “and we have presented our work at national and international conferences this year. The Swiss pharmaceutical company Iscador, who provided the mistletoe for our trial, is also interested in a potential multi-site trial here.” This could be the next step towards Mistletoe Therapy becoming more widely available. 

“The additional funds from the Elizabeth Blackwell Institute also enabled me to travel to Switzerland”, Lorna continued. “I visited Iscador and was shown how the mistletoe was grown and then processed for therapeutic use. I also met other researchers and finally had the opportunity to meet the Austrian doctoral student I began co-supervising just as we went into the first COVID-19 lockdown in March 2020. Her study of the introspective experience of cancer patients taking mistletoe therapy long-term is now complete and we have recently published this work in the Integrative Cancer Therapies journal.” 

COVID outbreaks 

Alongside this project, Lorna followed up her study of the necessary changes in general practice delivery at the start of the pandemic by completing an analysis of similarities in the 64 COVID-19 outbreaks in GP surgeries reported to the UK Health Security Agency (UKHSA) from south-west England, using funds from the Elizabeth Blackwell Institute to more than double the number of outbreaks included in the study. 

“This allowed me to investigate changes over time and to undertake a more comprehensive thematic analysis” said Lorna. “I presented this work, which I undertook in collaboration with the UKHSA’s south-west Health Protection Team, at a national conference attended by GPs. Our findings are also being prepared for publication and will enhance a joint funding application.” 

New studies 

During her Elizabeth Blackwell Institute funded work, Lorna was also invited by the Institute to take part in a study of equality, diversity and inclusion in research funding and this has led to her new role as project lead on two studies considering how research can be improved by enhancing research culture and through increased transparency increased transparency

“The funds from the Elizabeth Blackwell Institute have really helped to enhance my projects, as well as enabling me to travel and to make connections I otherwise would have struggled to establish. They’ve had a substantial impact, not only on my work, but also on my career.” 

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