Oncologic mistletoe therapy -: physicians use and estimated efficiency

Background and Objectives: In the field of unorthodox therapies in oncology, mistletoe extracts represent the most important method in Germany. In spite of its use for decades, there is no sufficient evidence for its efficiency. Since physicians have been identified to be the main providers of unconventional cancer therapies, the question of what experiences they have made using mistletoe extracts and other methods. Persons and methods: In a cross-sectional study, 202 physicians in their private practices answered a structured, pretested questionnaire on unconventional cancer therapies, including their attitudes towards them and their judgement on efficiency. Response rate 80.2%. Results: 79.2% of the physicians reported to provide unconventional cancer therapies, especially older and more experienced doctors. Among these, the rate of physician with a special preference of mistletoe extracts was 44.4%. The average probability to achieve complete or partial remissions with mistletoe extracts, eventually in combination with other unconventional methods was estimated to be 6% and 15%, thus receiving slightly lower estimates than other methods. With respect to changes in quality of life, use of mistletoe extracts was judged to be inferior to other methods (p(T-Test) = 0.063; p(T-Test) = 0.059) Further more, mistletoe extracts were significantly less frequently used because the physician was convinced of its efficiency (p = 0.025). Conclusion:Clinical studies to prove possible benefits of mistletoe extracts are mandatory. It remains unclear why this method has become so popular in spite of providers moderate judgements on efficiency.