Alternative
medicine
Are mistletoe extract injections the next big thing in cancer therapy?
Joe Sugarman / Spring 2014 Posted in HealthTagged ruscombe mansion community health
center, kimmel cancer center, ludwig center for cancer genetics
and therapeutics, oncology, cancer, alternative medicine
In September 2008, Ivelisse Page, a 37-year-old mother of four,
was diagnosed with colon cancer. Several weeks later, she had 15 inches of her
colon and 28 lymph nodes removed. But in December of that same year, Page's
doctor, Luis Diaz, an associate professor of oncology in the School of
Medicine, had to deliver the devastating news that the cancer had spread to her
liver. He told her that she had just an 8 percent chance of surviving for more
than two years.
Page had more surgery to remove 20 percent of her liver, but
instead of undergoing conventional chemotherapy, she pondered the suggestion of
another of her doctors, Peter Hinderberger of Baltimore's Ruscombe Mansion
Community Health Center. A specialist in using complementary therapies,
Hinderberger had seen positive effects from injections of mistletoe extract.
The liquid, derived from the poisonous, semiparasitic mistletoe plant, has been
a popular natural remedy in treating cancer in Europe for years, but
Hinderberger is one of the few physicians nationwide who regularly use the
therapy.
Page and Diaz had never heard of the treatment. Diaz, who is also
the director of translational medicine at the Ludwig Center for Cancer Genetics
and Therapeutics at the Johns Hopkins Kimmel Cancer Center, reviewed several
European studies on the extract and somewhat reluctantly gave Page the green
light. "I'm an oncologist who treats with chemotherapy— and I'm really
good at it—and here's somebody who says not only do I not want chemotherapy,
but I still want you to be my oncologist while I'm getting mistletoe,"
Diaz says. "I reviewed the literature on mistletoe in other parts of the
world and there is some acceptance of it. I was willing to work with her."
The next time the doctor saw his patient, he was amazed. "The
one thing I noticed was that as soon as she went on it, she started feeling
better," he recalls. "That's a universal feature I've seen in all
patients who get mistletoe. Their [color] improves; they have more
energy."
Page has been cancer-free since the operation on her liver and
attributes her turnaround to a combination of surgery, diet and exercise, and
the mistletoe. Now she's made it her mission to bring the extract from its
European manufacturers to the United States, where the Food and Drug
Administration has yet to issue its stamp of approval. She knew Diaz could help
establish the necessary clinical trials. "I told her that the trials would
cost millions of dollars, which I thought would subdue her a bit, but it didn't,"
Diaz says. "Instead, she went into overdrive." Page and her husband,
Jimmy, formed a nonprofit called Believe Big to connect cancer patients with
doctors who use nonconventional therapies and also to raise funds for the
three-stage clinical trials. Through benefit dinners, fundraising walks, and
donations, Believe Big has raised most of the $300,000 required for stage 1
testing, which could begin this summer. While Diaz says it's not uncommon for a
nonprofit to fund clinical work, it's highly unusual for an individual to be
the driving force.
Researchers at Johns Hopkins have been increasingly looking at
naturally derived medicines to fight disease, Diaz notes. "Being at
Hopkins rather than a private practice physician, my mission is to make things
better, to improve treatments. I know that what we do for patients now isn't
what the finality will be once we get it figured out. And I know that there
needs to be new ideas."
Channing Paller, an assistant professor of oncology at the School
of Medicine and the principal investigator for the study, says her colleagues
are surprised when she mentions the mistletoe trials, but they realize that
patients are interested in these new therapies. "In the past, doctors may
have wondered if they were giving their patients snake oil," says Paller,
who has worked on other Hopkins studies involving treatment of prostate cancer
with pomegranate and an extract of muscadine grape skins. "But I think
people are becoming a little more open-minded. We don't treat these natural products
any differently than any other immunotherapy trial that we do. Every new
potential treatment, including natural products such as herbs, needs to be
studied rigorously and go through all FDA-required testing before it can be
given to a patient."
Diaz says that in Europe, clinical trials for mistletoe have
produced "confusing and mixed" results. Some studies have
demonstrated improvements in patients suffering from certain types of cancers,
such as breast, colon, pancreatic, or melanoma, but other studies have shown
the treatment to be ineffective in reducing tumor size or preventing the spread
of the disease. Paller says mistletoe's primary benefit could lie in its
ability to boost the immune system, as studies have revealed that it can help
patients better withstand the side effects of chemotherapy. Mistletoe extract's
efficacy, safety, and dosage recommendations will all be thoroughly tested
during the course of Hopkins' multiyear study.
