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 spi te of its use for decades, there is no sufficient evidence for its efficien cy. Since physicians have been identified to be the main providers of uncon ventional 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 pr ivate practices answered a structured, pretested questionnaire on unconvent ional cancer therapies, including their attitudes towards them and their ju dgement 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 mi stletoe extracts, eventually in combination with other unconventional metho ds 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 mist letoe extracts was judged to be inferior to other methods (p(T-Test) = 0.06 3; p(T-Test) = 0.059) Further more, mistletoe extracts were significantly l ess frequently used because the physician was convinced of its efficiency ( p = 0.025). Conclusion:Clinical studies to prove possible benefits of mistletoe extract s are mandatory. It remains unclear why this method has become so popular i n spite of providers moderate judgements on efficiency.