Verein für Krebsforschung

In traditional medicine, natural remedies are often used based on empirical observation and experimental knowledge. Even today, the prescription of phytotherapeutics at major centers for integrative medicine, such as Klinik Arlesheim (KLA) in Switzerland, frequently reflects physician experience rather than a purely guideline-based approach. Therefore, prescribing patterns may offer valuable insights into the clinical logic and cultural framework behind the use of specific remedies. This study examines the use of bitter herbal preparations at KLA as a case example of how routine health data can support hypothesis generation and provide insight into therapeutic culture. This real-world data study involved the analysis of KLA’s prescription database between 2018 and 2019. A total of 301,821 prescriptions were screened, focusing on 66,038 prescriptions containing 34 predefined natural bitter remedies. The analysis was narrowed to 10 frequently used mono- and multi-herbal bitter preparations. Indications, forms of administration and prescribing clinical departments were analysed descriptively. A total of 10,660 prescriptions of bitter preparations were identified. Bitter preparations were most frequently prescribed in psychiatry and oncology particularly for patients experiencing anxiety, stress and stress-related nausea. This pattern diverges from their traditional gastrointestinal use and may reflect evolving clinical applications in integrative care. The study also demonstrates the potential of structured clinical data to surface novel patterns and research hypotheses. The prescribing patterns of bitter substances observed in this study highlight underexplored areas of integrative care, particularly in psychosomatic and oncological contexts. These findings underscore the value of structured, practice-based data as a window into lived therapeutic traditions. Future research should examine both the clinical effects and efficacy as well as the cultural dimensions of phytotherapeutic use, including the unconventional administration of herbal bitters.

Cancer-related fatigue is one of the most common symptoms in patients with cancer. Fatigue reduces health-related quality of life. The Cancer Fatigue Scale (CFS) is a brief instrument that captures the multidimensional nature of fatigue with robust validity. The original scale was developed/validated with Japanese cancer patients. It was our aim to report the psychometric properties of an English translation of the CFS. This cross-sectional study was conducted between February-October 2008 in London, UK. Three groups were recruited: cancer patients (index group), diabetic patients (chronic disease control group), and a healthy control group. All participants completed a questionnaire on recruitment and a subset were retested at 2-8 weeks. Reliability was assessed with analysis of internal consistency (Cronbach's alpha), homogeneity (item-total correlations) and test-retest reliability. Construct validity was assessed with inter-subscale correlations. To assess convergent validity, the correlations between the CFS and FNS, EORTC - QLQ C30, and HADS were examined with Spearman Rank correlation coefficients. The discriminant validity was determined by the known group method. 160 participants were recruited: 60 cancer and 50 diabetes patients, and 50 healthy patients. Cronbach's alphas for the total scale and all three subscales (range 0.83,0.94) were all above the 0.70 criterion suggested for group comparisons thus the CFS showed excellent internal consistency. Homogeneity measures all fulfilled the 0.20 criterion (range 0.53-0.84). Combining the three groups, all test-retest correlations for the CFS and its subscales were above 0.7. Physical and affective subscales showed 100% scaling success. Both scores and sub-scores for the CFS correlated positively (p < 0.001) with FNS and HADS depression and anxiety subscales. The CFS correlated positively (p < 0.001) with all but one item of the EORTC-QLQ C30. This evaluation of the measurement properties of the CFS-English shows that it is a reliable and valid tool for assessing key dimensions of cancer-related fatigue.

Cancer-related fatigue (CRF) is common among breast cancer (BC) survivors. In addition to aerobic training, psychoeducation, sleep education/restriction, and mindfulness-based therapies are shown to reduce CRF. This study investigates the predictive effect of hygiogenetic and salutogenetic concepts, such as autonomic regulation (aR), self-regulation (SRS) and internal coherence (ICS) along with sleep quality (PSQI) and quality of life (EORTC QLQ C30, including cognitive, emotional and physical functioning) on the success of CRF therapies. Two studies are analyzed: a pilot (CRF-1) with 36 BC patients and a follow-up study (CRF2) with 126 patients either randomized or assigned to therapy by preference. All parameters were assessed at baseline and 10 weeks post-intervention (T1), and in CRF-2 also six months later (T2), and after four years (T3). Multiple linear regression models were applied. Trait aR and ICS are shown to be significant predictors of CRF when all timepoints of the CRF-2 study are included (βTrait aR = −0.170, df = 70, p < 0.001; βICS = −0.210, df = 70, p < 0.01) as well as when combined with data of the CRF-1 study (βTrait aR = −0.144, df = 101, p = 0.001; βICS = −0.211, df = 101, p < 0.01). Cognitive Function showed a borderline significance only at T3 and when all CRF-2 study time measurements were combined (βCF = −0.073, df = 70, p < 0.05). Using data from two studies with multimodal, aerobic and combined CRF treatments, this study highlights Trait aR and ICS at baseline as long-term predictors of CRF even four years after intervention. A stable autonomic regulation including rest/activity regulation and internal coherence are predictors for therapy response of a multimodal, combination or aerobic treatment in breast cancer survivors with CRF.

Viscum album, commonly known as mistletoe or European mistletoe, is a semi-parasitic plant that grows on leafy and coniferous trees. Mistletoe was used medicinally in ancient Greece (460 - 377 BC) to treat disorders of the spleen and complaints associated with menstruation. Nowadays, V. album extracts are most frequently used for complementary cancer therapy in both human and veterinary medicine. Since the early 1920s, V. album preparations derived from aqueous extracts have been commercially available in several countries, such as Iscador®, Eurixor®, Helixor®, and Abnoba viscum®. The anticancer activities of mistletoe have been ascribed to a combination of cytotoxic and immunological effects. However, the in vitro cytotoxicity of V. album extracts is not only associated with antitumor metabolites present in aqueous extracts since non-aqueous preparations have demonstrated anticancer activity too. Using ethanolic preparations, Holandino`s group demonstrated the potential antitumor effect of V. album mother tinctures on different tumoral lineages. Considering the influence of harvest conditions and host trees, ongoing studies attempt to unravel the action mechanisms of preparations derived from alcoholic V. album extracts to provide scientific evidence for new approaches in cancer therapy. This round table discussion aims to review the latest in vitro and in vivo findings using preparations of V album derived from alcoholic extracts in different experimental cancer models. The themes are organized into four parts: 1) The history of the Viscum album and differences between aqueous and ethanolic extracts, how mother tincture is obtained, and the biological effect on different tumor lines (Prof. Carla Holandino´s talk); 2) Preparation of ultra-diluted medicines in different homeopathic scales, and their biological effect on murine melanoma model in vitro study (Prof. Priscila Inhauser´s talk); 3) Effects of ultra-dilutions of V album in an experimental in vivo model of murine melanoma (Prof. Elizabeth C Perez´s talk).

Introduction: European mistletoe (Viscum album L.) has been gaining increasing interest in the field of oncology as a clinically relevant adjunctive treatment in many forms of cancer. In the field of phytopharmacology, harvesting time is pivotal. In the last century, a form of metabolomic fingerprinting based on pattern formation was proposed as a way to determine optimal harvesting times to ensure high quality of mistletoe as raw material for pharmaceutical use. In order to further evaluate the information obtained with this metabolomic fingerprinting method, we analysed a large time series of previously undigitised daily mistletoe chromatograms dating back to the 1950s. Methods: These chromatograms were scanned and evaluated using computerized image analysis, resulting in 12 descriptors for each individual chromatogram. We performed a statistical analysis of the data obtained, investigating statistical distributions, cross-correlations and time self-correlations. Results: The analysed dataset spanning about 27years, contains 19,037 evaluable chromatograms in daily resolution. Based on the distribution and cross-correlation analyses, the 12 descriptors could be clustered into six independent groups describing different aspects of the chromatograms. One descriptor was found to mirror the annual rhythm being well correlated with temperature and a phase shift of 10days. The time self-correlation analysis showed that most other descriptors had a characteristic self-correlation of ∼50days, which points to further infradian rhythms (i.e., more than 24h). Discussion: To our knowledge, this dataset is the largest of its type. The combination of this form of metabolomic fingerprinting with the proposed computer analysis seems to be a promising tool to characterise biological variations of mistletoe. Additional research is underway to further analyse the different rhythms present in this dataset.

Introduction: Cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma (BCC) belong to the group of keratinocyte carcinomas (KC). Actinic keratosis (AK) is a precursor lesion of cSCC. The incidences of cSCC, BCC, and AK are currently strongly increasing. Different standard therapies exist for these conditions but are not always applicable or successful. Hydrophilic Viscum album extracts have been used in anthroposophic cancer therapy since 1917. Viscum album lipophilic extract (VALE) is prepared by means of supercritical CO2 extraction. This retrospective case series assessed the safety and clinical effects of a topical application of 10% VALE in individual cases of cSCC, BCC, and AK. Methods: For this retrospective case series, a positive vote was obtained from the Ethics Committee of the University of Witten/Herdecke (No. 146/2020). Eligible patients signed a declaration of consent prior to inclusion in the study. The main outcome parameters were the clinical response to treatment with VALE and adverse drug reactions. Risk factors, concomitant therapies and diseases, further diagnostic and therapeutic information were documented where available. Data analysis was performed on the level of patients and of individual lesions. Results: The study population consisted of 55 patients with 74 skin lesions. Individual case analysis accompanied by photographic documentation revealed typical and promising treatment courses. Clinical response rates (complete + partial remissions) for individual lesions were 78% for cSCC, 70% for BCC, and 71% for AK. Complete remission rates for individual lesions were 56% for cSCC, 35% for BCC, and 15% for AK. In cSCC and BCC, shorter times to best clinical response were observed. Adverse drug reactions were reported in 5 patients including erythema and inflammatory reactions of mostly moderate severity that resolved completely. In one case, therapy was temporarily paused, in four cases it was continued without interruption. Discussion/Conclusion: The results of this study suggest that VALE is a safe and tolerable extract under whose application complete and partial remissions of KC could be observed. To improve and assess the efficacy of VALE, prospective investigations are necessary.

<strong>Abstract: </strong>The genus Viscum comprises a large number of semi-parasitic shrubs popularly known as Mistletoe. The Viscum species grow in many countries of Europe, Africa, and Asia with different popular uses in ornamentation, foods and medicine. Many studies about Viscum have been done over the last years focusing on biological activities and chemical composition of the aqueous extracts, mainly related to anthroposophical medicines. However, it is known that non-aqueous preparations, as alcoholic extracts, have demonstrated different biological<em> </em>activities that are species – and host tree – dependent. Considering the potential of these alcoholic extracts, a scoping review was conducted using data from three online databases: PubMed, Scopus and Embase. Inclusion criteria consisted of the <em>in vitro</em>, <em>in vivo</em>, <em>ex vivo</em>, clinical, and chemical studies of alcoholic extracts from Viscum species. The present review summarized 124 original publications about fourteen Viscum species. <em>Viscum album</em>, <em>Viscum articulatum</em> and <em>Viscum coloratum</em> were the main studied species. Alcoholic extracts demonstrated hypotensive, anticancer, antimicrobial, analgesic and anti-inflammatory capabilities, among other biological activities. Flavonoids, phenolic acids, and terpenoids represented 48%, 24%, and 11% of the total identified compounds, respectively. This review contributes to the knowledge of alcoholic preparations of the Viscum species and points out the lack of clinical studies concerning these different extracts.