By Dr. Ashley Chauvin ND

A common side effect of chemotherapy and radiation is cancer related fatigue (CRF).  58% to 94% of patients with breast cancer experience CRF during treatment, and between 56% and 95% have CRF after they receive adjuvant chemotherapy (1). This can be a large concern as fatigue can also be related to reduced activity and changes in mood.  This can have a large impact patient’s quality of life.  In fact, cancer related fatigue has been reported to be one of the most distressing symptoms reported by breast cancer survivors.

The reason for this fatigue is due to chemotherapy and radiation therapy have an impact on the body’s red and white blood cell counts (aka the immune cells).  Your oncology team will be monitoring your blood work frequently.  

As a part of your naturopathic support plan during cancer treatment, your ND will make suggestions to help improve your energy and reduce fatigue.  These suggestions may include nutritional advice such as how much protein you need during treatment, and tools to help you reach that goal.  They may discuss lifestyle recommendations that include an exercise prescription that is safe during chemotherapy and radiation. 

They may make supplement recommendations that include vitamins and botanicals.  Some supplements should not be used during conventional treatment as they may impact the efficacy of radiation or chemotherapy.  Depending on the type of conventional treatment you are receiving, these suggestions will be unique to you. 

One of the best ways to reduce cancer related fatigue and protect healthy cells during conventional treatment is using mistletoe therapy as part of your integrative treatment plan.

Across Europe, Viscum album L. (mistletoe) extracts are some of the most common herbal extracts used in supportive cancer care and have been studied in many clinical trials.  Mistletoe is a safe, non-toxic therapy.  

Studies have looked at using mistletoe therapy in patients with breast cancer and have showed the following interesting findings:

  • Mistletoe is well tolerated by patients (2).
  • The components of the mistletoe plant (especially the mistletoe lectins) have a strong effect on cancer cells. These components have been shown to cause apoptosis (programmed cell death) in cancer cells (3).
  • Mistletoe is protective to healthy cell DNA and has immunostimulating effects (4).
  • Mistletoe has been shown to be safe while receiving chemotherapy for breast cancer (5).
  • Mistletoe can help maintain quality of life during chemotherapy and when chemotherapy ends possibly due to reduction in chemotherapy related side effects (2).
  • When mistletoe is added to conventional treatment, it may be supportive in helping with cancer related fatigue, insomnia and physical functioning. (6).
  • Patients receiving mistletoe during chemotherapy had less neutropenia (decrease in white blood cells), less pain and better appetites (5).
  • For patients who are taking hormone therapy such as Tamoxifen, mistletoe has been shown to be safe (8). 

Mistletoe is administered to patients as an intravenous (IV) route or as a subcutaneous injection (an injection given under the skin, often in the abdomen).  Dr. Ashley has a special interest in supporting women during and after breast cancer treatment to help them regain their lives and thrive after a cancer diagnosis. Her goals are to help women feel in control of their health and health care and to provide safe and effective options for improving the health of breast cancer patients. Contact the office by submitting an inquiry to book a complimentary 15 minute consult to discuss your personal needs.



1. Berger AM, Gerber LH, Mayer DK. Cancer-related fatigue: implications for breast cancer survivors. Cancer. 2012 Apr 15;118(8 Suppl):2261-9. doi: 10.1002/cncr.27475. PMID: 22488700.

2. Eisenbraun J, Scheer R, Kröz M, Schad F, Huber R. Quality of life in breast cancer patients during chemotherapy and concurrent therapy with a mistletoe extract. Phytomedicine. 2011 Jan 15;18(2-3):151-7. doi: 10.1016/j.phymed.2010.06.013. Epub 2010 Aug 19. PMID: 20724129.

3. Marvibaigi M, Supriyanto E, Amini N, Abdul Majid FA, Jaganathan SK. Preclinical and clinical effects of mistletoe against breast cancer. Biomed Res Int. 2014;2014:785479. doi: 10.1155/2014/785479. Epub 2014 Jul 20. PMID: 25136622; PMCID: PMC4127267.

4. Wrotek S, Skawiński R, Kozak W. Immunostymulujące właściwości preparatów pozyskiwanych z jemioły i ich zastosowanie w onkologii [Immunostimulatory properties of mistletoe extracts and their application in oncology]. Postepy Hig Med Dosw (Online). 2014 Oct 23;68:1216-24. Polish. doi: 10.5604/17322693.1126850. PMID: 25380204.

5. Complementary Treatment with Mistletoe Extracts During Chemotherapy: Safety, Neutropenia, Fever, and Quality of Life Assessed in a Randomized Study. J Altern Complement Med. 2018 Sep/Oct;24(9-10):954-961. doi: 10.1089/acm.2018.0159. PMID: 30247950; PMCID: PMC6157372.

6. Oei SL, Thronicke A, Kröz M, von Trott P, Schad F, Matthes H. Impact of Oncological Therapy and Viscum album L Treatment on Cancer-Related Fatigue and Internal Coherence in Nonmetastasized Breast Cancer Patients. Integr Cancer Ther. 2020 Jan-Dec;19:1534735420917211. doi: 10.1177/1534735420917211. PMID: 32478590; PMCID: PMC7273755.

7. Weissenstein U, Kunz M, Oufir M, Wang JT, Hamburger M, Urech K, Regueiro U, Baumgartner S. Absence of herb-drug interactions of mistletoe with the tamoxifen metabolite (E/Z)-endoxifen and cytochrome P450 3A4/5 and 2D6 in vitro. BMC Complement Altern Med. 2019 Jan 18;19(1):23. doi: 10.1186/s12906-019-2439-2. PMID: 30658716; PMCID: PMC6339413.