Durable Clinical Remission of a Skull Metastasis Under Intralesional Viscum album Extract Therapy: A Case Report

• Published in: Integrative medicine (Encinitas, Calif.) Vol. 17; no. 2; p. 60
• Main Authors: Werthmann, Paul Georg, Huber, Roman, Kienle, Gunver Sophia
• Format: Journal Article
• Language: English
• Published: Mendota Heights InnoVision Health Media, Inc 01-04-2018
• Subjects: Cancer therapies; Case reports; Chemotherapy; Metastasis; Radiation therapy; Thyroid cancer; Germany
• ISSN: 1546-993X; 1945-7081

Background: Skull metastases are rare and mostly asymptomatic, but they can cause pain and carry the risk of an invasion into the brain. Radiotherapy can be effective and surgical excision is sometimes used with mixed results; however, clinical studies comparing different treatment options or evidence-based practice guidelines are not available. Viscum album extracts (VAE) used as an adjunct treatment in cancer patients show immune-modulating and cytotoxic properties, as well as positive impact on quality of life and sometimes survival. Durable regression of malignant and premalignant lesions after intratumoral application of VAE have been reported in case reports. Case Presentation: A 68-y-old woman was diagnosed with rectal cancer and lung metastases. After surgical resection and various chemotherapy regimens, she experienced periods of stable disease. However, during the course, metastases to multiple bone sites, the chest wall, and the liver were identified. Histological examination of 1 of the bone lesions revealed a follicular thyroid carcinoma. An osteolytic parietal bone lesion progressed to a metastasis of the skull despite radiation and chemotherapy. The patient asked for additional integrative medical treatment for this painful metastasis. Intralesional VAE treatments were applied weekly into the skull metastasis. After the first application, the patient felt pain relief and softening of the lesion. After 8 mo of continued VAE treatment, the metastasis showed partial remission (>50%) and then remained stable for 2 y, with the patient enjoying a good general condition. After this time, the condition deteriorated, and the patient died from progressive disease 77 mo after initial diagnosis. Patient's Perspective: "My whole well-being has changed and I've got more energy to do my things. Beforehand, there were days where I felt completely powerless and I wanted to give up. The mistletoe treatment helped me there." Conclusion: This case shows a durable clinical remission of a metastasis to the skull in a patient with rectal and thyroid cancer. Case reports about high-dose intratumoral VAE treatment in different cancers have previously shown positive results. Therefore, further investigations of intratumoral VAE treatment seem highly worthwhile-especially in symptomatic skull metastases not responding to radiotherapy or systemic therapies.