Although treatment of cancer patients with VA-E obviously has effects on immuno-competent cells, such as increased number and activity of lymphocytes, monocytes/ macrophages and granulocytes, the clinical relevance of this treatment is controversially discussed. On the other hand, the biological effects of VA-E treatment are highly dependent on the mode of application (Table 4), however, only the subcutaneous application is recommended. One cannot exclude the possibility that the effectiveness of mistletoe therapy in complementary cancer therapy may improve (1) by a differentiated use of VA-E and adapted route of application, and (2) by the combination of conventional treatment strategies with VA-E therapy.
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