Ivermectin and Cancer: Navigating Patient Curiosity in Oncology Nursing

In January 2025, a single episode of a high-profile podcast triggered a seismic shift in the oncology landscape. Following an endorsement by a celebrity guest who claimed acquaintance with individuals "cured" of stage IV cancer using a combination of ivermectin and fenbendazole, interest in the repurposed antiparasitic drug skyrocketed [1].

According to a University of California, Los Angeles (UCLA)–led study published in JAMA Network Open, prescriptions for ivermectin doubled overall and increased 2.5-fold among patients with cancer in the months following the broadcast of actor Mel Gibson’s appearance on “The Joe Rogan Experience.”

For oncology nurses, this surge is more than a statistical anomaly; it represents a complex challenge in patient education, safety monitoring, and the maintenance of the therapeutic alliance. Patients, often driven by a desire for control over their disease, are increasingly bringing "protocols" found online to the infusion suite.

"Our study evaluating the emerging interest in ivermectin indicated that there was a significant rise in Google searches for 'ivermectin' and 'cancer' in January 2025," says David J. Benjamin, MD, a medical oncologist at the Hoag Family Cancer Institute in Newport Beach, California [2]. Benjamin notes that although drug repurposing has existed for decades, the current momentum is uniquely driven by anecdotal digital platforms and social media echo chambers.

The gap between laboratory and clinic

The allure of ivermectin often stems from early scientific data. Preclinical studies have suggested that ivermectin may inhibit cancer cell proliferation and metastasis by targeting pathways such as Wnt/β-catenin and mitochondrial function. However, experts caution that these laboratory findings rarely translate to human success.

"At any given time, there are several thousand clinical trials ongoing," Benjamin explains. "While clinical trials that have successful outcomes are often discussed in news articles and social media, there are hundreds of examples of failed clinical trials with negative results despite promising preclinical data." He points to cardiovascular drugs such as aspirin, metformin, and statins, which showed immense promise in the laboratory but frequently failed to demonstrate clinical efficacy in oncology trials.

The American Society of Clinical Oncology (ASCO) echoed this skepticism in a mid-2026 clinical notice, stressing that achieving the drug concentrations required to replicate preclinical effects in humans would likely require doses far exceeding established safety limits [3]. As of mid-2026, there is no robust, peer-reviewed clinical evidence demonstrating that ivermectin is safe or effective for treating any human malignancy, aside from a few early-phase trials.

Identifying safety risks and interactions

For nurses, the most immediate concern is the potential for toxicity and harmful drug-drug interactions. Ivermectin is metabolized via the cytochrome P450 pathway in the liver. When combined with standard systemic cancer therapies, it can alter the pharmacokinetics of proven treatments, potentially increasing chemotherapy toxicity or rendering lifesaving medications ineffective.

"As of mid-2026, there are no completed prospective clinical trials that have examined the risks, toxicities, and drug-drug interactions of ivermectin with other standard-of-care cancer therapies," Benjamin warns. "One of the serious concerns and risks...is the unknowns associated with potential toxicities."

Fumiko Chino, MD, a radiation oncologist at The University of Texas MD Anderson Cancer Center, emphasizes the need for vigilant monitoring of functional status. "Obvious jaundice or other signs of liver failure would be bad," she says, noting that some "naturalist" protocols involve aggressive escalations. She describes one patient whose protocol aimed for a final dose of 15 pills per day. Nurses should watch for neurological symptoms—such as ataxia, dizziness, or confusion—and systemic issues such as hypotension, which are associated with high-dose ivermectin use.

Communication: From "compliance" to "adherence"

When a patient discloses the use of an unproven "protocol," the nurse’s reaction can determine the future of that patient’s care. Chino suggests a shift in perspective, moving away from the term "compliance," which implies a power imbalance, toward "adherence."

"We cannot force people to take our recommended treatments," Chino says. "As soon as patients feel like you're going to be judging them in a negative way, their mind will close—and so will sometimes their ability to answer questions forthrightly."

She encourages nurses to use a "grocery bag" approach to medication reconciliation. "I do encourage people to actually recommend that if people are on a lot of supplements or vitamins, [before the] next time you see them, say, ‘Bring me in the grocery bag full of your supplements. I want to look at them,’" Chino explains. This practical, nonjudgmental request allows for accurate documentation in the electronic health record while fostering a sense of transparency.

Benjamin recommends using open-ended prompts to ensure patients feel safe disclosing off-label use. "One approach to consider is to ask patients, 'What are the medications you are currently using to treat your cancer?'" he says. This phrasing allows the patient to freely discuss both prescribed and self-administered treatments without fear of immediate rebuttal.

The hidden "opportunity cost"

A risk associated with ivermectin use may not be the drug itself, but the opportunity cost—the danger of patients delaying or skipping proven treatments in favor of alternative protocols.

"The elevated prescribing observed among patients with cancer is particularly concerning. Individuals facing life-threatening illness may delay or forgo conventional treatments...potentially allowing their disease to progress," states the UCLA study. Chino notes that missed appointments or frequent, anxious inquiries through the patient portal can be red flags for social or psychological barriers that lead a patient toward alternative therapies.

Furthermore, there is a significant financial toxicity involved. "None of them are free," Chino observes of alternative treatments. "They can actually be very cumulative. They can actually squeeze patients in terms of their affordability—$80 a month is food for your family that patients don't have because they're spending it on something else."

Evaluating real-world data

Patients may cite recent publications to support their curiosity. One such study included a self-reported "Clinical Benefit Ratio of 84.4%” among patients with cancer using a combination of ivermectin and mebendazole. [4] However, this study was met with an immediate "Expression of Concern" from the journal's editorial board. [5] The journal, Anticancer Research, initiated a formal audit into the study’s data integrity, citing "serious scientific concerns...regarding the verifiability and statistical reliability, and ethical oversight of the underlying data set."

For oncology nurses, this serves as a critical teaching moment about the hierarchy of evidence.

"Nurses can use the opportunity of an online protocol to educate patients on the levels of evidence," Benjamin suggests. He notes that while a "case series" of a few patients might look impressive on social media, it does not carry the weight of a randomized controlled trial involving hundreds of participants. "The vast majority of cancer drugs that have received regulatory approval come from this high level of evidence rather than case reports."

Supporting the whole patient

The interest in ivermectin may often be a symptom of a patient’s search for agency. "Patients exploring these alternative therapies are often driven by a desire for control over their disease and are willing to explore all avenues that may give them hope," ASCO notes.

Benjamin highlights the ethical pillars of autonomy, beneficence, and nonmaleficence. Nurses can acknowledge a patient’s need for control (autonomy) while providing education on the lack of current understanding regarding risks (nonmaleficence).

Chino emphasizes that the pressure often comes from outside the clinic. "Many patients actually have a whole family, friends, community behind them. They're getting a lot of pressure from these people who are not in the exam room with you," she says. Identifying who is recommending the treatment can help nurses understand the patient's support system and social pressures.

As of mid-2026, the clinical community remains in a holding pattern. While trials such as the ICONIC study are beginning to accrue patients to rigorously evaluate ivermectin's role alongside immune-checkpoint inhibitors, the current recommendation is one of extreme caution.

"The key takeaway for ivermectin and cancer is that as of mid-2026, we do not know enough beyond preclinical data on whether ivermectin may help—or may hurt—an individual with cancer," Benjamin concludes. "Therefore, more studies are needed before we can provide an informed opinion on this matter."

For the oncology provider, this means staying grounded in the data while remaining a compassionate, open-eared advocate for patients navigating a sea of digital misinformation.

References

1. Rockwell MS, Kahn KL, Fendrick AM, Vangala S, Mafi JN. Ivermectin-benzimidazole prescribing following celebrity endorsement. JAMA Netw Open. 2026;9(5):e2616780. doi:10.1001/jamanetworkopen.2026.16780
2. Benjamin DJ, Rezazadeh Kalebasty A. 2833P Ivermectin in cancer, 2025: internet trends, scientific data, ongoing trials, and news coverage. Ann Oncol. 2025;36(suppl 2):S1402. doi:10.1016/j.annonc.2025.08.3445
3. ASCO clinical notice: recommending against ivermectin and fenbendazole for cancer treatment, outside of clinical trials. ASCO Connection. May 26, 2026. Accessed July 21, 2026. https://connection.asco.org/do/asco-clinical-notice-recommending-against-ivermectin-and-fenbendazole-cancer-treatment
4. Hulscher N, Victory K, Thorp JA, et al. Real-world clinical outcomes of ivermectin and mebendazole in cancer patients: results from a prospective observational cohort. Anticancer Res. 2026;46(6):3243-3255. doi:10.21873/anticanres.18194
5. Expression of concern: Real-world clinical outcomes of ivermectin and mebendazole in cancer patients: results from a prospective observational cohort. Anticancer Res. 2026;46(6):3243-3255. Anticancer Res. 2026;46(6):e3243. doi:10.21873/anticanres.18276