PC-SPES's therapeutic uses
PC-SPES is a natural product that was proposed as a treatment for prostate cancer, combining eight ingredients, including various herbs and a mushroom. The formulation initially garnered public and medical interest due to its purported anti-inflammatory and anticarcinogenic properties. It aimed to integrate principles from both Western and traditional Chinese medicine to support prostate health. However, investigations revealed that PC-SPES contained undisclosed pharmaceuticals, including diethylstilbestrol (DES), which is known to treat prostate cancer but carries significant risks, along with other medications that could complicate its safety profile.
While some studies indicated that PC-SPES might reduce prostate-specific antigen (PSA) levels and inhibit tumor growth, the effectiveness was likely attributed to the pharmaceutical components rather than the herbal ingredients. As a result of the safety concerns and the presence of unlisted drugs, PC-SPES was removed from the market in 2002. Its side effects mirrored those associated with estrogen treatments and included symptoms like hot flashes, breast tenderness, and increased risk of blood clots. Overall, PC-SPES’s therapeutic use has been highly scrutinized, leading to a decline in interest following the discovery of its true composition.
PC-SPES's therapeutic uses
DEFINITION: Natural plant product used to treat specific health conditions.
PRINCIPAL PROPOSED USE: Prostate cancer
Overview
PC-SPES was, ostensibly, a formulation of eight natural products (seven herbs and one mushroom): Isatis indigotica (dyer's-weed or glastum), Glycyrrhiza glabra (licorice), Panax pseudoginseng, Ganoderma lucidium (reishi mushroom), Scutellaria baicalensis (Chinese skullcap), Dendranthema morifolium (chrysanthemum), Rsbdosia rubescens (dong ling cao), and Serenoa repens (saw palmetto). The name PC-SPES was derived from the common abbreviation for prostate cancer (PC) and the Latin word spes, meaning “hope.” PC-SPES aimed to combine Western and traditional Chinese medicine in a single pill with anti-inflammatory, antioxidant, and anticarcinogenic properties to support prostate health. It was sold under the names PC SPES (BotanicLab) and Prostate-Res (ARC Nutrition). After its commercial launch in 1996, PC-SPES received considerable interest from the general public and reputable medical researchers as a treatment for prostate cancer. However, this claim turned out to be a fraud.
PC-SPES was not truly a purely herbal product; samples dating to 1996 were found to contain a form of pharmaceutical estrogen, diethylstilbestrol (DES), indomethacin (an anti-inflammatory medication in the ibuprofen family), and warfarin (a strong blood thinner). Samples subsequent to 1999 contained less DES, but they also showed less effectiveness in treating prostate cancer.
DES is used in prostate cancer treatment, but it presents a variety of risks, including blood clots in the legs. The other two pharmaceutical contaminants might actually reduce this risk (which may be why they were covertly added), but they present various risks of their own.
Therapeutic Dosages
The standard dosage of PC-SPES was six to nine 320-milligram (mg) capsules per day, taken on an empty stomach at least two hours before or after meals.
Therapeutic Uses
The only proposed use of PC-SPES was the treatment of prostate cancer. The formulation was tried at various stages of the disease, and preliminary research indicated that it had potential, particularly for treating prostate cancer that is no longer responsive to hormone therapies. Benefits were reported in the two main types of prostate cancer: hormone-sensitive and hormone-insensitive cancer. However, when the covert addition of pharmaceuticals was discovered, interest in this so-called herbal combination ended.
Scientific Evidence
All the results reported in the following paragraphs are consistent with the known effects of hormones related to estrogen and may be due to the DES present in PC-SPES rather than to the herbal constituents.
Test-tube studies of cancer cells found that PC-SPES decreases cell growth. promotes tumor cell death, reduces PSA (prostate-specific antigen) levels in both hormone-sensitive, and hormone-insensitive prostate cancers. and exerts estrogenic effects. In a rat study, PC-SPES treatment reduced the occurrence of prostate cancer tumors, inhibited their growth, and slowed the rate of cancer spread (metastasis) to the lungs. In one uncontrolled human study, PC-SPES produced a significant decrease in PSA levels for most of the thirty-three volunteers tested. Similar results were seen in another study of sixty-nine individuals by the same author and in a study of seventy people conducted by another researcher. Benefits were seen in other uncontrolled trials as well. In Germany and the UK, PC-SPES has been studied more extensively. Though some success was documented, the tolerability of the substance was noted to be less than researchers hoped.
Safety Issues
Because of the presence of unlisted pharmaceuticals, PC-SPES should not be used. It was removed from the American market in 2002 following the discovery of the undisclosed ingredients diethylstilbestrol (DES), warfarin, and alprazolam in the product. Side effects of PC-SPES closely resemble those of estrogen when taken by men for the treatment of prostate cancer; it may cause breast or nipple tenderness or swelling, loss of body hair, hot flashes, and loss of libido. Some individuals have also reported leg cramps, nausea and vomiting, and blood clots in the legs—side effects of PC-SPES increase with dosage. Also, there is one case report of PC-SPES taken at twice the recommended dose, causing internal bleeding, presumably because of the presence of warfarin (Coumadin), a strong blood thinner.
Bibliography
Ades, Terri. "PC-SPES: Current Evidence and Remaining Questions." CA: A Cancer Journal for Clinicians, vol. 51, no. 3, June 2001, pp. 199-204.
Michael Diaz, and Stephen G. Patterson. "Management of Androgen-Independent Prostate Cancer." Cancer Control, vol. 11, no. 6, 2017, p. 364-73. doi:10.1177/107327480401100604.
Oh, W. K., et al. “Activity of the Herbal Combination, PC-SPES, in the Treatment of Patients with Androgen-Independent Prostate Cancer.” Urology, vol. 57, 2001, pp. 122-26.
"PC-SPES." Memorial Sloan Kettering Cancer Center, 26 Feb. 2021, www.mskcc.org/cancer-care/integrative-medicine/herbs/pc-spes. Accessed 20 Sept. 2024.
"PC-SPES (PDQ®)–Health Professional Version." National Cancer Institute, 27 July 2017, www.cancer.gov/about-cancer/treatment/cam/hp/pc-spes-pdq. Accessed 20 Sept. 2024.
Weinrobe, M. C., and B. Montgomery. “Acquired Bleeding Diathesis in a Patient Taking PC-SPES.” New England Journal of Medicine, vol. 345, 2001, pp. 1213-14.