Abstract
The number of patients who seek treatment with complementary and alternative medicine has increased during the past decade. The trend is primarily driven by consumers who start to change their views toward conventional pharmaceutical approaches that are offered to them. Among all complementary and alternative therapies used in the management of prostate cancer, Prostate Cancer-SPES [Latin for “hope”] (PC-SPES) has attracted much national attention because of its potency, controversy, and recall by the US Food and Drug Administration. PC-SPES contains extracts from a mixture of eight common herbs that have been used for thousands of years. This article is devoted to reviewing the basic and clinical data of using PC-SPES in prostate cancer therapy. It also explores the difference in philosophies between Western medicine and herbal medicine and explains the inherent difficulties in evaluating herbal medicine. The article concludes that PC-SPES cannot be evaluated by the same standards established to test synthetic pharmaceutical compounds. Thus, new standards need to be developed for the evaluation of herbal medicine.
Similar content being viewed by others
References and Recommended Reading
Parker SL, Tong T, Bolden S, et al.: Cancer statistics, 1997. Cancer J Clin 1997, 47:5–27.
Eisenberg DM, David RB, Ettner SL, et al.: Trends in alternative medicine use in the United States: 1990–1997. JAMA 1998, 280:1569–1575.
Weiger W, Smith M, Boon H, et al.: Advising patients who seek complementary and alternative medical therapies for cancer. Ann Intern Med 2002, 137:889–903. This article contains good information on various CAM modalities; however, the authors offer too much of a negative view on advising patients on CAM.
Darzynkiewicz Z, Traganos F, Wu JM, et al.: Chinese herbal mixture PC SPES in treatment of prostate cancer [review]. Int J Oncol 2000, 17:729–736.
Silva D, Labarrere C, Slivova V, et al.: Ganoderma lucidum suppresses motility of highly invasive breast and prostate cancer cells. Biochem Biophys Res Commun 2002, 298:603–612.
Liu X, Yuan JP, Chung CK, et al.: Antitumor activity of the sporoderm-broken germinating spores of Gandoderma lucidum. Cancer Lett 2002, 182:155–161.
Chan RY, Chen WE, Dong A, et al.: Estogen-like activity of ginsenoside Rg1 derived from Panax notoginseng. J Clin Endocrinol Metab 2002, 87:3691–3695.
Yun TK: Panax ginseng: a non-organ specific cancer preventive. Lancet Oncol 2001, 2:49–55.
Bayne CW, Donnelly F, Ross M, et al.: Sernoa repens (Permixon): a 5 alpha-reductase I and II inhibitor: new evidence in a coculture model of BPH. Prostate 1999, 40:232–241.
Wilt TJ, Ishani A, Rutks I, et al.: Phytotherapy for benign prostatic hyperplasia. Public Health Nutr 2000, 3:459–472.
Chan FL, Choi HL, Chen ZY, et al.: Induction of apoptosis in prostate cancer cell lines by a flavonoid, baicalin. Cancer Lett 2000, 160:219–228.
Chen S, Ruan Q, Bedner E, et al.: Effects of the flavonoid baicalin and its metabolite baicalein on androgen receptor expression, cell cycle progression, and apoptosis of prostate cancer cell lines. Cell Prolif 2001, 34:293–304.
Hsieh T, Chen SS, Wang X, Wu J: Regulation of androgen receptor and prostate specific antigen in the androgenresponsive human prostate LNCap cells by ethanolic extracts of the Chinese herbal preparation PC-SPES. Biochem Mol Biol Int 1997, 42:535–544.
De la Taille A, Hayek OR, Buttyan R, et al.: Effects of a phytotherapeutic agent, PC-SPES, on prostate cancer: a preliminary investigation on human cell lines and patients. Br J Urol 1999, 84:845–850.
Halicka HD, Ardelt B, Juan G, et al.: Apoptosis and cell cycle effects induced by extracts of the Chinese herbal preparation PC SPES. Int J Oncol 1997, 11:437–448.
Kubota T, Hisatake J, Hisatake Y, et al.: PC-SPES: a unique inhibitor of proliferation of prostate cancer cells in vitro and in vivo. Prostate 2000, 42:163–171.
Hsieh TC, Lu X, Chea J, et al.: Prevention and management of prostate cancer using PC-SPES: a scientific perspective. J Nutr 2002, 132(suppl 11):3513S-3517S.
Tiwari RK, Geliebter J, Garikapaty VP, et al.: Anti-tumor effects of PC-SPES an herbal formulation in prostate cancer. Int J Oncol 1999, 14:713–719.
DiPaola R, Zhang H, Lambert G, et al.: Clinical and biologic activity of an estrogenic herbal combination (pc-spes) in prostate cancer. N Engl J Med 1998, 339:785–791. This paper first appeared in the New England Journal of Medicine, which brought PC-SPES to the attention of many physicians.
The Leuprolide Study Group: Leuprolide versus diethylstilbestrol for metastatic prostate cancer. N Engl J Med 1984, 311:1281–1286.
Oh WK, George DJ, Hackmann K, et al.: Activity of the herbal combination, PC-SPES, in the treatment of patients with androgen-independent prostate cancer. Urology 2001, 57:122–126.
Small E, Frohlich M, Bok R, et al.: Prospective trial of the herbal supplement PC-SPES in patients with progressive prostate cancer. J Clin Oncol 2000, 18:3595–3603. This paper is the largest published randomized clinical trial conducted using PC-SPES.
Bonham M, Arnold H, Montgomery B, et al.: Molecular effects of the herbal compound PC-SPES: identification of activity pathways in prostate carcinoma. Cancer Res 2002, 62:3920–3924.
Sovak M, Seligson AL, Konas M, et al: Herbal composition PCSPES for management of prostate cancer: identification of active principles. J Natl Cancer Inst 2002, 94:1261–1263. The authors of this paper revealed that the ingredients in PC-SPES varied by the lots. They also discovered the presence of indomethacin and DES in lots of PC-SPES, which made us think about spiking of PC-SPES with prescription drugs.
Guns ES, Goldenbery SL, Brown PN: Mass spectral analysis of PC-SPES confirms the presence of diethylstilbestrol. Can J Urol 2002, 9:1684–1688.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Yip, I., Cudiamat, M. & Chim, D. PC-SPES for treatment of prostate cancer: Herbal medicine. Curr Urol Rep 4, 253–257 (2003). https://doi.org/10.1007/s11934-003-0078-z
Issue Date:
DOI: https://doi.org/10.1007/s11934-003-0078-z