Written by Liene Dhooghe and the CAM-Cancer Consortium.
Updated February 8, 2017

PC-SPES

Does it work ?

Only limited clinical data are available of PC-SPES in prostate cancer. Many publications are case reports or observational studies but no randomized controlled trials have been conducted 9. A crossover study was interrupted because of observed contamination of PC-SPES with several prescription drugs.

Clinical trials

Following first observational and preliminary studies with PC-SPES, reporting a remarkable reduction in PSA levels10 and a significant improvement in quality of life and reduction in pain ratings11, several phase II studies were conducted in patients with androgen-insensitive prostate cancer. Overall a decline in PSA of at least 50% was observed12-15. In a randomized phase II clinical trial with crossover design, comparing PC-SPES to diethylstilbestrol, the analysis of the used PC-SPES showed, however, quantities of diethylstilbestrol and ethinyl estradiol16,17. Warfarin and indomethacin were also detected and the study therefore terminated18. The presence of these contaminants questions any observed effects rendering the clinical investigations useless19.

After the introduction of the renewed PC-Spes2, produced using improved quality control, only one study has been reported. It is a single-centre, prospective, open pilot study in 18 patients with advanced hormone refractory prostate cancer. The product used was analyzed and found to be free from diethylstilbestrol and warfarin. The results were not as positive compared to the described response of the original PC-SPES5.

Case reports

Several case reports were published, reporting a substantial decrease in serum prostate-specific antigen (PSA) levels following a regular use of PC-SPES20-24.

Citation Liene Dhooghe, CAM-Cancer Consortium. PC-SPES [online document]. http://ws.cam-cancer.org/The-Summaries/Herbal-products/PC-SPES. February 8, 2017.

References

  1. Blumenthal M. The rise and fall of PC-SPES: New generation of herbal supplement, adulterated product, or new drug? Integrative Cancer Therapies 2002;1(3):266-270.
  2. Sovak M, Seligson AL, Konas M, Hajduch M, Dolezal M, Machala M, Nagourney R. Herbal composition PC-SPES for management of prostate cancer: Identification of active principles. Journal of the National Cancer Institute 2002;94(17):1275-1281.
  3. Natural Treatments for Prostate Cancer (available on the internet). As example: http://health.groups.yahoo.com/group/natural_prostate_treatments/message/19573 accessed 8 February 2017.
  4. Lee CO. Complementary and alternative medicine patients are talking about: PC-SPES. Clinical Journal of Oncology Nursing 2005;9(1):113-114.
  5. Shabbir M, Love J, Montgomery B. Phase I trial of PC-spes2 in advanced hormone refractory prostate cancer. Oncology Reports 2008;19:831-835.
  6. Kosty MP. PC-SPES: Hope or hype? Journal of Clinical Oncology 2004;22(18):3657-3659.
  7. Yip I, Cudiamat M, Chim D. PC-SPES for treatment of prostate cancer: Herbal medicine. Current Urology Reports 2003;4:253-257.
  8. Marks LS, DiPaola RS, Nelson P, Chen S, Heber D, Belldegrun AS, Lowe FC, Fan J, Leaders FE, Pantuck AJ, Tyler VE. PC-SPES: Herbal formulation for prostate cancer. Urology 2002;60(3):369-375.
  9. Meyer JP, Gillat DA. PC-SPES: A herbal therapy for the treatment of hormone refractory prostate cancer. Prostate Cancer and Prostatic Diseases 2002;5:13-15.
  10. DiPaola RS, Zhang H, Lambert GH, Meeker R, Licitra E, Rafi MM, Zhu BT, Spaulding H, Goodin S, Toledano MB, Hait WN, Gallo MA. Clinical and biological activity of an estrogenic herbal combination (PC-SPES) in prostate cancer. The New England Journal of Medicine 1998;339(12):785-791.
  11. Pfeifer BL, Pirani JF, Hamann SR, Klippel KF. PC-SPES, a dietary supplement for the treatment of hormone-refractory prostate cancer. BJU International 2000;85:481-485.
  12. de la Taille A, Hayek OR, Buttyan R, Bagiella E, Burchardt M, Katz AE. Effects of a phytotherapeutic agent, PC-SPES, on prostate cancer: A preliminary investigation on human cell lines and patients. BJU International 1999;84:845-850.
  13. de la Taille A, Buttyan R, Hayek O, Bagiella E, Shabsigh A, Burchardt M, Burchardt T, Chopin DK, Katz AE. Herbal therapy PC-SPES: In vitro effects and evaluation of its efficacy in 69 patients with prostate cancer. The Journal of Urology 2000;164:1229-1234.
  14. Small EJ, Frohlich MW, Bok R, Shinohara K, Grossfeld G, Rozenblat Z, Kelly WK, Corry M, Reese DM. Prospective trial of the herbal supplement PC-SPES in patients with progressive prostate cancer. Journal of Clinical Oncology 2000;18(21):3595-3603.
  15. Oh WK, George DJ, Hackmann K, Manola J, Kantoff PW. Activity of the herbal combination, PC-SPES, in the treatment of patients with androgen-independent prostate cancer. Urology 2001;57(1):122-126.
  16. Oh WK, Kantoff PW, Weinberg V, Jones G, Rini BI, Derynck MK, Bok R, Smith MR, Bulbey GJ, Rosen RT, DiPaola RS, Small EJ. Prospective, multicenter, randomized phase II trial of the herbal supplement, PC-SPES, and diethylstilbestrol in patients with androgen-independent prostate cancer. Journal of Clinical Oncology 2004;22(18):3705-3712.
  17. Guns ES, Goldenberg SL, Brown PN. Mass spectral analysis of PC-SPES confirms the presence of diethylstilbestrol. The Canadian Journal of Urology 2002;9(6):1684-1688.
  18. Ko R, Wilson RD, Loscutoff S. PC-SPES. Urology 2003;61:1292-1292.
  19. Walsh PC. Editorial comment on “Prospective, multicenter, randomized phase II trial of the herbal supplement, PC-SPES, and diethylstilbestrol in patients with androgen-independent prostate cancer”. The Journal of Urology 2005;173:1966-1967.
  20. de la Taille A, Hayek OR, Burchardt M, Burchardt T, Katz AE. Role of herbal compounds (PC-SPES) in hormone-refractory prostate cancer: Two case reports. The Journal of Alternative and Complementary Medicine 2000;6(5):449-451.
  21. Olaku O, White JD. Herbal therapy use by cancer patients: A literature review on case reports. European Journal of Cancer 2011;47:508-514.'
  22. Lock M, Loblaw DA, Choo R, Imrie K. Disseminated intravascular coagulation and PC-SPES: A case report and literature review. The Canadian Journal of Urology 2001;8(4):1326-1329.
  23. Oh WK, George DJ, Kantoff PW. Rapid rise of serum prostate specific antigen levels after discontinuation of the herbal therapy PC-SPES in patients with advanced prostate carcinoma: report of four cases. Cancer 2002;94(3):686-689.
  24. Moyad MA, Pienta KJ, Montie JE. Use of PC-SPES, a commercially available supplement for prostate cancer, in a patient with hormone-naive disease. Urology 1999;54(2):319-323.
  25. Weinrobe MC, Montgomery B. Acquired bleeding diathesis in a patient taking PC-SPES. The New England Journal of Medicine 2001;345(16):1213-1214.
  26. Cordell GA. PC-SPES: A brief overview. Integrative Cancer Therapies 2002;1(3):271-286.
  27. Das P, Kaplan I. The role of PC-SPES, selenium, and vitamin E in prostate cancer. Oncology 2002;16(3):285-291.
  28. Schiff JD, Ziecheck WS, Choi B. Pulmonary embolus related to PC-SPES use in a patient with PSA recurrence after radical prostatectomy. Urology 2002;59(3):444vii-444viii.
  29. Chaudhary UB, Rashid M, Keane TE. PC-SPES withdrawal response. Acta Oncologica 2004;43:772-773.