What is it ?
Scientific name(s)/brand name(s)/common name(s)
PC-SPES stands for prostate cancer (PC) and spes, which is the Latin word for hope. It was a patented dietary supplement, manufactured by BotanicLab, Brea, California, USA, but was recalled by the FDA due to contamination with prescription drugs in 2002 and is no longer officially available1,2. Active Botanicals Ltd (UK) has redeveloped PC-spes2, which is not yet commercially available. Other similar products claim to be the replacement supplement for PC-SPES, however, often different combinations of plants are used (for example Prostectan, Prostasol, PC-Care, PC-Hope)3.
The original PC-SPES capsules contained 320 mg of eight Chinese herbs: 25.6 mg Dendranthema morifolium or Chrysanthemum morifolium flower; 32.0 mg Isatis tinctoria or Isatis indigotica leaf (dyer’s woad or glastum); 3.2 mg Glycyrrhiza uralensis root (Chinese liquorice, not to be mistaken with Glycyrrhiza glabrum); 99.2 mg Ganoderma lucidum stem (also known as Lingzhi or Reishi mushroom); 25.6 mg Panax pseudoginseng root (not to be mistaken with Panax ginseng); 35.2 mg Rabdosia rubescens or Isodon rubescens leaf; 19.2 mg Serenoa repens berry (saw palmetto); and 51.2 mg Scutellaria baicalensis or Scutellaria laterifolia root (Baikal skullcap)4.
Application and dosage
The recommended dose for “prostate health” was three to six capsules of PC-SPES per day on an empty stomach.
History/provider(s) / Legal issues
PC-SPES was commercially available from 1996 to 2002, until the California Department of Health Services Food and Drug Branch discovered warfarin and indomethacin in PC-SPES capsules. Independent laboratories also found diethylstilbesterol in some samples2. It was recalled by the FDA and voluntarily withdrawn from the market by BotanicLab. However, it remains accessible through internet and telephone order 4. Recently Active Botanicals Ltd (UK) has redeveloped PC-spes2, which is standardized against five active ingredients (baicalin, oridonin, wogonin, isoliquiritigenin, and licochacone A), compared to only two in the old PC-SPES (baicalin and oridonin). Independent quality control demonstrated no contaminants5. This product is, however, not yet commercially available. Other similar products claiming to be substitutes of PC-SPES, can be purchased online (for example Prostectan, Prostasol, PC-Care).
Mechanism of action
Because of the combination of several plant extracts, multiple mechanisms of action can be responsible for the claimed anticancer activity. Most of the agents have shown in vitro activity, ranging from stimulation of natural killer-cell activity to growth inhibition of different cell lines6. There are components that show estrogenic activity or inhibit 5-alpha reductase6. The extracts can induce apoptosis and can suppress cell growth by restricting cell cycle progression at G(1)/S phase7,8.
Claims of efficacy / Alleged indication(s)
PC-SPES is commercialized for prostate health and strengthening of the immune system. Scientific research is investigating its efficacy in androgen-independent and androgen-dependent prostate cancer.
Prevalence of use
In 2002, approximately 10,000 patients with prostate cancer were using PC-SPES in addition to standard therapy or as a sole treatment6.
Cost(s) and expenditures
In 2002, a bottle of 60 capsules of PC-SPES cost US$ 108.
CitationLiene Dhooghe, CAM-Cancer Consortium. PC-SPES [online document]. http://www.cam-cancer.org/CAM-Summaries/Herbal-products/PC-SPES. August 21, 2013.
Assessed as up to date in August 2013 by Barbara Wider.
Summary first published in January 2012, authored by Liene Dhooghe.
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- 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.
- Natural Treatments for Prostate Cancer (available on the internet). As example: URL: http://health.groups.yahoo.com/group/natural_prostate_treatments/message/19573
- Lee CO. Complementary and alternative medicine patients are talking about: PC-SPES. Clinical Journal of Oncology Nursing 2005;9(1):113-114.
- Shabbir M, Love J, Montgomery B. Phase I trial of PC-spes2 in advanced hormone refractory prostate cancer. Oncology Reports 2008;19:831-835.
- Kosty MP. PC-SPES: Hope or hype? Journal of Clinical Oncology 2004;22(18):3657-3659.
- Yip I, Cudiamat M, Chim D. PC-SPES for treatment of prostate cancer: Herbal medicine. Current Urology Reports 2003;4:253-257.
- 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.
- 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.
- 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.
- 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.
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- 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.
- 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.
- 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.
- 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.
- 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.
- Ko R, Wilson RD, Loscutoff S. PC-SPES. Urology 2003;61:1292-1292.
- 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.
- 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.
- Olaku O, White JD. Herbal therapy use by cancer patients: A literature review on case reports. European Journal of Cancer 2011;47:508-514.'
- 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.
- 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.
- 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.
- Weinrobe MC, Montgomery B. Acquired bleeding diathesis in a patient taking PC-SPES. The New England Journal of Medicine 2001;345(16):1213-1214.
- Cordell GA. PC-SPES: A brief overview. Integrative Cancer Therapies 2002;1(3):271-286.
- Das P, Kaplan I. The role of PC-SPES, selenium, and vitamin E in prostate cancer. Oncology 2002;16(3):285-291.
- 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.
- Chaudhary UB, Rashid M, Keane TE. PC-SPES withdrawal response. Acta Oncologica 2004;43:772-773.
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