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COMMENTS ON PC-SPES
The growing number of cancer patients, estimated presently in excess of 50%, not the least of which include those with prostate cancer, using complementary and alternative medicines continues to raise concern over their efficacy. Included therein, and specifically in the case of prostate cancer, has been the increased utilization of PC-SPES.
One can only hope that the independent reports in the medical literature by a number of investigators and patient advocates espousing the favorable effects of PC-SPES, were without knowledge of what now appears from recent reports to be adulterated (“spiked”) PC-SPES.
Analysis of several different lots of PC-SPES has disclosed the presence of powerful prescription drugs. Far from the heretofore referred to as “natural herbs” by the manufacturers, these range from diethylstilbestrol (DES) –a potent synthetic estrogenic drug- to the blood thinner warfarin and the anti-inflammatory agent indomethacin, an inhibitor of prostaglandins! Thus, and until proven otherwise, it appears that the adulterants, and not the “natural herbs” themselves, have been responsible for the impressive laboratory and clinical results seen with PC-SPES.
Based on the foregoing the FDA has issued a warning to consumers to stop taking PC-SPES. The principal manufacturer of PC-SPES, BotanicLab (Brea, California) has recalled PC-SPES following the identification of the contaminants by the California Department of Health.
Concerns raised earlier with the introduction of PC-SPES and its then suspect, but as yet not ascertained adulterants are:
• Really what is PC-SPES? If it is a “herbal cocktail” spiked with DES, than it should not (as discussed previously) be given to patients with a history of cardiovascular or thromboembolic disorders.
• And, if it is DES, than why spend approximately $300 per month for six capsules a day, i.e., $10 per day vs. taking DES at $1.50 per month or at a cost of 5˘ per day!
In follow-up to an earlier posting, recent studies point to the continuing use of PC-SPES, particularly among prostate cancer patients who do not respond to conventional therapies. Therein, the principle findings are significant reductions in levels of testosterone (to anorchid levels) and of PSA. It is further noted that associated adverse reactions continue, which include pulmonary emboli, hypertriglyceridemia, leg cramps, nausea, diarrhea, impotence, hot flushes and breast tenderness, all of which are similar to those observed with the former prevalent use of DES.
Clinical and post-mortem studies of cancer patients disclose the incidence of venous and arterial thrombosis to be as high as 10 and 50%, respectively. Deep vein thrombosis and pulmonary emboli are the most common forms reported as a significant cause of death in hospitalized cancer patients.
Malignant cells are known to express and release multiple factors which activate the coagulation cascade, e.g., elevated fibrinogen, its degradation products and thrombocytosis are routinely observed in up to 90% of patients with cancer. These abnormalities do not correlate with the development of clinical thrombosis and the definitive mechanisms of hypercoagulability in malignancy remains to be delineated, However, any circumstances which would exacerbate these and/or other predisposing factors would logically seem to be contraindicated. But then, if reason and logic prevailed, men, and not women, would ride a horse side-saddle!