Herbal Remedy Offers Hope for Cancer Patients
Health: Formula yields results after other prostate treatments fail. But scientists urge
caution on unregulated medications.
Saturday, October 21, 2000
By SHARI ROAN, Times Health Writer
PC SPES is a over the counter dietary supplement that is becoming popular among men with prostate cancer.
GLENN KOENIG / Los Angeles Times
A centuries-old Chinese herbal remedy is showing striking results in treating patients with
advanced prostate cancer, even winning support from doctors despite a lack of federal oversight.
The blend of eight herbs, used by an estimated 10,000 men and sold over
the counter,
appears to reduce signs of tumor growth in patients who have exhausted all conventional
treatments, according to studies in two well-regarded medical journals.
"I can't cite any other example in medicine where we've considered
an herbal compound in an
end-stage cancer situation and where other therapies have already failed," said Dr. Aaron E.
Katz, an associate professor of urology at Columbia University College of Physicians and
Surgeons.
The new studies, including one by Katz, on the effect of the supplement
are almost certain to
spark widespread demand. Almost 180,000 new cases of prostate cancer are diagnosed each
year in the United States, with 40,000 deaths.
The product's potency, and the likelihood that its use will grow, sharply
highlight the disparity
between the heavy regulation that traditional drugs undergo and the virtual absence of regulation
of supplements.
"We don't even know what the [supplement's] long-term side effects
are,"
said Dr. Eric J. Small of UC San Francisco, coauthor of the other new study of the product, sold
as PC SPES.
"For [drugs], the United States has extremely stringent regulations
that are the envy of the
world," said Dr. Ian M. Thompson Jr., chief of urology at the University of Texas Health Science
Center in San Antonio. "But for something like this, we have no oversight."
Accordingly, many unanswered questions about PC SPES remain: For whom
is the remedy
best suited? What dose is correct? How does it compare with other treatments?
Physicians are also worried because the supplement carries the risk of
serious side effects.
Most common are breast tenderness and enlargement because of herbs that act like estrogen.
But 2% to 4% of patients also run the risk of blood clots, a potentially fatal problem, the studies
found.
Because of this risk, Katz and other doctors say the therapy should generally
be used only on
patients who have not been helped by hormone therapy--even though the herbal supplement
appears to reduce tumor growth in men with any stage or type of prostate cancer.
"This is not for someone in an early stage," Katz said. "We
don't have enough long-term
follow-up."
In his study of 69 men, published this month in the Journal of Urology,
88% of patients taking
the product experienced a significant drop in a protein called prostate specific antigen, or PSA,
which is a marker for tumor growth.
Similar results, reported by Small, will appear in the November issue
of the Journal of Clinical
Oncology. Although there have been a handful of earlier
papers on PC SPES, the two new studies are the first to examine the product in a large number
of men.
Both studies also found that the herbal remedy reduced prostate specific
antigen levels in men
who had received hormone therapy, a standard approach to halt advanced disease, but who
were still experiencing cancer growth. In Katz's group, 74% of those men responded to the
herbal therapy; 54% in Small's study.
"There is a subset of patients where the hormone therapy does not work and the
cancer continues to grow. That's the form of the disease that will eventually kill a patient,"
Katz
said. The herbal treatment "is effective in those patients."
Some studies have also shown a reduction in pain and tumor activity in
men whose cancer has
spread to the bone or brain.
The supplement's benefits may be another reason the product should not
be sold over the
counter, Thompson said. In an editorial in the Journal of Urology, he questions whether
consumers should have to pay as much as $450 a month for a potentially lifesaving therapy.
Over-the-counter herbal remedies are rarely covered by insurance plans. The supplement is sold
in bottles of 60 capsules at $108. A typical regimen consists of six to nine capsules a day.
"The efficacy and toxicity of PC SPES should be a call to action
for elected officials to
demand testing of agents . . . that by any other definition are truly pharmaceuticals," said
Thompson.
According to a Food and Drug Administration representative, the 1994 Dietary
Supplement
Health and Education Act bars makers of supplements from saying that their products "cure,
treat, prevent or mitigate disease." The FDA has the authority to enforce that law, but has little
additional power to regulate herbal supplements.
Efforts have been made to boost the regulators' authority--including a
federal proposal that
would require manufacturers to supply information about warnings or cautions surrounding a
supplement's use. But there has been no sustained movement in the United States to hold
supplements to the same testing and manufacturing laws as for drugs.
The federal government hasn't entirely ignored PC SPES. Earlier this month,
the National
Center for Complementary and Alternative Medicine, part of
the National Institutes of Health, authorized a study of the remedy at the Johns Hopkins Center
for Cancer Complementary Medicine.
But the studies lag behind the powerful anecdotal evidence for the therapy,
which has been on
the market since 1996.
Michael Cook, 49, was diagnosed at the age of 45 with prostate cancer
that had already
spread to his ribs and pelvis.
Cook, a former magazine publisher who lives in Brea, was told that his
only option was treatment with hormones, which he decided to forgo because studies have
shown that hormones may work for only a limited time. After trying numerous other alternative
remedies, his prostate specific antigen had skyrocketed and his bone pain had moved to his
back.
"Then I heard about PC SPES," Cook said. After a month on the
herbs, his antigen levels
dropped from 80 to 0.2, he said.
"My doctor was stupefied by it," he said. "I've been on
PC SPES for three years now, and I
seem to be in complete remission."
The blend of herbs was brought to this country by Allan X. Wang, a Chinese
herbal doctor
who learned the formula from a long line of healers in his family, including a great-grandfather
who ministered to the last Chinese emperor.
In 1987, Wang enlisted the talents of a Western-trained herbal specialist
to tweak the mixture
into its current formula.
PC SPES is now manufactured exclusively by privately held BotanicLab,
which is based in
Brea. Although under the law, supplement manufacturers can't claim to treat disease, BotanicLab
acknowledges that "PC" stands for prostate cancer. "Spes" is Latin for hope.
Copyright 2000 Los Angeles Times
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