WARNING: PC-SPES® HAS BEEN RECALLED FROM THE U.S. MARKET AND SHOULD NOT BE USED.
Baicalein, baicalin, Chrysanthemum morifolium (chrysanthemum, mum, Chu-hua); Ganoderma lucidum (reishi mushroom, Ling Zhi), Glycyrrhiza glabra (licorice); Isatis indigotica Fort (Da Qing Ye, dyer's wood), Oridonin, Panax pseudo-ginseng (San Qi), PC-CARE, Ponicidin, Rabdosia rubescens (rubescens, Dong Ling Cao), S. baicalensis, Scutellaria baicalensis (skullcap, Huang-chin), Serenoa repens (saw palmetto).
Note: Not to be confused with SPES (a different product) or with copycat products marketed with similar names.
WARNING: THIS PRODUCT HAS BEEN RECALLED FROM THE U.S. MARKET AND SHOULD NOT BE USED.
PC-SPES® is an herbal combination product that was produced and marketed until early 2002 by BotanicLab, Inc. for the treatment of prostate cancer. The initials "PC" stand for "prostate cancer" and "spes" is Latin for hope.
Based on a Chinese herbal formula, the ingredients of PC-SPES® were officially listed as including Serenoa repens (saw palmetto) and seven other herbs: Chrysanthemum morifolium (chrysanthemum, mum, Chu-hua), Ganoderma lucidum (reishi mushroom, Ling Zhi), Glycyrrhiza glabra (licorice), Isatis indigotica Fort (Da Qing Ye, dyer's wood), Panax pseudo-ginseng (San Qi), Rabdosia rubescens (rubescens, Dong Ling Cao), and Scutellaria baicalensis (skullcap, Huang-chin).
In low quality studies, PC-SPES® was observed to reduce serum prostate specific antigen (PSA) levels, reduce evidence of metastatic disease, diminish pain, and improve quality of life in patients with prostate cancer. This evidence was viewed as promising by major U.S. cancer centers.
However, in early 2002, the U.S. Food and Drug Administration (FDA) Safety Information and Adverse Event Reporting Program issued a warning to consumers to avoid using PC-SPES® based on findings that the product contained the anticoagulant ("blood thinner") warfarin. Bleeding disorders had previously been reported with PC-SPES®. The manufacturer voluntarily recalled the product. Samples of PC-SPES® were later found to contain variable amounts of the non-steroidal anti-inflammatory drug indomethacin, the synthetic estrogen diethystilbesterol (DES), and the estrogen ethinyl estradiol.
A study published in the September 2002 issue of the Journal of the National Cancer Institute analyzed lots of PC-SPES® manufactured between 1996 and 2001. This evaluation found variable ingredients in PC-SPES® between lots, with higher levels of indomethacin and DES after 1999. These post-1999 samples were found to have much greater estrogenic properties compared to earlier samples, and to possess a higher level of activity against prostate cell lines in laboratory tests. After 2001, greater amounts of the natural constituents licochalcone A and baicalin, as well as warfarin, were found in samples. These results suggest that PC-SPES® produced at different times may not be equivalent or comparable, and that the "anti-cancer" effects of PC-SPES® may have been due to undeclared prescription drug ingredients.
Several other BotanicLab products have also been found to contain undeclared prescription drugs. It is not clear if these adulterants were present in raw materials obtained by BotanicLab from other sources or were added later in the manufacturing process.
Since BotanicLab closed its doors, several products with similar names have been introduced on the market, but none has been evaluated scientifically to the same extent as PC-SPES®. The National Center for Complementary and Alternative Medicine (NCCAM) has expressed willingness to support future research on formulations that are true to the claimed ingredients and proven not to be contaminated.