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Rapid rise of serum prostate specific antigen levels after discontinuation of the herbal therapy PC‐SPES in patients with advanced prostate carcinoma
Author(s) -
Oh William K.,
George Daniel J.,
Kantoff Philip W.
Publication year - 2002
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.10269
Subject(s) - medicine , prostate specific antigen , prostate , discontinuation , prostate carcinoma , carcinoma , oncology , prostate cancer , urology , cancer
BACKGROUND PC‐SPES is an herbal supplement whose mechanisms of action are poorly understood, but may be estrogenic. The objective of the current report is to describe the effects of discontinuing PC‐SPES treatment in four patients with androgen‐independent prostate carcinoma. METHODS Patient charts were retrospectively reviewed. A MEDLINE search was performed to investigate whether these effects of PC‐SPES had been previously reported. RESULTS Four men whose metastatic prostate carcinoma progressed despite androgen ablation and subsequent PC‐SPES treatment are described. All four patients developed a rapid increase in serum prostate specific antigen (PSA) within one month of stopping PC‐SPES, ranging from 345% to 880%. Two patients increased their PSA levels to 1300% and 1400% after 7 weeks. Compared to the rate of rise of PSA levels prior to and during PC‐SPES therapy, the rise after stopping this treatment was much higher than expected. Clinical symptoms remained relatively stable despite the serologic changes. CONCLUSIONS Discontinuing PC‐SPES therapy can be associated with a rapid rise in PSA. To the authors' knowledge, this effect has not been reported previously. This effect should be considered in the design of clinical trials as well as in the standard management of androgen‐independent prostate carcinoma patients. Cancer 2002;94:686–9. © 2002 American Cancer Society. DOI 10.1002/cncr.10269