Original Article
Clinical and Biologic Activity of an Estrogenic Herbal Combination (PC-SPES) in Prostate Cancer
N Engl J Med 1998; 339:785-791September 17, 1998
- Abstract
Background
Herbal mixtures are popular alternatives to demonstrated therapies. PC-SPES, a commercially available combination of eight herbs, is used as a nonestrogenic treatment for cancer of the prostate. Since other herbal medicines have estrogenic effects in vitro, we tested the estrogenic activity of PC-SPES in yeast and mice and in men with prostate cancer.
Methods
We measured the estrogenic activity of PC-SPES with transcriptional-activation assays in yeast and a biologic assay in mice. We assessed the clinical activity of PC-SPES in eight patients with hormone-sensitive prostate cancer by measuring serum prostate-specific antigen and testosterone concentrations during and after treatment.
Results
In complementary yeast assays, a 1:200 dilution of an ethanol extract of PC-SPES had estrogenic activity similar to that of 1 nM estradiol, and in ovariectomized CD-1 mice, the herbal mixture increased uterine weights substantially. In six of six men with prostate cancer, PC-SPES decreased serum testosterone concentrations (P<0.05), and in eight of eight patients it decreased serum concentrations of prostate-specific antigen. All eight patients had breast tenderness and loss of libido, and one had venous thrombosis. High-performance liquid chromatography, gas chromatography, and mass spectrometry showed that PC-SPES contains estrogenic organic compounds that are distinct from diethylstilbestrol, estrone, and estradiol.
Conclusions
PC-SPES has potent estrogenic activity. The use of this unregulated mixture of herbs may confound the results of standard or experimental therapies and may produce clinically significant adverse effects.
Media in This Article
Figure 3
Results of High-Performance Liquid Chromatography, Gas Chromatography, and Mass Spectrometry of PC-SPES and the Estrogens Estrone, Estradiol, and Diethylstilbestrol (DES).Figure 2
Effect of PC-SPES on the Growth of the PL3 Strain of S. cerevisiae. Article Activity
- Article
Herbal therapies are unconventional treatments in wide use for many diseases. They are sold as nutritional supplements for numerous illnesses, including the common cold (echinacea),1 benign prostatic hypertrophy (saw palmetto),2 and depression (Saint Johnswort).3 Among patients with cancer, the use of unconventional medicines, including herbal therapies, has been reported to be as low as 5 percent and as high as 60 percent.4,5 PC-SPES is an herbal combination used by patients with prostate cancer that consists of eight herbs: chrysanthemum, isatis, licorice, Ganoderma lucidum, Panax pseudo-ginseng, Rabdosia rubescens, saw palmetto, and scutellaria (skullcap).6-8
Herbal therapies can have important biologic activities. For example, saw palmetto inhibits 5α-reductase, an enzyme involved in testosterone metabolism,9 and Saint Johnswort, like pharmacologic antidepressants, blocks monoamine oxidase activity.10 Although PC-SPES is promoted as a nonestrogenic food supplement, some of its constituents have estrogenic activity.6-8 Licorice competes with estradiol in an estrogen-receptor–binding assay,11 and ginseng induces estrogen-regulated expression of pS2, a small protein found in breast cancer, in cultured MCF-7 breast-cancer cells.12 The clinical implications of such activities are unknown.
We recently observed that PC-SPES had clinical activity in a man with prostate cancer that had recurred after radical prostatectomy. His prostate-specific antigen concentration was 34 ng per milliliter when he started taking PC-SPES, without concurrent therapies. After one month, he reported breast tenderness and loss of libido, and his prostate-specific antigen had decreased to 0.4 ng per milliliter. These findings prompted a study to determine the mechanism of these effects. Our results indicate that PC-SPES has estrogenic activity, reduces concentrations of serum testosterone, exerts activity against prostate cancer, and causes untoward side effects.
Methods
Materials
PC-SPES was purchased from Botaniclab (Brea, Calif.) in the form of 320-mg capsules for laboratory and clinical studies. To determine whether the composition of PC-SPES varied from lot to lot, we made four separate purchases of PC-SPES and analyzed each batch. Ginseng (Action Labs, Long Island, N.Y.) and saw palmetto (Fingerprint Botanicals, General Nutrition, Pittsburgh) were purchased from a health-food vendor. Stock solutions of PC-SPES and herbal extracts were prepared by exposing them to ethanol (dilution, 1:10 wt/vol) for 24 hours. Estrone, 17β-estradiol, and diethylstilbestrol were purchased from Sigma Chemical (St. Louis). Ovariectomized CD-1 mice (weight, 18 to 20 g) were purchased from Charles River Laboratories (Wilmington, Mass.) and housed under standard conditions in the Robert Wood Johnson Medical School vivarium.
Estrogen-Receptor Activity and Estrogen-Dependent Growth
The estrogenic activity of PC-SPES was assessed with a β-galactosidase assay with the yeast strain Y253 (ura3–52,his3–Δ200, leu2–Δ1,lys2–801,ade2–101,yap1::leu2). In Y253, two plasmids were introduced. One is the plasmid YEp90HEGO, which expresses the human estrogen receptor α. The other plasmid (PYER1) carries the lacZ gene, which encodes the enzyme β-galactosidase. In this plasmid, the upstream activating sequence of the gene was replaced by two estrogen-response elements. In this system, β-galactosidase activity is proportional to the degree of activation of estrogen-response elements.13
A complementary growth-based assay used the Saccharomyces cerevisiae strain PL3 (ura3–Δ1,his3–Δ200,leu2–Δ1,trp1::3ERE–URA3), which was a gift of Dr. R. Losson.13 PL3 carries a URA3 gene that is under the control of the estrogen-response element. Transcription of URA3, which is required for the growth of the cells in medium lacking uracil, is dependent on the activation of the human estrogen receptor by a ligand. Cells were seeded in 96-well plates in 190 μl of medium lacking uracil. Serial dilutions of 10 μl of 17β-estradiol or PC-SPES extract were added to the cultures, and growth was observed for four days.
Studies in Animals
Ovariectomized CD-1 mice received 1 ml of either a suspension of PC-SPES (five mice) or vehicle alone (five) orally on days 0, 1, 2, and 3. The suspension contained five capsules of PC-SPES ground into powder and suspended in 20 ml of an aqueous solution containing 5 percent gum arabic. Three additional animals received no treatment throughout the course of the experiment. On day 4, the animals were weighed and then killed by cervical dislocation. The uteri were removed and weighed. All studies in animals were approved by the institutional animal care and use committee of the Robert Wood Johnson Medical School.
High-Performance Liquid Chromatography, Gas Chromatography, and Mass Spectrometry
PC-SPES capsules were treated with 5 ml of 100 percent ethanol, the insoluble herbal residues were precipitated by centrifugation at 3500 rpm for 20 minutes, and the ethanol extract was dried under a stream of nitrogen. The dried residues were dissolved in 1 ml of ethanol and filtered through 0.45-μm cellulose acetate membranes, and 40-μl aliquots were analyzed by high-performance liquid chromatography as previously described.14,15 Elutants were collected from the column, dried under a stream of nitrogen, and analyzed by gas chromatography and mass spectrometry. The dried elutants were redissolved in 30 μl of ethyl acetate and exposed to 50 μl of bis(trimethylsilyl)trifluoroacetamide at 68°C for 45 minutes. Gas chromatography and mass spectrometry were performed on a Varian Star gas chromatograph (model 3400, Varian, Walnut Creek, Calif.) coupled with a Varian Saturn ion-trap mass spectrometer (model 2000, Varian). A 30 m by 0.32 mm by 0.25 μm DB-5 capillary column (J and W Scientific, Folsom, Calif.) was used for the separation. The 3-μl sample was injected into the gas chromatograph at a temperature of 280°C. The column temperature was programmed to increase from 35°C to 300°C over a period of 55 minutes. The mass spectrometer was set to scan particles with a mass-to-charge ratio ranging from 17 to 600 every 0.6 second.
Clinical Studies
We studied eight patients: seven were enrolled in an observational study approved by the institutional review board at Robert Wood Johnson Medical School, and one met eligibility requirements before the study began (Patient 1). All eight patients had histologically proved prostate cancer, without progression during previous androgen-ablation therapy. The patients were required to have taken PC-SPES for at least one month and to have taken a minimum of four 320-mg capsules of PC-SPES daily for two weeks. During the study they could not receive any standard forms of androgen-ablation therapy. The effects of PC-SPES were assessed with a standardized questionnaire. Serum prostate-specific antigen and testosterone concentrations were measured while the patients were taking PC-SPES and two to six weeks after they had stopped taking the preparation. Pretreatment prostate-specific antigen concentrations were obtained from the patients' records.
Statistical Analysis
Data are presented as means ±SE. The uterine weights in the animals were compared with use of the Wilcoxon rank-sum test. The patients' prostate-specific antigen and testosterone values were compared with use of the Wilcoxon signed-rank test. All P values were two-sided.
Results
Estrogenic Activity in Yeast
We used two yeast strains to measure the estrogenic activity of PC-SPES. First, Y253 yeast harboring the lacZ gene under the control of the human estrogen receptor was treated with PC-SPES or estradiol. The PC-SPES extract caused a dose-dependent increase in β-galactosidase activity (Figure 1AFigure 1
Effect of PC-SPES and Estradiol on β-Galactosidase Activity of Y253 Yeast with a lacZ Construct Downstream of a Human Estrogen-Response Element.). A 1:200 dilution of the extract had estrogenic activity equivalent to that of 1 nM estradiol (Figure 1A and Figure 1B).We next analyzed the effects of estradiol and PC-SPES on the growth of the estrogen-dependent S. cerevisiae strain PL3. An ethanol extract from four separate batches of PC-SPES (1:200 dilution) or 1 nM estradiol supported the growth of PL3 in uracil-deficient medium (Figure 2Figure 2
Effect of PC-SPES on the Growth of the PL3 Strain of S. cerevisiae. ). Table 1Table 1
Effect of Herbal Extracts and Estradiol on the Growth of Estrogen-Dependent Yeast. shows that all four batches of highly dilute PC-SPES extract (1:20,000) supported the growth of PL3. Estradiol supported growth of the yeast at a minimal concentration of 1×10–5 nM. Growth was not supported by herbal extracts of saw palmetto or ginseng.Estrogenic Activity in Animals
To determine whether PC-SPES has estrogenic activity in animals, we treated ovariectomized CD-1 mice with 1 ml of a suspension of PC-SPES or vehicle daily for four days. As shown in Table 2Table 2
Effect of PC-SPES in Mice., animals given PC-SPES had a mean uterine weight of 76.9±12.1 mg, as compared with a weight of 18.5±3.2 mg in mice given vehicle (P=0.008) and 19.5±2.8 mg in untreated animals.Effect of PC-SPES on Serum Testosterone and Prostate-Specific Antigen in Patients with Prostate Cancer
We evaluated the activity of PC-SPES in eight patients with biopsy-proved prostate cancer before and during treatment with PC-SPES and in six patients two to six weeks after treatment was stopped (Table 3Table 3
Effect of PC-SPES on Testosterone and Prostate-Specific Antigen Concentrations.). Serum testosterone concentrations decreased during the use of PC-SPES and increased within three weeks after PC-SPES was discontinued (P<0.05) (Table 3). The mean testosterone concentration was 237.0±81 ng per deciliter (822±281 nmol per liter; range, 25 to 494 ng per deciliter [87 to 1713 nmol per liter]) during treatment and 879±144 ng per deciliter (3047±499 nmol per liter; range, 301 to 1324 ng per deciliter [1044 to 4590 nmol per liter]) after treatment was discontinued. The serum testosterone concentration was below the normal reference range in four of the eight patients, and in two patients (Patients 1 and 3 in Table 3) it was below 30 ng per deciliter (104 nmol per liter), a concentration similar to that in patients receiving a standard regimen of androgen-ablation therapy.16 Serum testosterone concentrations were within the normal reference range in four patients during treatment with PC-SPES (Patients 4, 5, 6, and 8 in Table 3) and increased within three weeks if the treatment was discontinued.The serum prostate-specific antigen concentration was assessed before and during the use of PC-SPES. It decreased in all eight patients after the initiation of treatment with PC-SPES (Table 3), whether the initial concentration was high (as in Patients 1 and 3) or low (as in Patient 8). The concentration began to increase within three weeks after PC-SPES was discontinued (Table 3).
Other clinical effects observed during PC-SPES use were similar to those observed with pharmacologic doses of estrogen.16-18 All eight patients had breast tenderness and loss of libido. One patient had a superficial venous thrombosis after taking nine capsules of PC-SPES per day for more than one month. No other serious adverse effects were noted.
Composition of PC-SPES
We used high-performance liquid chromatography to analyze the composition of PC-SPES. Representative chromatograms for estrone, estradiol, and diethylstilbestrol are shown in Figure 3AFigure 3
Results of High-Performance Liquid Chromatography, Gas Chromatography, and Mass Spectrometry of PC-SPES and the Estrogens Estrone, Estradiol, and Diethylstilbestrol (DES).. High-performance liquid chromatography of PC-SPES demonstrated four peaks over a period of 53 to 64 minutes (Figure 3B). Elutants corresponding to each of these four peaks had estrogenic activity in the yeast-growth assay (data not shown).The peaks representing estrone and estradiol (Figure 3A) differed from the major peaks found in PC-SPES (Figure 3B). Since peak X of PC-SPES resembled that of diethylstilbestrol, we analyzed this peak using gas chromatography and mass spectrometry. Peak X elutants contained a mixture of organic chemicals (Figure 3D). Among them, only one peak (labeled peak Y in Figure 3D) resembled diethylstilbestrol (Figure 3C). In-line mass spectrometric analysis of this peak (inset in Figure 3D) showed that it differed from that of diethylstilbestrol (inset in Figure 3C).
Discussion
We found that PC-SPES, an unregulated herbal dietary supplement, has potent estrogenic activity in yeast, mice, and humans. In patients with prostate cancer, it causes clinically significant reductions in serum testosterone concentrations, decreases in prostate-specific antigen concentrations, and side effects similar to those of pharmacologic doses of estrogen.
In all eight patients we studied, PC-SPES reduced serum testosterone concentrations to levels shown in the randomized trial by the Leuprolide Study Group to have antitumor activity.16 PC-SPES also reduced the serum prostate-specific antigen concentration in all eight patients; moreover, in the six patients who stopped taking PC-SPES, prostate-specific antigen increased within two to six weeks after treatment was discontinued (Table 3). The magnitude of this effect varied, perhaps because of the wide range of initial prostate-specific antigen values or differences in the types of local therapy the patients had received. The increase in prostate-specific antigen after the discontinuation of PC-SPES occurred at about the same time as the increase in testosterone. For example, three weeks after Patient 1 stopped taking PC-SPES, the testosterone concentration had increased from 25 to 674 ng per deciliter (87 to 2337 nmol per liter) and the prostate-specific antigen concentration had increased from 0.4 ng per milliliter to 5.4 ng per milliliter, with an increase to 17.0 ng per milliliter at six weeks.
Previous studies of patients with prostate cancer have shown that the effects of pharmacologic doses of estrogen are similar to those of PC-SPES.16-19 Our study assessed patients whose tumors were not known to be refractory to androgen-ablation therapy; the effects of PC-SPES on cancer that is refractory to hormone therapy and whether tumors would become resistant to the effects of this compound are unknown.20
The adverse effects of PC-SPES were similar to those of estrogen. All patients in our study experienced impotence and breast tenderness, and one patient had a superficial venous thrombosis. Prior studies of estrogen therapy in men with prostate cancer have assessed the frequency of these effects.16-19 For example, the Leuprolide Study Group reported that 49 percent of patients who were treated with diethylstilbestrol for metastatic prostate cancer experienced breast tenderness, and 7 percent had venous thrombosis.16 Aprikian et al. also found that the most common adverse effect of diethylstilbestrol treatment was gynecomastia and that 2 of 55 patients had thrombosis (1 had a pulmonary embolus).18
Our laboratory data support the hypothesis that the clinical effects of PC-SPES are due at least in part to estrogenic activity. PC-SPES activates the human estrogen-response element in two yeast systems. The estrogenic activity of a 1:200 dilution of a stock extract of one 320-mg PC-SPES capsule was similar to that of 1 nM estradiol in both the yeast lacZ and growth assays. PC-SPES also had estrogenic activity in mice. Ovariectomized CD-1 mice given PC-SPES had significantly heavier uteri than control mice. Other groups have used this mouse model to study the estrogenicity of various compounds.15,21 The CD-1 mouse has also been used to study the teratogenic effects of estrogens.22,23 Prenatal exposure of CD-1 mice to diethylstilbestrol results in reproductive tract anomalies similar to those that occur in women who were exposed to diethylstilbestrol prenatally.23 Given the potential toxicity of PC-SPES in pregnant women, studies of this herbal combination in animal models are warranted.
Halicka et al. found that PC-SPES inhibited the growth of PC-3 cells (prostate-tumor cells) and MCF-7 cells (breast-tumor cells) in cell culture.7 Hsieh et al. demonstrated that PC-SPES decreased both the production of prostate-specific antigen and the expression of androgen receptors in cultures of LNCaP prostate-tumor cells.8 We do not know whether these effects of PC-SPES on cultured tumor cells are independent of estrogenic activity, since estrogen alone induces apoptosis in tumor-cell lines.24
PC-SPES has potent estrogenic activity and contains multiple organic compounds, but not the known estrogens estrone, estradiol, and diethylstilbestrol or chemicals with similar structures and metabolites. Since our laboratory found estrogenic activity in elutants of PC-SPES corresponding to separate peaks obtained from high-performance liquid chromatography, multiple phytoestrogens may be responsible for the observed activity. Our results suggest that PC-SPES may prove useful in the treatment of hormonally sensitive prostate cancer; but when used concurrently with standard or experimental therapies PC-SPES may confound the results. In addition, estrogens can have substantial toxic effects, and the safety of nutritional supplements with substantial estrogenic activity needs to be evaluated. These data demonstrate that unregulated, commercially available dietary supplements may have biologic activity that can affect diseases, standard medical therapy, and general health.
Supported in part by grants from the National Cancer Institute (NCI-CA72720, RO3-CA77133, and CA57142), Environmental and Occupational Health Sciences Institute (ES05022), and the Environmental Protection Agency (R825386-010).
We are indebted to L. Korn, Ph.D., Department of Environmental and Community Medicine and Center for Biostatistics, Robert Wood Johnson Medical School, for biostatistical analysis and to Ted Colterelli for collecting data on the patients.
Source Information
From the Departments of Medicine (R.S.D., E.L., M.M.R., B.T.Z., H.S., S.G., W.N.H., M.A.G.), Pediatrics (H.Z., G.H.L.), and Pharmacology (W.N.H.), University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, New Brunswick; the Cancer Institute of New Jersey, New Brunswick (R.S.D., G.H.L., R.M., E.L., M.M.R., B.T.Z., H.S., S.G., W.N.H., M.A.G.); and the Environmental and Occupational Health Sciences Institute, Piscataway, N.J. (H.Z., G.H.L., R.M., B.T.Z., M.B.T., M.A.G.).
Address reprint requests to Dr. DiPaola at the Cancer Institute of New Jersey, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, 195 Little Albany St., New Brunswick, NJ 08901.
- References
References
1
See DM ,Broumand N ,Sahl L ,Tilles JG . In vitro effects of echinacea and ginseng on natural killer and antibody-dependent cell cytotoxicity in healthy subjects and chronic fatigue syndrome or acquired immunodeficiency syndrome patients. Immunopharmacology 1997;35:229-235
CrossRef | Web of Science | Medline2
Carraro JC ,Raynaud JP ,Koch G , et al. Comparison of phytotherapy (Permixon) with finasteride in the treatment of benign prostate hyperplasia: a randomized international study of 1,098 patients. Prostate 1996;29:231-240
CrossRef | Web of Science | Medline3
Volz HP . Controlled clinical trials of hypericum extracts in depressed patients -- an overview. Pharmacopsychiatry 1997;30:Suppl 2:72-76
CrossRef | Web of Science | Medline4
Risberg T ,Lund E ,Wist E ,Kaasa S ,Wilsgaard T . Cancer patients use of nonproven therapy: a 5-year follow-up study. J Clin Oncol 1998;16:6-12
Web of Science | Medline5
Eisenberg DM ,Kessler RC ,Foster C ,Norlock FE ,Calkins DR ,Delbanco TL . Unconventional medicine in the United States: prevalence, costs, and patterns of use. N Engl J Med 1993;328:246-252
Full Text | Web of Science | Medline6
Fan S, Wang X. SPES, composition of herbal extracts: U.S. patent number 5,417,979. May 1995.
7
Halicka HD ,Ardelt B ,Juan G , et al. Apoptosis and cell cycle effects induced by extracts of the Chinese herbal preparation PC SPES. Int J Oncol 1997;11:437-438
Web of Science | Medline8
Hsieh T ,Chen SS ,Wang X ,Wu JM . Regulation of androgen receptor (AR) and prostate specific antigen (PSA) expression in the androgen-responsive human prostate LNCaP cells by ethanolic extracts of the Chinese herbal preparation, PC-SPES. Biochem Mol Biol Int 1997;42:535-544
Medline9
Delos S ,Carsol JL ,Ghazarossian E ,Raynaud JP ,Martin PM . Testosterone metabolism in primary cultures of human prostate epithelial cells and fibroblasts. J Steroid Biochem Mol Biol 1995;55:375-383
CrossRef | Web of Science | Medline10
Cott JM . In vitro receptor binding and enzyme inhibition by Hypericum perforatum extract. Pharmacopsychiatry 1997;30:Suppl 2:108-112
CrossRef | Web of Science | Medline11
Zava DT ,Blen M ,Duwe G . Estrogenic activity of natural and synthetic estrogens in human breast cancer cells in culture. Environ Health Perspect 1997;105:Suppl 3:637-645
CrossRef | Web of Science | Medline12
Duda RB ,Taback B ,Kessel B , et al. pS2 expression induced by American ginseng in MCF-7 breast cancer cells. Ann Surg Oncol 1996;3:515-520
CrossRef | Web of Science | Medline13
Pierrat B ,Heery DM ,Lemoine Y ,Losson R . Functional analysis of the human estrogen receptor using a phenotypic transactivation assay in yeast. Gene 1992;119:237-245
CrossRef | Web of Science | Medline14
Suchar LA ,Chang RL ,Rosen RT ,Lech J ,Conney AH . High-performance liquid chromatography separation of hydroxylated estradiol metabolites: formation of estradiol metabolites by liver microsomes from male and female rats. J Pharmacol Exp Ther 1995;272:197-206
Web of Science | Medline15
Zhu BT ,Lech J ,Rosen RT ,Conney AH . Effect of dietary 2(3)-tert-butyl-4-hydroxyanisole on the metabolism and action of estradiol and estrone in female CD-1 mice. Cancer Res 1997;57:2419-2427
Web of Science | Medline16
The Leuprolide Study Group
Full Text | Web of Science | Medline17
Droz JP ,De Smedt E ,Kattan J , et al. Phase I trial of high-dose fosfestrol in hormone-refractory adenocarcinoma of the prostate. Prostate 1994;24:62-66
CrossRef | Web of Science | Medline18
Aprikian AG ,Fair WR ,Reuter VE , et al. Experience with neoadjuvant diethylstilboestrol and radical prostatectomy in patients with locally advanced prostate cancer. Br J Urol 1994;74:630-636
CrossRef | Medline19
Citrin DL ,Kies MS ,Wallemark CB , et al. A phase II study of high-dose estrogens (diethylstilbestrol diphosphate) in prostate cancer. Cancer 1985;56:457-460
CrossRef | Web of Science | Medline20
McDonnell TJ ,Troncoso P ,Brisbay SM , et al. Expression of the protooncogene bcl-2 in the prostate and its association with emergence of androgen-independent prostate cancer. Cancer Res 1992;52:6940-6944
Web of Science | Medline21
Fielden MR ,Chen I ,Chittim B ,Safe SH ,Zacharewski TR . Examination of the estrogenicity of 2,4,6,2'6'-pentachlorobiphenyl (PCB 104), its hydroxylated metabolite 2,4,6,2'6'-pentachloro-4-biphenylol (HO-PCB 104), and a further chlorinated derivative, 2,4,6,2'4'6'-hexachlorobiphenyl (PCB 155). Environ Health Perspect 1997;105:1238-1248
CrossRef | Web of Science | Medline22
Walker BE . Uterine tumors in old female mice exposed prenatally to diethylstilbestrol. J Natl Cancer Inst 1983;70:477-484
Web of Science | Medline23
Walker BE . Complications of pregnancy in mice exposed prenatally to DES. Teratology 1983;27:73-80
CrossRef | Medline24
Robertson CN ,Roberson KM ,Padilla GM , et al. Induction of apoptosis by diethylstilbestrol in hormone-insensitive prostate cancer cells. J Natl Cancer Inst 1996;88:908-917
CrossRef | Web of Science | Medline
- Citing Articles (132)
Citing Articles
1
Aung Naing, Saneese K. Stephen, Moshe Frenkel, Chandtip Chandhasin, David S. Hong, Xiudong Lei, Gerald Falchook, Jennifer J. Wheler, Siqing Fu, Razelle Kurzrock. (2011) Prevalence of complementary medicine use in a phase 1 clinical trials program. Cancer 117:22, 5142-5150
CrossRef2
F L Bishop, A Rea, H Lewith, Y K Chan, J Saville, P Prescott, E von Elm, G T Lewith. (2011) Complementary medicine use by men with prostate cancer: a systematic review of prevalence studies. Prostate Cancer and Prostatic Diseases 14:1, 1-13
CrossRef3
Mi Ra Seon, So Young Park, Soo Jin Kwon, Soon Sung Lim, Hyun Ju Choi, Heesook Park, Do Young Lim, Jong-Sang Kim, Choong Hwan Lee, Jongdai Kim, Jung Han Yoon Park. (2011) Hexane/ethanol extract of Glycyrrhiza uralensis and its active compound isoangustone A induce G1 cycle arrest in DU145 human prostate and 4T1 murine mammary cancer cells. The Journal of Nutritional Biochemistry
CrossRef4
Hui-Man Cheng, Chia-Cheng Li, Calvin Yu-Chian Chen, Hsin-Yi Lo, Wen-Yu Cheng, Chang-Hsien Lee, Shi-Zhe Yang, Shih-Lu Wu, Chien-Yun Hsiang, Tin-Yun Ho. (2010) Application of bioactivity database of Chinese herbal medicine on the therapeutic prediction, drug development, and safety evaluation. Journal of Ethnopharmacology 132:2, 429-437
CrossRef5
S. Khady Ndao-Brumblay, Carmen R. Green. (2010) Predictors of Complementary and Alternative Medicine Use in Chronic Pain Patients. Pain Medicine 11:1, 16-24
CrossRef6
Xuemei Liu, Mingming Zhang, Bo Jin, Mingming Zhang. 2009. Chinese herbs for symptom palliation in patients with lung cancer. .
CrossRef7
Chao Liu, Junmin Chen, Yanqiu Gao, Bao Deng, Kunshen Liu, Chao Liu. 2009. Endothelin receptor antagonists for pulmonary arterial hypertension. .
CrossRef8
Yong-Chun Li, Kyoung-Hee Kim, Hong-De Xu, Dae-Hun Park, Yeon-Shik Choi, Hye-Rim Hwang, Min-Jae Lee, Jong-Jin Choi, Myung-Sang Kwon, Hong-Sun Yook. (2009) Antioxidative Effects and Anti-proliferative Effects of MeOH, BuOH and Ethyl Acetate Fractionated from Stephania delavayi Diels. Journal of the Korean Society of Food Science and Nutrition 38:3, 297-301
CrossRef9
Jie Liu, Sadaaki Tamura, Kenji Kurashiki, Kuniyoshi Shimizu, Kiyoshi Noda, Fumiko Konishi, Shoichiro Kumamoto, Ryuichiro Kondo. (2009) Anti-Androgen Effects of Extracts and Compounds from Ganoderma lucidum. Chemistry & Biodiversity 6:2, 231-243
CrossRef10
Jessica Clement, Glenn Bubley. (2008) Prostasol and Venous Thromboembolism. Urology 72:3, 664-666
CrossRef11
Cesar Ramos-Remus, Ashwinikumar Raut. (2008) Complementary and alternative practices in rheumatology. Best Practice & Research Clinical Rheumatology 22:4, 741-757
CrossRef12
Eric Yarnell, Kathy Abascal. (2008) Holistic Approaches to Prostate Cancer. Alternative and Complementary Therapies 14:4, 164-180
CrossRef13
Marjan Nassiri Asl, Hossein Hosseinzadeh. (2008) Review of Pharmacological Effects ofGlycyrrhiza sp. and its Bioactive Compounds. Phytotherapy Research 22:6, 709-724
CrossRef14
Young-Gab Yun, Byung-Hun Jeon, Jong-Hyun Lee, Sun-Kyung Lee, Hwa-Jeong Lee, Kyung-Hee Jung, Jun-Lee, Chang-Duk Jun, Suk-Keun Lee, Eun-Cheol Kim. (2008) Verticinone induces cell cycle arrest and apoptosis in immortalized and malignant human oral keratinocytes. Phytotherapy Research 22:3, 416-423
CrossRef15
Won-Kyoung Shon, Chi-Heum Cho, Sabarish Ramachandran, Dae-Kyu Song, So-Jin Shin, Sang-Hoon Kwon, Soon Do Cha. (2008) Induction of apoptosis by Hibiscus protocatechuic acid in human uterine leiomyoma cells. Korean Journal of Gynecologic Oncology 19:1, 48
CrossRef16
Jie Liu, Kuniyoshi Shimizu, Fumiko Konishi, Kiyoshi Noda, Shoichiro Kumamoto, Kenji Kurashiki, Ryuichiro Kondo. (2007) Anti-androgenic activities of the triterpenoids fraction of Ganoderma lucidum. Food Chemistry 100:4, 1691-1696
CrossRef17
J. Daniell Rackley, Peter E. Clark, M. Craig Hall. (2006) Complementary and Alternative Medicine for Advanced Prostate Cancer. Urologic Clinics of North America 33:2, 237-246
CrossRef18
Timothy J. Daskivich, William K. Oh. (2006) Recent progress in hormonal therapy for advanced prostate cancer. Current Opinion in Urology 16:3, 173-178
CrossRef19
Guru Sonpavde, Thomas E. Hutson, William R. Berry. (2006) Hormone refractory prostate cancer: Management and advances. Cancer Treatment Reviews 32:2, 90-100
CrossRef20
DiPaola, Robert S., Morton, Ronald A., . (2006) Proven and Unproven Therapy for Benign Prostatic Hyperplasia. New England Journal of Medicine 354:6, 632-634
Full Text21
Mark A. Moyad. (2005) Prescription versus herbal medications for prostate cancer prevention: Why history cannot be allowed to repeat itself in your clinical practice. Current Prostate Reports 3:4, 160-168
CrossRef22
Rumi Fujita, Jie Liu, Kuniyoshi Shimizu, Fumiko Konishi, Kiyoshi Noda, Shoichiro Kumamoto, Chie Ueda, Hisatoshi Tajiri, Shuhei Kaneko, Yoshitaro Suimi, Ryuichiro Kondo. (2005) Anti-androgenic activities of Ganoderma lucidum. Journal of Ethnopharmacology 102:1, 107-112
CrossRef23
S BROWNIE. (2005) The development of the US and Australian dietary supplement regulationsWhat are the implications for product quality?. Complementary Therapies in Medicine 13:3, 191-198
CrossRef24
Akiko Hara, Norio Iizuka, Yoshihiko Hamamoto, Shunji Uchimura, Takanobu Miyamoto, Ryouichi Tsunedomi, Koji Miyamoto, Shoichi Hazama, Kiwamu Okita, Masaaki Oka. (2005) Molecular dissection of a medicinal herb with anti-tumor activity by oligonucleotide microarray. Life Sciences 77:9, 991-1002
CrossRef25
David Sadava, Jennifer Winesburg. (2005) Contaminants of PC-SPES are not responsible for cytotoxicity in human small-cell lung carcinoma cells. Cancer Letters 220:2, 171-175
CrossRef26
Ching Hsaing Hsu, Chun Mei Lu, Tung Ti Chang. (2005) Efficacy and safety of modified Mai-Men-Dong-Tang for treatment of allergic asthma. Pediatric Allergy and Immunology 16:1, 76-81
CrossRef27
Chih-Jen Cheng, Yeong-Hwang Chen, Tom Chau, Shih-Hua Lin. (2004) A hidden cause of hypokalemic paralysis in a patient with prostate cancer. Supportive Care in Cancer 12:11, 810-812
CrossRef28
(2004) The Effects of Isoflavone Supplementation on Serum PSA, Lipid Profile, Antioxidant and Immune System in Prostate Cancer Patients. Journal of the Korean Society of Food Science and Nutrition 33:8, 1294-1301
CrossRef29
Yue Fu, Tze-chen Hsieh, Junqiao Guo, Jan Kunicki, Marietta Y.W.T. Lee, Zbigniew Darzynkiewicz, Joseph M. Wu. (2004) Licochalcone-A, a novel flavonoid isolated from licorice root (Glycyrrhiza glabra), causes G2 and late-G1 arrests in androgen-independent PC-3 prostate cancer cells. Biochemical and Biophysical Research Communications 322:1, 263-270
CrossRef30
Xuemei Liu, Mingming Zhang, Bo Jin, Mingming Zhang. 2004. Chinese herbs for symptom palliation in patients with lung cancer. .
CrossRef31
Shuk-Mei Ho. (2004) Estrogens and anti-estrogens: Key mediators of prostate carcinogenesis and new therapeutic candidates. Journal of Cellular Biochemistry 91:3, 491-503
CrossRef32
Jian Ping Liu, Lise Lotte Gluud, Bodil Als-Nielsen, Christian Gluud, Jian Ping Liu. 2004. Artificial and bioartificial support systems for liver failure. .
CrossRef33
Ichinosuke HYODO. (2004) Complementary and Alternative Medicine in Cancer Treatment. Japanese Journal of Complementary and Alternative Medicine 1:1, 7-15
CrossRef34
Mohamed M Rafi. (2004) Elucidating the role of nutraceuticals in overexpressing antiapoptotic proteins in prostate cancer. Nutrition 20:1, 78-82
CrossRef35
Colin G. Rousseaux, Howard Schachter. (2003) Regulatory issues concerning the safety, efficacy and quality of herbal remedies. Birth Defects Research Part B: Developmental and Reproductive Toxicology 68:6, 505-510
CrossRef36
S.M. BIERS, S.F. BREWSTER. (2003) The use of aspirin with PC-SPES may not prevent pulmonary embolism. BJU International 92, e28-e28
CrossRef37
Norio Iizuka, Masaaki Oka, Kotaro Yamamoto, Akira Tangoku, Koji Miyamoto, Takanobu Miyamoto, Shunji Uchimura, Yoshihiko Hamamoto, Kiwamu Okita. (2003) Identification of common or distinct genes related to antitumor activities of a medicinal herb and its major component by oligonucleotide microarray. International Journal of Cancer 107:4, 666-672
CrossRef38
Robert S. DiPaola, Henry J. Durivage, Barton A. Kamen. (2003) High time for low-dose prospective clinical trials. Cancer 98:8, 1559-1561
CrossRef39
S.-C. Teng, H.-J. Tsai, M.-C. Tsai, W.-M. Lee, I.-C. Chen, C.-C. Lin. (2003) Using Both Chemical and Biological Fingerprints for the Quality Study of Estrogenic Licorice (Glycyrrhiza uralensis). Journal of Food Science 68:7, 2372-2377
CrossRef40
R.P Smith, P Devine, H Jones, A DeNittis, R Whittington, J.M Metz. (2003) Internet use by patients with prostate cancer undergoing radiotherapy. Urology 62:2, 273-277
CrossRef41
Daniel Sliva, Miroslav Sedlak, Veronika Slivova, Tatiana Valachovicova, Frank P. Lloyd, Nancy W.Y. Ho. (2003) Biologic Activity of Spores and Dried Powder from Ganoderma lucidum for the Inhibition of Highly Invasive Human Breast and Prostate Cancer Cells. The Journal of Alternative and Complementary Medicine 9:4, 491-497
CrossRef42
Kang-Beom Kwon, Eun-Kyung Kim, Byung-Cheul Shin, Eun-A Seo, Jin-Woo Park, Jong-Suk Kim, Byung-Hyun Park, Do-Gon Ryu. (2003) Induction of apoptosis by takrisodokyeum through generation of hydrogen peroxide and activation of caspase-3 in HL-60 cells. Life Sciences 73:15, 1895-1906
CrossRef43
Richard Ko, Raymond D. Wilson, Susan Loscutoff. (2003) PC-SPES. Urology 61:6, 1292
CrossRef44
Cynthia L Martel, Paul H Gumerlock, Frederick J Meyers, Primo N Lara. (2003) Current strategies in the management of hormone refractory prostate cancer. Cancer Treatment Reviews 29:3, 171-187
CrossRef45
Barrie R Cassileth, Andrew J Vickers. (2003) Complementary and alternative therapies. Urologic Clinics of North America 30:2, 369-376
CrossRef46
Ian Yip, Michelle Cudiamat, David Chim. (2003) PC-SPES for treatment of prostate cancer: Herbal medicine. Current Urology Reports 4:3, 253-257
CrossRef47
Motohiro Kanazawa, Yoshiko Satomi, Yoichi Mizutani, Osamu Ukimura, Akihiro Kawauchi, Toshiyuki Sakai, Masaki Baba, Toru Okuyama, Hoyoku Nishino, Tsuneharu Miki. (2003) Isoliquiritigenin Inhibits the Growth of Prostate Cancer. European Urology 43:5, 580-586
CrossRef48
John F Ward, Michael L Blute. (2003) Chemoprevention of prostate cancer. Expert Review of Anticancer Therapy 3:2, 203-214
CrossRef49
Monte S. Willis, Frank H. Wians. (2003) The role of nutrition in preventing prostate cancer: a review of the proposed mechanism of action of various dietary substances. Clinica Chimica Acta 330:1-2, 57-83
CrossRef50
DAVID J.A. JENKINS, CYRIL W.C. KENDALL, MARIO A. D’COSTA, CHUNG-JA JACKSON, EDWARD VIDGEN, WILLIAM SINGER, JASON A. SILVERMAN, GEORGE KOUMBRIDIS, JOHN HONEY, A. VENKET RAO, NEIL FLESHNER, LAURENCE KLOTZ. (2003) Soy Consumption and Phytoestrogens: Effect on Serum Prostate Specific Antigen When Blood Lipids and Oxidized Low-Density Lipoprotein are Reduced in Hyperlipidemic Men. The Journal of Urology 169:2, 507-511
CrossRef51
Ioana Bica, Alice M. Tang, Sarah Skinner, Donna Spiegelman, Tamsin Knox, Sherwood Gorbach, Ira B. Wilson. (2003) Use of Complementary and Alternative Therapies by Patients With Human Immunodeficiency Virus Disease in the Era of Highly Active Antiretroviral Therapy. The Journal of Alternative and Complementary Medicine 9:1, 65-76
CrossRef52
Alice L. Murkies, Mark Frydenberg. 2003. Phytoestrogens. , 192-201.
CrossRef53
Roderich E. Schwarz, Cecile A. Donohue, David Sadava, Susan E. Kane. (2003) Pancreatic cancer in vitro toxicity mediated by Chinese herbs SPES and PC-SPES: implications for monotherapy and combination treatment. Cancer Letters 189:1, 59-68
CrossRef54
Mary Ann Richardson, Stephen E Straus. (2002) Complementary and alternative medicine: Opportunities and challenges for cancer management and research. Seminars in Oncology 29:6, 531-545
CrossRef55
Grace Powers Monaco, Gilbert Smith. (2002) Informed consent in complementary and alternative medicine: Current status and future needs. Seminars in Oncology 29:6, 601-608
CrossRef56
William K Oh, Eric J Small. (2002) Complementary and alternative therapies in prostate cancer. Seminars in Oncology 29:6, 575-584
CrossRef57
W. Reid Pitts. (2002) RE: EDITORIAL COMMENT. The Journal of Urology2131
CrossRef58
W. Reid Pitts. (2002) RE: EDITORIAL COMMENT: RE: DIETHYLSTILBESTEROL REVISITED: ANDROGEN DEPRIVATION, OSTEOPOROSIS AND PROSTATE CANCER. The Journal of Urology 168:5, 2131
CrossRef59
Daniel Sliva, Carlos Labarrere, Veronika Slivova, Miroslav Sedlak, Frank P Lloyd, Nancy W.Y Ho. (2002) Ganoderma lucidum suppresses motility of highly invasive breast and prostate cancer cells. Biochemical and Biophysical Research Communications 298:4, 603-612
CrossRef60
Zongwei Cai, F. S. C. Lee, X. R. Wang, W. J. Yu. (2002) A capsule review of recent studies on the application of mass spectrometry in the analysis of Chinese medicinal herbs. Journal of Mass Spectrometry 37:10, 1013-1024
CrossRef61
M. M. Lee, J. S. Chang, B. Jacobs, M. R. Wrensch. (2002) Complementary and Alternative Medicine Use Among Men With Prostate Cancer in 4 Ethnic Populations. American Journal of Public Health 92:10, 1606-1609
CrossRef62
Leonard S Marks, Robert S DiPaola, Peter Nelson, Sophie Chen, David Heber, Arie S Belldegrun, Franklin C Lowe, John Fan, Floyd E Leaders, Allan J Pantuck, Varro E Tyler. (2002) PC-SPES: herbal formulation for prostate cancer. Urology 60:3, 369-375
CrossRef63
William K OH. (2002) Secondary hormonal therapies in the treatment of prostate cancer. Urology 60:3, 87-92
CrossRef64
Eric J Small. (2002) Editorial comment 1. Urology 60:3, 376-377
CrossRef65
Jin Wu, Yaojiong Wu, Burton B Yang. (2002) Anticancer activity of Hemsleya amabilis extract. Life Sciences 71:18, 2161-2170
CrossRef66
Cora N. Sternberg. (2002) Highlights of contemporary issues in the medical management of prostate cancer. Critical Reviews in Oncology/Hematology 43:2, 105-121
CrossRef67
HS Pandha, RS Kirby. (2002) PC-SPES: phytotherapy for prostate cancer. The Lancet 359:9325, 2213-2215
CrossRef68
Katsuya Tasaki, Gertraud Maskarinec, Dianne M. Shumay, Yvonne Tatsumura, Hisako Kakai. (2002) Communication between physicians and cancer patients about complementary and alternative medicine: exploring patients' perspectives. Psycho-Oncology 11:3, 212-220
CrossRef69
Nancy B. Davis, Linda Nahlik, Nicholas J. Vogelzang. (2002) Does Pc-Spes Interact With Warfarin?. The Journal of Urology 167:4, 1793
CrossRef70
Mark A Moyad. (2002) Complementary/alternative therapies for reducing hot flashes in prostate cancer patients: reevaluating the existing indirect data from studies of breast cancer and postmenopausal women. Urology 59:4, 20-33
CrossRef71
NANCY B. DAVIS, LINDA NAHLIK, NICHOLAS J. VOGELZANG. (2002) Does Pc-Spes Interact With Warfarin?. The Journal of Urology1793
CrossRef72
Rachel S Rosenberg Zand, David J.A Jenkins, Theodore J Brown, Eleftherios P Diamandis. (2002) Flavonoids can block PSA production by breast and prostate cancer cell lines. Clinica Chimica Acta 317:1-2, 17-26
CrossRef73
Mary Ann Richardson. (2002) Complementary and Alternative Therapy Use in Gynecologic Oncology: Implications for Clinical Practice. Gynecologic Oncology 84:3, 360-362
CrossRef74
Jonathan D Schiff, Wendy S Ziecheck, Benjamin Choi. (2002) Pulmonary embolus related to PC-SPES use in a patient with PSA recurrence after radical prostatectomy. Urology 59:3, 444vii-444viii
CrossRef75
Heather A Jones, James M Metz, Pamela Devine, Stephen M Hahn, Richard Whittington. (2002) Rates of unconventional medical therapy use in patients with prostate cancer: standard history versus directed questions. Urology 59:2, 272-276
CrossRef76
William K. Oh, Daniel J. George, Philip W. Kantoff. (2002) Rapid rise of serum prostate specific antigen levels after discontinuation of the herbal therapy PC-SPES in patients with advanced prostate carcinoma. Cancer 94:3, 686-689
CrossRef77
Mark A Moyad. (2002) The placebo effect and randomized trials: analysis of alternative medicine. Urologic Clinics of North America 29:1, 135-155
CrossRef78
William K Oh, Eric J Small. (2002) PC-SPES and prostate cancer. Urologic Clinics of North America 29:1, 59-66
CrossRef79
Mark A Moyad. (2002) Lifestyle/dietary supplement partial androgen suppression and/or estrogen manipulation. Urologic Clinics of North America 29:1, 115-124
CrossRef80
Mary L. Chavez. (2002) PC-SPES for the Treatment of Prostate Cancer?. Journal of Herbal Pharmacotherapy 2:3, 73-89
CrossRef81
LINDA R. CHAMBLISS. (2001) Alternative and Complementary Medicine: An Overview. Clinical Obstetrics and Gynecology 44:4, 640-652
CrossRef82
Takayuki Ikezoe, Sophie S. Chen, David Heber, Hirokuni Taguchi, H. Phillip Koeffler. (2001) Baicalin is a major component of PC-SPES which inhibits the proliferation of human cancer cells via apoptosis and cell cycle arrest. The Prostate 49:4, 285-292
CrossRef83
Georgi Pirtskhalaishvili, Ronald L. Hrebinko, Joel B. Nelson. (2001) The Treatment of Prostate Cancer. . An Overview of Current Options. Cancer Practice 9:6, 295-306
CrossRef84
Georgi Pirtskhalaishvili, Ronald L. Hrebinko, Joel B. Nelson. (2001) The Treatment of Prostate Cancer. . Cancer Practice 9:6, 295-306
CrossRef85
Weinrobe, Mark C., Montgomery, Bruce, . (2001) Acquired Bleeding Diathesis in a Patient Taking PC-SPES. New England Journal of Medicine 345:16, 1213-1214
Full Text86
Rachel S Rosenberg Zand, David J.A Jenkins, Eleftherios P Diamandis. (2001) Effects of natural products and nutraceuticals on steroid hormone-regulated gene expression. Clinica Chimica Acta 312:1-2, 213-219
CrossRef87
Judith S. Jacobson, Anitha P. Chetty. (2001) Complementary and alternative medicine in prostate cancer. Current Oncology Reports 3:5, 448-452
CrossRef88
S. Chen, Q. Ruan, E. Bedner, A. Deptala, X. Wang, T.C. Hsieh, F. Traganos, Z. Darzynkiewicz. (2001) Effects of the flavonoid baicalin and its metabolite baicalein on androgen receptor expression, cell cycle progression and apoptosis of prostate cancer cell lines. Cell Proliferation 34:5, 293-304
CrossRef89
Michael Smith, Edward J. Mills. (2001) Select Complementary/Alternative Therapies for Prostate Cancer : The Benefits and Risks. Cancer Practice 9:5, 253-255
CrossRef90
S.Bruce Malkowicz. (2001) The role of diethylstilbestrol in the treatment of prostate cancer. Urology 58:2, 108-113
CrossRef91
Sophie Chenn. (2001) In vitro mechanism of PC spes. Urology 58:2, 28-35
CrossRef92
R. Wong, C.M. Sagar, S.M. Sagar. (2001) Integration of Chinese medicine into supportive cancer care:A modern role for an ancient tradition. Cancer Treatment Reviews 27:4, 235-246
CrossRef93
Matthew R. Smith. (2001) COMPLEMENTARY AND ALTERNATIVE THERAPIES FOR ADVANCED PROSTATE CANCER. Hematology/Oncology Clinics of North America 15:3, 559-571
CrossRef94
Milos Sovak. (2001) Grape Extract, Resveratrol, and Its Analogs: A Review. Journal of Medicinal Food 4:2, 93-105
CrossRef95
Thambi Dorai, Yi-Chen Cao, Bhuvaneswari Dorai, Ralph Buttyan, Aaron E. Katz. (2001) Therapeutic potential of curcumin in human prostate cancer. III. Curcumin inhibits proliferation, induces apoptosis, and inhibits angiogenesis of LNCaP prostate cancer cells in vivo. The Prostate 47:4, 293-303
CrossRef96
Ian Yip, Nelida Duran. (2001) The role of complementary medicine in the treatment of prostate cancer. Current Urology Reports 2:3, 231-236
CrossRef97
Katherine A. Harris, Eric J. Small. (2001) Secondary hormonal manipulation of prostate cancer. Current Urology Reports 2:3, 224-230
CrossRef98
Katherine A Harris, Eric J Small. (2001) Hormonal treatment for prostate cancer. Expert Opinion on Investigational Drugs 10:3, 493-510
CrossRef99
Pamela Talalay, Paul Talalay. (2001) The Importance of Using Scientific Principles in the Development of Medicinal Agents from Plants. Academic Medicine 76:3, 238-247
CrossRef100
Katherine A. Harris, David M. Reese. (2001) Treatment Options in Hormone-Refractory Prostate Cancer. Drugs 61:15, 2177-2192
CrossRef101
William K Oh, Daniel J George, Kristin Hackmann, Judith Manola, Philip W Kantoff. (2001) Activity of the herbal combination, PC-SPES, in the treatment of patients with androgen-independent prostate cancer. Urology 57:1, 122-126
CrossRef102
Franky L. Chan, H.L. Choi, Z.Y. Chen, Peter S.F. Chan, Y. Huang. (2000) Induction of apoptosis in prostate cancer cell lines by a flavonoid, baicalin. Cancer Letters 160:2, 219-228
CrossRef103
E Ernst. (2000) The role of complementary and alternative medicine in cancer. The Lancet Oncology 1:3, 176-180
CrossRef104
ALEXANDRE DE LA TAILLE, RALPH BUTTYAN, OMAR HAYEK, EMILIA BAGIELLA, AHMAD SHABSIGH, MARTIN BURCHARDT, TATJANA BURCHARDT, DOMINIQUE K. CHOPIN, AARON E. KATZ. (2000) HERBAL THERAPY PC-SPES: IN VITRO EFFECTS AND EVALUATION OF ITS EFFICACY IN 69 PATIENTS WITH PROSTATE CANCER. The Journal of Urology1229-1234
CrossRef105
ALEXANDRE DE LA TAILLE, RALPH BUTTYAN, OMAR HAYEK, EMILIA BAGIELLA, AHMAD SHABSIGH, MARTIN BURCHARDT, TATJANA BURCHARDT, DOMINIQUE K. CHOPIN, AARON E. KATZ. (2000) HERBAL THERAPY PC-SPES: IN VITRO EFFECTS AND EVALUATION OF ITS EFFICACY IN 69 PATIENTS WITH PROSTATE CANCER. The Journal of Urology 164:4, 1229-1234
CrossRef106
Alexandre de la Taille, Omar R. Hayek, Martin Burchardt, Tatjana Burchardt, Aaron E. Katz. (2000) Role of Herbal Compounds (PC-SPES) in Hormone-Refractory Prostate Cancer: Two Case Reports. The Journal of Alternative and Complementary Medicine 6:5, 449-451
CrossRef107
Norio Iizuka, Koji Miyamoto, Shoichi Hazama, Shigefumi Yoshino, Kiyoshi Yoshimura, Kiwamu Okita, Tetsuo Fukumoto, Shigeru Yamamoto, Akira Tangoku, Masaaki Oka. (2000) Anticachectic effects of Coptidis rhizoma, an anti-inflammatory herb, on esophageal cancer cells that produce interleukin 6. Cancer Letters 158:1, 35-41
CrossRef108
Laura Boehnke Michaud, BCOP. (2000) Complementary/Alternative Therapies. Potential Safety Issues in Cancer Care. Cancer Practice 8:5, 243-247
CrossRef109
Irvin H Hirsch. (2000) Integrative urology: a spectrum of complementary and alternative therapy. Urology 56:2, 185-189
CrossRef110
Rachel S. Rosenberg Zand, David J.A. Jenkins, Eleftherios P. Diamandis. (2000) Steroid hormone activity of flavonoids and related compounds. Breast Cancer Research and Treatment 62:1, 35-49
CrossRef111
GLENN S. GERBER. (2000) SAW PALMETTO FOR THE TREATMENT OF MEN WITH LOWER URINARY TRACT SYMPTOMS. The Journal of Urology 163:5, 1408-1412
CrossRef112
B.L. Pfeifer, J.F. Pirani, S.R. Hamann, K.F. Klippel. (2000) PC-SPES, a dietary supplement for the treatment of hormone-refractory prostate cancer. BJU International 85:4, 481-485
CrossRef113
Joseph I. Boullata, Angela M. Nace. (2000) Safety Issues with Herbal Medicine. Pharmacotherapy 20:3, 257-269
CrossRef114
Tetsuya Kubota, Junichi Hisatake, Yasuko Hisatake, Jonathan W. Said, Sophie S. Chen, Stuart Holden, Hirokuni Taguchi, H. Phillip Koeffler. (2000) PC-SPES: A unique inhibitor of proliferation of prostate cancer cells in vitro and in vivo. The Prostate 42:3, 163-171
CrossRef115
NAUMAN TARIQ, DAVID J.A. JENKINS, EDWARD VIDGEN, NEIL FLESHNER, CYRIL W.C. KENDALL, JON A. STORY, WILLIAM SINGER, MARIO D’COSTA, NORMAN STRUTHERS. (2000) EFFECT OF SOLUBLE AND INSOLUBLE FIBER DIETS ON SERUM PROSTATE SPECIFIC ANTIGEN IN MEN. The Journal of Urology 163:1, 114-118
CrossRef116
NAUMAN TARIQ, DAVID J. A. JENKINS, EDWARD VIDGEN, NEIL FLESHNER, CYRIL W. C. KENDALL, JON A. STORY, WILLIAM SINGER, MARIO D???COSTA, NORMAN STRUTHERS. (2000) EFFECT OF SOLUBLE AND INSOLUBLE FIBER DIETS ON SERUM PROSTATE SPECIFIC ANTIGEN IN MEN. The Journal of Urology114
CrossRef117
Mary Ann Richardson, Jeffrey D. White. (2000) Complementary/Alternative Medicine and Cancer Research. A National Initiative. Cancer Practice 8:1, 45-48
CrossRef118
Marguerite C. Lippert, Rebecca McClain, James C. Boyd, Dan Theodorescu. (1999) Alternative medicine use in patients with localized prostate carcinoma treated with curative intent. Cancer 86:12, 2642-2648
CrossRef119
Messing, Edward M., Manola, Judith, Sarosdy, Michael, Wilding, George, Crawford, E. David, Trump, Donald, . (1999) Immediate Hormonal Therapy Compared with Observation after Radical Prostatectomy and Pelvic Lymphadenectomy in Men with Node-Positive Prostate Cancer. New England Journal of Medicine 341:24, 1781-1788
Full Text120
Cesar Ramos-Remus, Sergio Gutierrez-Ureña, Paul Davis. (1999) EPIDEMIOLOGY OF COMPLEMENTARY AND ALTERNATIVE PRACTICES IN RHEUMATOLOGY. Rheumatic Disease Clinics of North America 25:4, 789-804
CrossRef121
De La Taille, Hayek, Buttyan, Bagiella, Burchardt, Katz. (1999) Effects of a phytotherapeutic agent, PC-SPES, on prostate cancer: a preliminary investigation on human cell lines and patients. BJU International 84:7, 845-850
CrossRef122
WILLIAM R. FAIR. (1999) Willet F. Whitmore, Jr. Lecture: BACK TO THE FUTURE-THE ROLE OF COMPLEMENTARY MEDICINE IN UROLOGY. The Journal of Urology 162:2, 411-420
CrossRef123
Mark A Moyad, Kenneth J Pienta, James E Montie. (1999) Use of PC-SPES, a commercially available supplement for prostate cancer, in a patient with hormone-naive disease. Urology 54:2, 319-323
CrossRef124
David Orentlicher, Michael K. Hehir. (1999) Advertising Policies of Medical Journals: Conflicts of Interest for Journal Editors and Professional Societies. The Journal of Law, Medicine & Ethics 27:2, 113-121
CrossRef125
Ian Yip, David Heber, William Aronson. (1999) NUTRITION AND PROSTATE CANCER. Urologic Clinics of North America 26:2, 403-411
CrossRef126
Eric J. Small. (1999) Advances in prostate cancer. Current Opinion in Oncology 11:3, 226
CrossRef127
Mark A. Moyad. (1999) ALTERNATIVE THERAPIES FOR ADVANCED PROSTATE CANCER. Urologic Clinics of North America 26:2, 413-417
CrossRef128
Robert M. Russell. (1999) Editorial. Is There a Role for Botanical/Herbal Products in Clinical Practice?. Nutrition in Clinical Care 2:2, 65-66
CrossRef129
(1999) PC-SPES in Prostate Cancer. New England Journal of Medicine 340:7, 566-568
Full Text130
C. O. Granai. (1999) Expectations about alternative therapies and women with gynecological cancer. Current Opinion in Obstetrics and Gynaecology 11:1, 3-10
CrossRef131
Arthur Zucker. (1999) LAW AND ETHICS. Death Studies 23:2, 191-193
CrossRef132
Angell, Marcia, Kassirer, Jerome P., . (1998) Alternative Medicine — The Risks of Untested and Unregulated Remedies. New England Journal of Medicine 339:12, 839-841
Full Text
- Letters
