Dramatic prostate-specific antigen response with activatedhemicellulose compound in metastatic castration-resistantprostate cancerJeffrey Turnera and Uzair Chaudharyb Castration-resistant prostate cancer (CRPC) is an incurable disease with limited treatment options. Herbal Keywords: activated hemicellulose compound, castration-resistant prostate supplements are unconventional treatments for a variety of cancer, prostate-specific antigen response diseases. Active hemicellulose compound (AHCC) isa Japanese supplement discovered by hybridizing several aDivision of Hematology/Oncology, Department of Medicine, Medical Universityof South Carolina, Charleston and bLowcountry Hematology and Oncology, mushrooms used in traditional healing for the purpose of maintaining ‘super immunity’. We report on a 66-year-old gentleman with CRPC with an excellent serologic response Correspondence to Uzair B. Chaudhary, MD, Lowcountry Hematology andOncology, SC 29464, USA to AHCC. This case hypothesizes that AHCC may Tel: + 1 843 881 5844; fax: + 1 843 881 9499; have potential activity against CRPC. Anti-Cancer Drugs Received 22 April 2008 Revised form accepted 25 August 2008 Casodex was then discontinued to assess for androgen The median survival of patients with castration-resistant withdrawal response; however, his subsequent PSA values prostate cancer (CRPC) is approximately 18 months. After continued to escalate to a level of 69.3 ng/ml by June failure of hormonal therapy, secondary hormonal maneuvers, ketoconazole, and taxotere-based chemotherapy remain the discussed with him; however, it was at this time that he mainstay of treatment. The use of unconventional herbal began self-administering ImmPower’s AHCC mushroom supplements in many malignancies has been increasing over supplement. By the end of June 2007 his PSA had declined the last several years. We report our experience with to 3.35 ng/ml (95% reduction). Further follow-up demon- active hemicellulose compound (AHCC), a composition of strated that his PSA dropped to a nadir of 1.5 ng/ml by mushroom mycelia extract, in a patient with CRPC.
August 2007. The most recent PSA level in November2007 remained low at 2.57 ng/ml. Repeat imaging revealed stable bone disease and he continues to The patient was a 66-year-old Caucasian gentleman who supplement with AHCC at this time. He has been doing initially presented in July 2006 with a 2 month history well symptomatically with an improvement in his of left hip pain and 12 pound weight loss. MRI of the ambulation because of alleviated pain.
lumbar spine demonstrated osteoblastic metastases alongwith vertebral collapse at multiple levels consistent with metastatic disease. Subsequently, he was admitted to Prostate cancer is the sixth most common cancer in the hospital and initial prostate-specific antigen (PSA) was world, but is the single most common noncutaneous greater than 2000 ng/ml. Digital rectal exam revealed malignancy in the United States representing approxi- a hard, multinodular prostate. Transrectal ultrasound- mately 29% of all cancers diagnosed in men each year.
guided biopsy revealed high-grade prostate adenocarci- In the United States, approximately 218 890 cases are noma with Gleason score of 4 + 5 = 9. He was initiated on diagnosed annually, and approximately 27 050 deaths complete androgen blockade with leuprolide and bicalu- tamide. He also received palliative radiotherapy to thelumbar spine. At the time of discharge from the hospital, The use of unconventional herbal supplements in his PSA had declined to 993 ng/ml. Subsequent PSA malignancy has been increasing over the past few years.
levels continued to decline through November 2007 at A review of complementary alternative medicine around which time it was 2.57 ng/ml (Fig. 1). In January 2007, the world estimates average prevalence of complementary he received one infusion of samarium-153 because of alternative medicine at 31% [1]. Herbal remedies including plant and fungi extracts have been utilizedin the treatment of prostate cancer for several years.
Unfortunately, starting in February 2007 his PSA begin to AHCC is a compound consisting of mushroom mycelia, rise. By April 2007, his PSA had escalated to 29.3 ng/ml.
extract, candelila wax, cyclodextrin, and microcrystalline c 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Copyright Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
At 4 months, the patient began self-administering activated hemicellulose compound. PSA, prostate-specific antigen.
cellulose. It has been demonstrated that AHCC has stimulatory factor) production by macrophages [4] and activity in prostate cancer, ovarian cancer, and multiple IFN-g production by antigen-specific CD8 + T cells [5].
In the study by Ghoenum et al. [6], it seems that twotumor cell lines were analyzed, K562 (an erythroleukemia As detailed in our case, we report a case of a 66-year-old cell line) and Raji (a Burkitt cell lymphoma) of Caucasian gentleman with CRPC with high-risk features human origin. Reults demonstrated that AHCC inhibits who benefited less than 6 months from initial complete tumor cell growth in a dose-dependent manner. Both tumor cell lines were sensitive toward AHCC toxicity, butRaji cells were more sensitive than K562. AHCC at Subsequently, androgen withdrawal demonstrated no a concentration of 1 mg/ml caused 21 and 43% reduction benefit given a surge in his PSA and ultimately, the in growth of K562 and Raji cells, respectively.
self-administration of AHCC resulted in a dramatic PSAdecrease within 1 month, which continued to control his In conclusion, based on limited studies to date, it seems disease today, over 6 months from initial supplementation that AHCC may have a role in the management of prostate cancer patients especially those who have failedhormonal therapy. Larger studies are required to analyze Although the exact mechanism by which AHCC boosts the impact on this new therapy in prostate cancer natural killer (NK) activity remains under investigation, theoretically it seems that AHCC works by stimulatingNK cells and by direct anticancer activity.
Ernst E, Cassileth BR. The prevalence of complementary/alternative medicinein cancer: a systematic review. Cancer 1998; 83:777–782.
It has been hypothesized that AHCC activates NK cells Ghoneum M, Wimbley M, Salem F, McKlain A, Attallah N, Gill G.
by increasing their binding capacity to tumor cells by Immunomodulatory and anticancer effects of active hemicellulose compound(AHCC). Int J Immunother 1995; 11:23–28.
two-fold, and also by increasing natural cell granularity.
Aviles H, Belay T, Vance M, Sun B, Sonnenfeld G. Active hexose correlated compound enhances the immune function of mice in the hindlimb-unloading recognized by C-type lectins, such as lectin-1 on NK model of spaceflight conditions. J Appl Physiol 2004; 97:1437–1444.
Yagita A, Matsuzaki S, Wakasugi S, Sukegawa Y. H-2 haplotype-dependent cells, thus initiating innate immunity. C-type lectins serum IL-12 production in tumor-bearing mice treated with various mycelial are also expressed on other cell types, including Gao Y, Zhang D, Sun B, Fujii H, Kosuna K, Yin Z. Active hexose correlated macrophages, dendritic cells, and gd-T cells, which may compound enhances tumor surveillance through regulating both innate and further influence NK cells and the innate immune adaptive immune responses. Cancer Immunol Immunother 2005; 55: response through the production of cytokines. Earlier Ghoenum M. NK-immunomodulation by active hemicellulose compound reports suggest that AHCC influences the production of AHCC in 17 cancer patients. Abstract of 2nd Meeting Society of Natural a variety of cytokines [3], including enhanced IL-12 (NK Immunity, Taormina, Italy. 25–28 May 1994.
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