(MY) Jaws the return

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Sunday September 16, 2007-The Star

 

 

Jaws, the return

 

By Dr ALBERT LIM KOK HOOI

 

The poor maligned shark in food and medicine

 

LIKE Yao Ming (NBA basketball star), I pledged to stop eating shark's

fin soup and I have kept to my word. This is because much of the

shark's fin we eat is from fins cut from living sharks. This finning

process is cruel and wasteful. The finless and often still living

sharks are thrown back into the sea to die from suffocation,

starvation or to be eaten by other sharks or animals.

 

There is a lone important contrary voice. Giam Choo Hoo, a member of

the CITES Animals Committee, tells us to go ahead and eat shark's fin

soup without guilt.

 

According to him, most of the shark's fin that end up on our dinner

tables is from fins of dead sharks rather than those obtained from the

finning process.

 

In the meantime, as the controversy rages on, I am not taking my

chances and will continue to honour my pledge. Shark cartilage extract

(I wonder how much of it comes from the deplorable finning process)

puts sharks in the news for another reason.

 

 

Sharks kill an average of 4.3 persons per year due to unprovoked

attacks. To repay the sharks for their homicidal tendencies, we kill

about 40 million of them each year to indulge in our food fancies and

to manufacture a product largely unproven in cancer treatment.

It is claimed that sharks do not get cancer (they do). Because of the

low incidence of cancer in sharks, shark cartilage has been advocated

as an effective treatment against cancer.

 

Anti-angiogenic substances (anti-new blood vessel formation) are

useful in cancer treatment. They are found in shark cartilage. By

another extension in illogic, cartilage (shark, bovine or any other)

is thought to be effective in cancer therapy.

 

Before we examine the evidence whether shark cartilage should be used

in treating cancer, let us get three points absolutely clear: (i)

sharks do get cancer (ii) the rate of shark cancer is not known from

existing data and (iii) even if the incidence of cancer were lower in

sharks, this is irrelevant to the use of crude shark cartilage

extracts for cancer treatment.

 

Charles Loprinzi M.D. is a senior staff member of the Department of

Oncology at the Mayo Clinic. He and his colleagues published their

findings on the evaluation of shark cartilage in patients with

advanced cancer in the journal Cancer (July 1, 2005, Volume 104).

 

This was a two-arm, randomised, placebo-controlled, double-blind

clinical trial. You cannot get more scientific or intellectually

honest than this because of the four qualifiers I italicised.

 

Apart from the standard treatment for incurable breast or colorectal

cancer, the patients were randomly assigned to take either a shark

cartilage product or a placebo. The trial was unable to demonstrate

any suggestion of efficacy for the shark cartilage product.

 

Many other trials have been conducted to disprove that shark cartilage

has any value whatsoever in cancer treatment.

 

I shall tell you of one such trial hot off the presses. It was

presented at the 43rd Annual Meeting of the American Society of

Clinical Oncology (ASCO) held in early June this year in Chicago.

 

Dr Charles Lu, Associate Professor in the Department of Thoracic

Oncology in the University of Texas, and his colleagues, conducted a

randomised multicentre phase III study involving some 380 patients

with unresectable stage III lung cancer who received shark cartilage

plus standard therapy (chemotherapy and/or radiotherapy) or placebo

plus standard therapy.

 

The overall survival between the groups was found to be insignificant.

I quote Dr Lu, " These results definitely demonstrate that this shark

cartilage extract is not effective when combined with

chemo-radiotherapy. "

 

He added that current data do not support the use of shark

cartilage-derived products as cancer treatment.

 

Pseudoscience is any body of knowledge, methodology, belief or

practice that claims to be scientific or is made to appear scientific.

It is not in line with science as a body of knowledge of the world and

as a method of obtaining that knowledge.

 

The term pseudoscience itself is based on the Greek root pseudo-

(false or pretending) and science (derived from Latin scientia,

meaning knowledge).

 

Many alternative and complementary medical practices masquerade as

science and can be labelled pseudoscience. They talk vaguely of the

immune system and detoxification, which are terms reminiscent of what

we learnt in our science class.

 

But there are insufficient measurements in such practices. The

patients who undergo such treatments are not carefully charted before

treatment, e.g. their marrow, renal, liver and cardiac functions are

not documented. Their tumour burden is also not thoroughly evaluated

and quantified.

 

The same lack of measurements happens after treatment. The patient and

treatment outcome data in alternative and complementary medicine are

not subject to rigorous statistical analysis.

 

Crude shark cartilage sells well to the public (United States,

Malaysia, everywhere). This represents a failure of our society to

deal with pseudoscience.

 

There is a stark contrast between the rigour of scientific peer review

and the lack of checks and balances in the popular press when it comes

to " scientific " articles.

 

We have failed to ingrain the value of intellectual honesty and to

promote the ability of the media and the public to think critically.

 

Sharks kill an average of 4.3 persons per year due to unprovoked

attacks. This may be less than the number of Mat Rempits killed a week

on our roads.

 

To repay the sharks for their homicidal tendencies, we kill about 40

million of them each year to indulge in our food fancies and to

manufacture a product largely unproven in cancer treatment.

 

 

Dr Albert Lim Kok Hooi is a consultant oncologist. For further

information, e-mail starhealth. The information

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