 When it comes to marketing unproven cancer treatments, the internet has become the wild west. Fraudsters are able to take advantage of people like never before. Cancer patients find quackery on the web, bemoaned the National Cancer Institute. Did you know there were more than 200,000 documents about cancer on the web? What? When was this published? Oh, 1996. It's just a few years after the web was born. Not to worry, though, said the author of Dr. Linden's Guide to Online Medicine. It takes a lot of time and money to maintain a web page, so don't worry. The massive information on the internet will dwindle during the next few years as the internet matures. Right, yes, dwindling from 200,000 down to a mere quarter of a billion. And one of the most commonly recommended quote-unquote alternative cancer cures on popular websites is shark cartilage. Much has been made in recent years of the mystical aura afforded to the stuff. Clearly, part of it is the visceral fear of cancer, combined with a healthy respect for a creature that survived basically unchanged since prehistoric times. It's been reported that sharks rarely get cancer and their skeleton is made out of cartilage, and so logic has led some to believe that this must be the reason for sharks' relative health. Not exactly sure that's logical, but they do have a lot of cartilage. Cartilage, in general, has few blood vessels, and blood vessels are important for cancer growth, and all this conspired to prime fraught cancer patients for shameful exploitation by pseudoscience. In the supplement industry, with the addition of just one myth, and that's sharks don't get cancer. But they do get cancer, after all. Just another layer of fallacious arguments, successfully convincing desperate cancer patients to buy ineffective products. But wait, you don't know if it's ineffective until you put it to the test. 60 patients with a variety of advanced cancers given like a dozen scoops a day of shark cartilage and not a single, even partial response, was noted in any of their tumors. Ineffective, with no salutary effect on the quality of life, in fact suffering significant gastrointestinal toxicity from the stuff. All the while, the tumors progressed in all the patients. But what's missing from this survival graph? What happened in the control group? There was no control group. So while this is what you'd expect to see in advanced cancer patients, how do we know the cancers wouldn't have progressed even faster without the shark cartilage? That's why we need randomized controlled trials, but there weren't any, until the Mayo Clinic stepped up. A randomized placebo-controlled double-blind clinical trial for patients with incurable breast or colorectal carcinoma. Data on a total of 83 patients was analyzed, and there was no difference in survival between patients getting shark cartilage versus those getting placebo. Nor any suggestion of improvement and quality of life. There was evidently a prostate cancer study, too. Only five patients were even able to complete the study, and in all five, their cancers continued to progress unabated. So unfortunately, the claims for benefits of shark cartilage are completely unsubstantiated by any objective data from controlled clinical trials. Not so fast, said supplement manufacturers. Maybe these crude commercial shark cartilage powders just don't have high enough levels of whatever active components there may be, so cancer patients should instead be taking shark cartilage extract pills. So the National Cancer Institute said, fine, we'll test that, too, just to make absolutely sure, and so they funded a randomized double-blind placebo-controlled trial to put it to the test. Unlike the other shark cartilage dietary supplement studies, they used the purified extract, and the study outcome was unambiguous. It failed. The shark cartilage group lived 14 months, and the placebo group lived 15 months, so no significant difference in survival or to time progression or tumor response rate. So these clinical studies suggest shark cartilage is not just an unproven cancer remedy, but actually a well-disproven one. Yet despite the overwhelming evidence to the contrary, such claims persisted. For example, the Huxter, who started it all, wrote a sequel. Sharks still don't get cancer. Perhaps the only cure for this myth is to spread the rumor that cartilage from the noses of such quacks fights cancer, too. Anyway, if you really want to eat angiogenesis inhibitors, why sit down to a bowl of cartilage powder when you could just eat an apple or drink green tea or turmeric or pomegranates, berries and nuts, soybeans, flaxseeds, broccoli, all of which have been shown to have anti-angiogenic effects.