Comprehensive Guide to Shark Cartilage

Shark CartilageDr. James Meschino DC, MS, ND
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General Features
Contrary to the popular marketing campaign associated with the use of Shark Cartilage as a dietary supplement, shark’s do get cancer, and promoting the use of Shark Cartilage based upon the notion that shark’s do not get cancer is false and highly misleading. However, some experimental and animal studies show that a particular Shark Cartilage extract may play role in one aspect of cancer prevention and/or treatment, but how this translates into the prevention and/or treatment of human cancers is not well understood, although some preliminary studies have been encouraging. At present, Shark Cartilage is one of many natural health products that continue to be studied as potential chemopreventive and cancer treatment agents.

Principle Active Constituents
Shark Cartilage is a type of connective tissue comprised of proteoglycans (mucopolysaccharides), protein substances, calcium, sulfur, and collagen protein. Which of these constituents exerts anti-tumor effects is unknown at this time.
Clinical Application and Mechanism of Action
1. Cancer – Preliminary research in the 1980’s suggested that Shark Cartilage inhibits angiogenesis (the growth of new blood vessels). Since cancer cells must build new blood vessels to provide themselves with nourishment for growth and replication, this effect (anti-angiogenesis) is associated with potentially stopping the spread of cancer. 3,4,5,6,7,8,9 (see also soy isoflavones, genistein, in this document) Shark Cartilage also inhibits matrix metalloproteases (MMP’s), which break down the ground substance between cells, and more easily permit the spread of cancer to adjacent tissues. 4
A few preliminary studies suggest that individuals with certain cancers may benefit from Shark Cartilage supplementation, however, well-designed research trials yielded negative results. 1,2,16,17 Nevertheless, there is some evidence to support the use of Shark Cartilage as part of the complementary treatment for various cancers, including lung, prostate, and breast cancer. 10,11,12,13,14,15
Double-blind trials, which are currently underway in Canada and the United States, are required to provide conclusive evidence that Shark Cartilage is a useful adjunct in cancer treatment, but there are no significant risks attached to using Shark Cartilage supplementation in individual cases at this time. 1,2
2. Osteoarthritis – The use of glucosamine sulfate has been shown to be very effective in the treatment of osteoarthritis. As glucosamine provides the body with raw material from which if can synthesize certain components of joint cartilage, some individuals promote the idea that ingesting cartilage itself may act in a similar manner as glucosamine. Presently, there are no studies of any kind to support this contention, and as is the case with the use of chondroitin sulfate, bovine cartilage, sea cucumber, green-lippid mussel (all of which contain whole cartilage components). It is unlikely that Shark Cartilage provides as significant an effect on the repair, regeneration and preservation of joint cartilage, as does glucosamine sulfate. 2 (see glucosamine sulfate in this document)
Dosage and Standardized Grade
Cancer Treatment: 60-100 gms per day, orally or by enema. This is a very high dose, which provides the body with 2 - 2.5 gms (2500 mg of calcium) daily. This is considered the upper limit of safe intake for calcium, although no cases of calcium toxicity have been reported at this level of Shark Cartilage supplementation. Nevertheless, practitioners and patients should be on the look out for any signs or symptoms of calcium toxicity when doses in this range are being used (see calcium in this document, for signs and symptoms of toxicity).
Adverse Side Effects, Toxicity and Contraindications
Shark Cartilage appears to be a safe supplement. 1,2 There is one reported case of a patient who developed liver inflammation after taking Shark Cartilage supplements, but later recovered fully after the Shark Cartilage supplement was discontinued. 18 Therapeutic doses of Shark Cartilage may increase the potential for calcium toxicity, although there are no reported cases of this occurring to date.

Drug-Nutrient Interactions
There are no well-known drug-nutrient interactions for Shark Cartilage known at this time.
Pregnancy and Lactation
During pregnancy and lactation, the only supplements that are considered safe include standard prenatal vitamin and mineral supplements. All other supplements or dose alterations may pose a threat to the developing fetus and there is generally insufficient evidence at this time to determine an absolute level of safety for most dietary supplements other than a prenatal supplement. Any supplementation practices beyond a prenatal supplement should involve the cooperation of the attending physician (e.g., magnesium and the treatment of preeclampsia.)

References: Pregnancy and Lactation
1. Encyclopedia of Nutritional Supplements. Murray M. Prima Publishing 1998.
2. Reavley NM. The New Encyclopedia of Vitamins, Minerals, Supplements, and Herbs. Evans and Company Inc. 1998.
3. The Healing Power of Herbs (2nd edition). Murray M. Prima Publishing 1995.
4. Boon H and Smith M. Health Care Professional Training Program in Complementary Medicine. Institute of Applied Complementary Medicine Inc. 1997.
References
1. Healthnotes, Inc. 2001. www.healthnotes.com: Cartilage (Bovine and Shark)
2. Natural Product Encyclopedia. www.consumerslab.com: Shark Cartilage
3. Lee A, Langer R. Shark cartilage contains inhibitors of tumor angiogenesis. Science 1983;221:1185-7
4. Dupont E, Savard PE, Jourdain C et al. Antiangiogenic properties of a novel shark cartilage extract: Potential role in the tratment of psoriasis. J Cutan med Surg 1998;2:146-52
5. Sheu JR, Fu CC, Tsai ML et al. Effect of U-995, a potent shark cartilage-derived angiogenesis inhibitor, on anti-antiogenesis and and anti-tumor activities. Anticancer Res 1889;18:4435-41
6. Davis PF, he Y, Furneaux RH et al. Inhibition of angiogenesis by oral ingestion of powdered shark cartilage in a rat model. Microvasc Res 1997;54:178-82
7. Oikawa T, Ashino-Fuse H, Shimamura M et al. A novel angiogenic inhibitor derived from Japanes shark cartilage (I). Extraction and estimation of inhibitory activities toward tumor and embryonic angiogenesis. Cancer Lett 1990;51:181-6
8. McGuire TR, Kazakoff PW, Hoie EB et al. Antiproliferative activity of shark cartilage with and without tumor necrosis factor-alpha in human umbilical vein endothelium. Pharmacotherapy 1996;16:237-44
9. Lee A, Langer R. Shark cartilage contains inhibitors of tumor angiogenesis. Science 1983 1983;221:1185-7
10. Riviere M, Latreille J, Falardeau P et al. AE-941 (Neovastat), an inhibitor of angiogenesis: phase I/II cancer clinical trial results. Cancer invest 1999;17(suppl1):16-7
11. Jamali M-A, Riviere M, Falardeau P et al. Effect of AE-941 (neovastat), an angiogenesis inhibitor, in the Lewis lung carcinoma metastatic model, efficacy, toxicity prevention and survival. Clin Invest Med 1998;(suppl):S16
12. Riviere M, Falardeau P, Latreille J et al. Phase I/II lung cancer clinical trial results with AE-941 (neovastat), an inhibitor of angiogenesis. Clin Invest Med 1998;(suppl):S14
13. Riviere M, Alaoui-Jamali M, Falardeau P et al. Neovastat: an inhibitor of angiogenesis with anti-cancer activity. Presented at: American Association for Cancer Research Annual Meeting 39 March 28-April 1 1998;New Orleans, LA
14. Blaseck J, Alaoui-Jamali M, Wang T et al. Oral administration of Neovastat inhibits tumor progression in animal models of progressive tumor growth and metastasis. Int J Oncol 1997;11(suppl):934
15. Dupont E, Alaoui-Jamali M, Wang T et al Angiostatic and antitumoral activity of AE-941 (Neovastat), a molecular fraction derived from shark cartilage. Presented at: American Association for Cancer Research Annual Meeting 38 April 12-16 1997;San Diego CA
16. Horsman MR, Alsner J, Overgaard J. The effect of shark cartilage extractrs on the growth and metastatic spread of the SCCVII carcinoma. Acta Oncol 1998;37:441-5
17. Miller DR, Anderson GT, Stark JJ et al. Phase I/II trial the safety and efficacy of shark cartilage in the treatment of advanced cancer. J Clin Oncol 1998;16:3649-55
18. Ashar B, Vargo E. Shark cartilage-induced hepatitis. Ann Intern Med 1996;125:780-1