Mike Wallace
60 Minutes, CBS Television
51 W 52nd Street
New York, NY
USA       10019


Mike Wallace:

On 28-Feb-1993 you hosted the 60 Minutes broadcast Sharks Don't Get Cancer whose Cuban study purported to demonstrate that shark cartilage cures cancer.

Everything hinges on The Cuban Study

In a nutshell, the Cuban study is widely summarized as follows.  Twenty-nine terminally-ill cancer patients were administered shark cartilage for sixteen weeks, mainly by means of retentive rectal enema but also orally, and

• during the sixteen weeks of therapy, 9/29 patients died of cancer,
  
  
• over the course of four years following the therapy, 0/29 more died of cancer, 6/29 died of causes other than cancer, and 14/29 survived.
  
  

I attend to only survival rates because they are the most objective measures of effect.  Alternative measures such as feeling good are too open to influence by extraneous factors — for example, patients could conceivably have reported feeling better after shark-cartilage therapy out of fear of being excluded from the study if they reported feeling no better or feeling worse.  Even if the shark-cartilage didn't seem to be doing them any good, the Cuban patients might have wanted to continue therapy because the alternative may have been to be left to die without further treatment of any kind.

Tumor size also is less objective than death, as tumor size may be determined by palpation, and even measurement using a ruler on an X-ray (or other image) can be affected by a difference in the angle at which the X-ray is taken, by the angle of placement of the ruler over an image that is not symmetrical, and ultimately always depends on a subjective decision concerning where exactly the border is on a blurred splotch in the X-ray.  The apparent size of an image on an X-ray will also be affected by its brightness, and which in turn can be controlled by X-ray machine, and by film-processing settings, not to mention by the particular machine, or by the brand of X-ray film, used.

Also not worth looking at is any measure that is susceptible to easy manipulation — for example, Dr. Eli Glatstein (sometimes written Gladstein) of the University of Texas Southwestern Medical Center looking at before-and-after X-rays had no way of telling whether the dates of the X-rays had been switched.  The value of the Glatstein contribution is further reduced by your failing to specify that he was allowed to look at all of the X-rays, leaving open the possibility that he was handed only a small sample, and "many of them of poor quality" by your own admission, and complained of by Glatstein with the words: "Got all this junk on the film of some of them."

Are these results fraudulent?

Even in data as abbreviated as the above, symptoms of fraud are evident:

What about the 0/29 who died of cancer after the Cuban Study was completed?

That 9/29 patients died of cancer within the first 16 weeks, but not a single additional patient died of cancer after that falls short of credibility for the simple reason that nature does not tend to confine its deaths so neatly to only one side of some temporal marker.

At the same time, we can find stronger reason for doubting that none died of cancer following the end of the Cuban study.  Specifically, William Lane admits that at the end of the sixteen-week interval during which shark cartilage therapy was administered, five of the surviving patients (all of whom had been selected for being terminally ill, remember) were observed to be deteriorating.  One must be surprised, then, at the claim that every last one of these five patients who had been diagnosed as terminally ill and who were observed to be deteriorating despite sixteen weeks of shark-cartilage therapy, somehow — inexplicably and miraculously — went on to survive four more years after the therapy was terminated.  Here are the five that I think were deteriorating:

At sixteen weeks, the tumor had begun to grow again.  (Patient 3, p. 103) After four weeks, the tumor had shrunk considerably, but at sixteen weeks, it had started to grow again.  (Patient 4, p. 103) At sixteen weeks, a bone scan revealed possible new tumor growth.  (Patient 7, p. 104) At sixteen weeks, all signs indicated that the liver disease had worsened.  (Patient 11, p. 104) The surgery revealed that a new tumor was growing [...]  (Patient 15, p. 105) Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993, p. 101.  (I have assigned the patient numbers to William Lane's eighteen descriptions)

An observer not committed to proving that shark-cartilage therapy is effective might even be tempted to conclude that if the five above patients were deteriorating after sixteen weeks of shark-cartilage therapy, and if after the termination of therapy they managed to live another four years at least, then shark-cartilage therapy promotes cancer, and relief is achieved by withdrawing the therapy.  But of course such speculation would be profitable only if William Lane's reporting of the Cuban study could be trusted.

What about the 6/29 who died of "other causes" after the Cuban Study was completed?

One cannot avoid the recognition that 6 patients (out of the 20 who survived the Cuban study) dying of other causes is a remarkably high death rate — namely 6/20 = 30% in the course of four years.  A death rate this astronomical calls for some explanation, and in casting about for an explanation, one cannot help noticing that what all these 20 death-prone people had in common was their cancer, which suggests that cancer may have played a leading causal role.

This line of thinking calls to mind the question of how one determines whether a patient died of cancer or of other causes.  Consider how tricky the assignment of causality can become:

• A terminally-ill cancer patient despairs of his condition and commits suicide by driving his car into a concrete wall — would he be said to have died of cancer or to have committed suicide?
  
  
• A terminally-ill cancer patient is impaired by his medication, and accidentally veers off the road and into a concrete wall — would he be said to have died of cancer or of an automobile accident?
  
  
• Radiation or other therapy compromises a terminally-ill cancer patient's immune system so that he catches pneumonia and dies — would he be said to have died of cancer, or of pneumonia?
  
  
• A terminally ill cancer patient kept alive only by life-support systems has the plugged pulled on him — would he be said to have died of cancer, or to have been killed by his caretakers?
  
  

In choices such as the above, William Lane may be suspected of having preferred to credit the non-cancer causes; however, all cases such as the above could be categorized as cancer deaths upon the recognition that cancer had been the fundamental cause that triggered some more immediate cause, and that in the absence of that immediate cause, the cancer would have caused death not long afterward anyway.

Thus, documentation of the full details of the causes of death of these six patients who died of "other causes" would contribute toward the authentication of the Cuban study.

What about the 14/29 who were still alive after four years?

It is possible that the claim that 14/29 were still alive after four years is false, and that in fact 0/29 were alive after as little as three years:

A 1996 videotape distributed free-of-charge by Lane Labs contained testimonials from three cancer survivors and from several physicians who "have come to trust the effectiveness of this all natural therapy."  Dr. Lane, who narrated the tape, stated that nine of the 29 "terminal" patients in the Cuban study had died within four months but the rest were alive after four years.  But early in 1996, John F. Prudden, M.D., a former associate professor of surgery at Columbia University's College of Physicians and Surgeons who had conducted research on bovine cartilage for more than 40 years, stated that all of the patients had died. Stephen Barrett, M.D., FDA and FTC Attack Shark Cartilage, QuackWatch, revised 09-Jun-2000 www.quackwatch.com/04ConsumerEducation/News/shark.html (footnote numbers removed and blue font added)

Reflecting on the above statement reveals three incongruities:

1. If the Cuban study was conducted in 1993, and the videotape was made in 1996, there hasn't been quite enough time to determine the four-year outcome referred to.
   
   
2. William Lane appears to be claiming that 20 out of the 20 patients who survived the first four months also survived the first four years, thus forgetting his other statements that 6 ended up dying of "other causes."
   
   
3. If John Prudden did claim that "all of the patients had died," and if his claim is true, then that makes William Lane not simply a misinterpreter of data, and not simply a manipulator of data, but rather a mountebank of Wizard-of-Oz proportions.

How Sick Were The 29 Patients To Begin With?

Your 60 Minutes broadcast casually refers to them only as "29 terminally ill cancer patients."  However, it is necessary to be more specific.  Just how ill were they?

In the case of breast cancer, several stages of illness have been defined:  www.cancerlinksusa.com/breast/stage.htm#6

And alternative definitions can be found for different cancers, as for example in the case of prostate cancer:  www.cancerlinksusa.com/prostate/treatment/

In the following summary of the Cuban study, Lane states that all 29 patients were Stage IV:

What was so exciting about the Cuban research?  Of the study's original 29 terminal patients, nine (or 31%) died of cancer.  But those deaths occurred within the study's first 17 weeks.  No other patients have died of cancer since, though six have died of unrelated causes.  Among the remaining patients, 14 (or 48%) are completely well and cancer-free after more than three years (as of June 15, 1995).  These results are especially impressive, even incredible, considering all patients had been diagnosed with stage IV cancer, the most advanced level of the disease. I. William Lane, Ph.D., Sharks Don't Get Cancer, Catholic Digest, February 1996 members.aol.com/RobinJoker/sharksdont.html (blue emphasis added)

All patients being Stage IV is critical to William Lane's case, as it is his excuse for not having a control group:

According to no less an institution than the FDA, control groups are not necessary in studies involving stage IV cancer patients since nearly all of the patients die and even keeping 10% alive would be extraordinary... I. William Lane writing in the Townsend Letter for Doctors, quoted in Commonweal www.commonweal.org/cartconflict.html (bold and ellipses were in the original)

Overlooking for the moment that we will be seeing a table below that shows a five-year survival probability of 16% for Stage IV breast cancer, we instead maintain the thread of our argument by noting that — oops! — "one or two" of the 29 patients might in reality have been only Stage III:

With stage IV cancer patients, this is very impressive, even incredible, even if one or two patients might have been at stage III rather than at stage IV at the outset. I. William Lane, Ph.D., Shark cartilage therapy: A personal history of its development, p. 4 www.publishedresearch.net/sharkcartilage/book_shark_cartilage_therapy_page4.htm (blue emphasis added)

And then again, maybe there were so many Stage III patients that it would be inaccurate to refer to only "one or two":

Twenty-seven terminal cancer patients, all classified as either Stage III or Stage IV, were chosen to participate. Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993, p. 101.  (Blue emphasis added.  Why William Lane makes reference to 27 patients and not the usual 29 will be discussed shortly.)

At one point, William Lane even lets slip a "stage II," although this is possibly a typo:

These patients included six breast, five prostate, five central nervous system (brain), two stomach, two liver, two ovarian, two uterus, two esophageal, two tonsil and one urinary bladder stage II or IV cases. I. William Lane, MS, PhD, Shark Cartilage Therapy Evaluated, ChiroWeb.com www.chiroweb.com/archives/12/05/11.html (blue emphasis added)

In any case, even if we fault Lane only for a tiny eruption of imprecision — that is, for really meaning Stage III above and not the Stage II that is printed — then he nevertheless demonstrates that what he really thinks about his 29 patients is not that they were all Stage IV, and not that they were mostly Stage IV, but rather that they were an unspecified mix of Stages III and IV.  However, once we recognize that William Lane's stage categorization is undisciplined enough to permit him to come up with different statements on different occasions, then it is possible to wonder whether some Stage II patients might have been admitted into the study as Stage III, and whether some Stage III patients might have been admitted into the study as Stage IV, and even whether there were any Stage IV patients at all — or in short that it is possible to wonder whether the Cuban-study patients were initially less sick than represented on your broadcast.

What survival probabilities are associated with each stage?  Supposing now that for the sake of argument we disbelieve John Prudden's statement above that 0/29 of the Cuban patients survived, and accept instead William Lane's statement that after four years 14/29 were still alive, then that would give us a four-year survival rate of 14/29 = 48%, which is not that impressive given the data in the table below which contains the five-year survival rates for breast cancer:

Stage	5-year Relative Survival Rate
0	100%
I	98%
IIA	88%
IIB	76%
IIIA	56%
IIIB	49%
IV	16%

www.imaginis.com/breasthealth/staging.asp

Intra-stage heterogeneity.  The survival probabilities in the table above concern all patients, and not just the most promising cases.  However, it must be recognized that within any category, say only within Stage IIIB, some patients will be energetic while others are lethargic, some will carry on with their lives while others are debilitated, some will give little outward sign of their illness while others are visibly unwell.  The above table provides survival data for all such patients, heterogeneous within each category though they may be.  When selecting patients for participation in the Cuban study, however, the temptation that the Cuban researchers would have been exposed to would have been to select only the strongest patients from within each category.  Selecting the strongest cases would have the effect of extending the longevity of the patients in the study, and the extended longevity would then be credited to the shark-cartilage enemas.

And so even if the Cuban study did produce a four-year survival of 14/29 = 48% (and not the 0/29 = 0% that John Prudden claims), this falls within the bounds of the unexceptional in the table above, where we see five-year survival rates for Stage IIIA, IIIB, and IV cancers of 56%, 49%, and 16%.  If the Cuban study was marred by bias during patient selection (or by any other bias or error) which helped raise the four-year survival rate to 48%, then the results may even be demoted from unexceptional to poor, a demotion which would recategorize shark cartilage therapy as not only useless, but harmful; as not only failing to destroy the cancer, but as helping the cancer destroy the patient.

It must be recalled that the survival-rate table above applies to breast cancer only, and different tables would apply to other types of cancers, and that the patients in the Cuban study suffered from a variety of cancers.  Our discussion above, then, should be taken not as demonstrating that a four-year survival rate of 48% is middling or poor, but only that it could well be middling or poor, and that William Lane has fallen far short of convincing us that it is high because he has presented not even a single survival table, let alone a survival table for each of the types of cancers that were afflicting the patients in his study.

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We can't believe in shark cartilage therapy unless we have confidence in William Lane's Integrity

	William Lane, Ph.D.

Because of the ease of fabricating or manipulating data, our degree of confidence in "scientific" results must be proportional to the integrity of the researcher who presents them.  Among the qualities that signal integrity are the following:

• Education: Research is more credible when published by someone who has degrees in the relevant field of study from reputable institutions.  William Lane, however, has no training in oncology or even in medicine.
  
  
• Publication: Research is more credible when offered by someone who has a reputation in the field, and publishes in peer-reviewed journals.  William Lane, however, has not to this day published a single paper on shark cartilage therapy in any peer-reviewed journal, and oncology researchers view him as a quack.
  
  
• Affiliation: Research is more credible when conducted by someone who is affiliated with a reputable university or research facility.  William Lane, however, enjoys no such affiliation, not even in Cuba.
  
  
• Collaboration: Individuals working alone find it easier to succumb to the temptation to cook their data, whereas individuals working with colleagues, graduate students, research assistants, and support staff benefit from having all these individuals serve the indispensible role of whistle-blowers in case the project veers off in the direction of fraud.  That collaborators can be seen to be people of integrity doesn't hurt.
  
  However, William Lane's collaborators are noted not for their research integrity but for their military rank in a third-world dictatorship, of which William Lane demonstrates his foolishness by boasting, and concerning which you demonstrate your foolishness by broadcasting his boast:
  
  

  WALLACE:  (Voiceover)  The study was set up by a group of Cuban military doctors who initially were quite skeptical. Dr. LANE:  They opened the door and in walked six colonels and seven lieutenant colonels — no one lower than a major — and they introduced themselves.  "I'm Colonel So-on in charge of surgery," "I'm Colonel So-on in charge of — of oncology,"  "I'm So-on" — and I suddenly was talking to the elite of the medical establishment of this country. Sharks Don't Get Cancer, CBS News, 60 Minutes, 28-Feb-1993, Volume XXV, Number 23, Burrelle's Information Services, p. 4.

  
  
• Disinterestedness: On the one hand, we envision a researcher working at a university or research facility, disinterestedly asking the question of whether a treatment helps or hurts or has no effect.  If the study produces positive results, such a researcher is pleased to bring to the world's attention an effective therapy; if negative results, then he is pleased to warn the world away from a useless or harmful therapy.  Certainly the university researcher's salary remains unchanged whether his results are positive or negative.  At the other extreme is a researcher with a strong conflict of interest — he stands to be enriched if the results come out positive, and stands to lose his investment if the results come out negative.  It is imprudent for the public to bestow belief with equal readiness in the two contrasting cases.
  
  William Lane clearly falls into the second category.  He was heavily invested in a positive outcome.  If he could convince 60 Minutes that shark cartilage cured cancer, he would become rich; if 60 Minutes concluded that shark cartilage was snake oil, he would be wiped out.  William Lane's role with regard to shark cartilage was not that of a scientist seeking truth, it was that of a promoter seeking profit:
  
  

  WALLACE:  (Voiceover)  While doctors like Eli Glatstein are looking for something that makes tumors shrink, Bill Lane continues traveling around the world marketing shark cartilage. Sharks Don't Get Cancer, CBS News, 60 Minutes, 28-Feb-1993, Volume XXV, Number 23, Burrelle's Information Services, p. 8.

  
  
• Accessibility: Research is more credible if those who conducted it, and those who participated as subjects, are later available for questioning, and if the raw data are accessible for review by others.  In this regard, William Lane flunks again — no one today has access to anything, not to the patients, not to the medical records or X-rays, not to the Cubans who conducted the research:
  
  

  Lane has supplied the phone number of Dr. Menendez in Cuba, but it has not been possible to reach him for confirmation of this outcome.  Lane conceded that it is very difficult for independent observers to verify these results given the travel restrictions to Cuba. Commonweal www.commonweal.org/cartcuban.html

  
  
• Consistency: Finally, one can look for clues that are indicative of incompetence or mendacity, clues such as inconsistency and self-contradiction.  We have already seen above major incongruities suggestive of fraud, and we will see more of the same throughout the present letter below.  What the immediate section illustrates is not William Lanes' profound errors or deceptions, but rather his habit of speaking casually and carelessly, and his disregard of exactitude, of consistency, of precision.
  
  This is evident, for example, in a comparison of the descriptions of the Cuban study that William Lane presents in many locations on the Internet (we saw one above) with the description that he presents in his book, Sharks Don't Get Cancer.  In the book:
  
  

  ---

  • The number of patients is inexplicably reduced from 29 to 27.
    
    
  • No reference is made to the 9/29 who died in the first sixteen weeks of the study.
    
    
  • The 20 patients still alive at the end of the Cuban study is changed to 18 patients "who had remained in the study for sixteen weeks," and Lane restricts his discussion to these 18.
    
    
  • Despite having said that he was restricting his attention to 18 patients "who had remained in the study for sixteen weeks," a reading of the descriptions of these eighteen patients reveals that in fact 5/18 never did survive to the end of the study:
    
    

    This patient passed away before the sixteen-week evaluation.  (Patient 6, p. 104) The woman, however, did not survive into the sixteenth week.  (Patient 8, p. 104) Although the woman had been experiencing a noticeable decrease in pain, she passed away before completing the study.  (Patient 9, p. 104) Before the sixteen-week evaluation, this patient died of an intestinal obstruction that was not related to the cancer.  (Patient 17, p. 106) She passed away before the sixteen-week evaluation.  (Patient 18, p. 106) Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993.  (Assignment of patient numbers is mine.)

    
    

  ---

  
  A similar casualness and lack of discipline is evident throughout William Lane's reporting of the Cuban study.  Thus, the sixteen-week duration of the study sometimes becomes a seventeen-week duration, or a four-month duration, and all of these clash with the claim of Dr. Charles Simone (who collaborated in the Cuban study and was featured on your broadcast) that it was a 20-week study.  Or, below William Lane reduces the number dying during the study from 9 to 8, and increases the number surviving long after the study from 14 to 15:
  
  

  Eight died during the 16 week study, and six have died since the study was completed.  Fifteen of the 29 patients, diagnosed as terminal before the study began, are still alive a year later — a remarkable result by any measure. I. William Lane, MS, PhD, Shark Cartilage Therapy Evaluated, ChiroWeb.com www.chiroweb.com/archives/12/05/11.html

  
  Or, on p. 103 of his book, William Lane's fifth patient starts out her participation in the Cuban study with "a 90-centimeter tumor" which after six weeks of shark-cartilage therapy "had decreased to 85 centimeters in length."  That would be an ovarian tumor about half an inch short of one yard long, shrinking to 2½ inches short of a yard.  One supposes either that the patient was gifted with an extraordinary capacity for survival and deserved a place in the Guiness Book of World Records, or that William Lane suffered a momentary confusion between centimeters and millimeters, and that his responsibilities as an entrepreneur left him little time to proofread his scientific writing.
  
  

On not a single one of the above criteria, then, are we able to find reassurance that William Lane can be trusted.

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The consensus of the scientific community is that The Theory Makes No Sense

The classic theory of why shark cartilage should destroy tumors is as follows:

MIKE WALLACE:  Bill Lane has spent his life in the fishing industry.  "Fish get cancer," he says.  "We humans get cancer, but sharks don't."  Bill Lane believes there's something in the cartilage of a shark that stops cancer tumors from growing, growing in sharks and in humans. Sharks Don't Get Cancer, CBS News, 60 Minutes, 28-Feb-1993, Volume XXV, Number 23, Burrelle's Information Services, p. 2.

Basically, cancers that have solid tumors require a blood supply to feed the tumors.  Cartilage is tissue that contains no blood vessels due to special proteins that inhibit blood vessel formation.  These proteins are called "antiangiogenesis" factors.  This term is derived from "anti" meaning here that it will inhibit, "angio" meaning "pertaining to blood vessels," and "genesis" meaning "formation of."  Without blood vessels to feed the tumor, it will die. The blood network of a tumor is fragile.  Tumor capillaries are different from those of normal tissues and may be considered to be "immature."  Their walls are thinner and decidedly more fragile.  Tumor blood vessels are constantly broken down and replaced by new blood vessels.  When an existing blood vessel is broken down in the presence of antiangiogenesis factors, it is not replaced by a new vessel and the section of the tumor fed by that blood vessel dies (necrosis). Interview With Dr. I. William Lane, Interviewed By Richard A. Passwater Ph.D., Shark Cartilage and Cancer, Revisited: A follow-up interview, Health World Online www.healthy.net/asp/templates/interview.asp?PageType=Interview&ID=182

However, Saul Green lays out four reasons why William Lane's classic theory cannot work:

The informed consumer should understand the following about shark cartilage: Ingested foods are all subjected to the digestive action of the stomach acids as well as to digestive enzymes and bile in the small intestine.  Shark Cartilage is no exception.  The anti-angiogenesis activity of shark cartilage is due to the proteins it contains, but each of these proteins is destroyed by stomach acids. These proteins are large and even if undigested, they will not pass through the wall of the small intestine to get into the circulatory system. Shark proteins are foreign to the host so the immune system will react to their presence in the circulation, by producing antibodies.  Continued exposure to these proteins could trigger allergic reactions including anaphylactic shock. To inhibit angiogenesis, the intact shark cartilate proteins would not only have to get into the circulatory system but they would also need to be maintained at a concentration around the tumor site that is effective for growth inhibition.  Since the amounts of these anti-angiogenic proteins in native shark cartilate is minute, pounds of the raw cartilage would have to be eaten each day to achieve an inhibitory concentration. Saul Green, Ph.D., Shark cartilage, Healthcare Reality Check www.hcrc.org/faqs/sharks.html

A couple of examples underline the futility of trying to introduce proteins into the blood stream through the process of digestion:

Rattle snake venom is a protein that can kill you if it gets into the bloodstream.  The protein from pure milk could also kill you if it got into the blood stream.  Yet you can drink the rattle snake venom and milk and it will be digested like other proteins and not cause any problems. Aubrey Pilgrim, Quackery, Prostate Pointers www.prostatepointers.org/prostate/lay/apilgrim/chapter19.html

The following statement is useful not only for the creative illustration which accompanies it, but also for the further example of insulin as a protein that cannot get into the blood stream through digestion, and also for debunking William Lane's use of rectal enema to deliver shark cartilage (which he did for one reason only — to avoid the vomiting that shark cartilage induces when swallowed):

Should There Be a Shark in Your Medicine Cabinet? Dr. Ruth Kava [...] To suggest that a protein can be absorbed and still function as an entire unit after being broken down by the digestive process is disingenuous.  The fact that a protein has been "pulverized" and suspended in a solution (as Lane claims to have done for shark cartilage) does not mean that that protein will be protected from digestion if it is eaten. If this sort of "protection" were possible, millions of diabetics would not have to inject the protein hormone insulin — they could simply take it in a pill.  But insulin, like any other protein, is broken down during digestion and is thus rendered inactive by the time its constituent amino acids are absorbed into the bloodstream.  It is more than likely that the same digestive processes that inactivate insulin would also inactivate any anticancer activity of shark cartilage. Lane also suggests in his book that the shark cartilage can be administered by enema into the lower gastrointestinal tract.  But the same absorption problem remains.  In normal digestion, this area of the intestine absorbs water and some minerals, but not whole proteins.  The probability that an effective amount of inhibitor could be absorbed by this route is virtually nil.  And since Lane himself, on page 57 of his book, states that "The potency of shark cartilage as an angiogenesis inhibitor increases with its increasing protein content," the inability of protein to be absorbed whole presents an insurmountable barrier to oral or rectal administration. Dr. Ruth Kava, Should There Be a Shark in Your Medicine Cabinet? Healthcare Reality Check www.hcrc.org/contrib/acsh/articles/sharks.html

From what we have read just above, it was to William Lane's claim that "finely divided shark cartilage" would pass "through the intestinal wall as a suspension" that the U.S. Patent Office might have found it easiest to object; however, it would appear that the Patent Office employees were insufficiently versed in human physiology to recognize that what William Lane was patenting was an impossibility:

Part of the patent referring to the action of shark cartilage reads as follows:  "This invention relates generally to a method of and a dosage unit for inhibiting angiogenesis or vascularization in an animal having an intestinal wall utilizing an effective amount of shark cartilage, particularly finely divided shark cartilage, for passing through the intestinal wall as a suspension for inhibiting interalia, tumor growth and metastasis, in particular Kaposi sarcoma, arthritis, in particular rheumatoid arthritis, diabetic retinopathy and neovascular glaucoma, psoriasis, and inflammatory diseases with vascular component." Herbs4GoodHealth Enterprises www.angelfire.com/mac/herbs4health/shark.html (blue font added)

The four counter-arguments presented by Saul Green above do not prove that shark cartilage is incapable of curing cancer, as it might cure cancer in some manner other than that expressed in William Lane's classic theory, as perhaps by simply supplying some chemical which is toxic to cancer cells, or somehow stimulating the immune system.  What the four counter-arguments do demonstrate is that William Lane justified his shark-powder business by offering a theory that appeals to a public lacking the expertise to evaluate it, but not to scientists who see its flaws.

Perhaps it is William Lane's own recognition that his theory is untenable that forced you to explain it for him on your broadcast, while he himself avoided talking about it:

MIKE WALLACE:  Tell me, what is it in shark cartilage that kills this — this blood network? Dr. WILLIAM LANE ("Sharks Don't Get Cancer"):  You know, Mike, today we've got so wrapped up in how does it happen, what is doing it, we've lost sight of the fact that it just happens.  It's non-toxic and it works.  Let's find out tomorrow why it works or what in it works, but let's just do — accept today.  It works.  (p. 2) Dr. LANE:  I'm getting hammered with theories all the time.  Now theories are great, but the important thing is what does the clinical trials show?  What does the patient tell you?  The patient is telling me that by giving them shark cartilage they're getting better.  And to me, that's all that's important.  (p. 3) Sharks Don't Get Cancer, CBS News, 60 Minutes, 28-Feb-1993, Volume XXV, Number 23, Burrelle's Information Services.

Furthermore, we shall see immediately below that William Lane's theoretical underpinnings are further eroded by the observation that sharks do get cancer, that cancer does attack cartilage, and that cartilage does have some blood supply — an accumulation of deviations (from theory postulates) so devastating as to put the theory up for candidacy as — among theories that have been influential and widely credited — one of the most preposterous of the 20th century.

As is to be expected, William Lane's own evaluation of his theory is somewhat more positive — on page 5 of his book, he awards himself a congratulatory pat on the back for having come up with "a brilliant theory."

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It would not have been hard for you to find out that Sharks Do Get Cancer

The oft-repeated sound bite that sells shark powder is that Sharks Don't Get Cancer!

MIKE WALLACE:  "Sharks Don't Get Cancer."  That's the title of a controversial book by Dr. William Lane, who holds a Ph.D. in biochemistry.  Bill Lane has spent his life in the fishing industry.  "Fish get cancer," he says.  "We humans get cancer, but sharks don't."  Bill Lane believes there's something in the cartilage of a shark that stops cancer tumors from growing, growing in sharks and in humans. Sharks Don't Get Cancer, CBS News, 60 Minutes, 28-Feb-1993, Volume XXV, Number 23, Burrelle's Information Services, p. 2.

However, the passage below outlines the thinking on the subject of Gary Ostrander, associate dean for research at Johns Hopkins Krieger School of Arts and Sciences, who concludes not only that sharks do get cancer, but also that whether they get cancer at the same or a different rate from other fish is unknown, and that some differences in cancer rates among fish might be explained not by their inherent resistance to cancer, but by how much carcinogen they swallow:

So Ostrander and a colleague combed through the National Cancer Institute's Registry of Tumors in Lower Animals.  There they uncovered 40 cases of benign and malignant tumors in sharks and their close relatives — skates, rays, and ratfish.  [...] And several biologists have called Ostrander and [registry director John] Harshbarger to report new cases of tumors in sharks.  Ostrander is visibly outraged by Lane and other marketers of shark cartilage.  Lane's data, he declares, is "largely bogus.  Sharks are being destroyed needlessly to exploit desperate people, based on erroneous information."  [...] In explaining the need for further research funding on sharks and their relatives, the House and Senate Appropriations Committee began with this clause: "The committee notes the unusually low incidence of cancer in sharks, skates, and rays." To Gary Ostrander, that premise lacks any sort of scientific foundation. Ostrander and Harshbarger's search of NCI's Registry of Tumors in Lower Animals clearly shows that sharks get cancer.  The Registry includes literature on and specimens of tumors in cold-blooded animals.  Ostrander and Harshbarger identified two previously undescribed cancers in sharks — a kidney cancer in a dogfish and a blood cell cancer in a sandbar shark.  They also found three tumors of the cartilage — calling into question the supposition that shark's cartilage protects the animals against cancer — and tumors in every other organ system except the respiratory system.  About a dozen were malignancies. Lane admits there have been cases of cancer occurring in sharks but contends that the numbers are "insignificant."  He writes in his book, "... while ALMOST No Sharks Get Cancer might have been a bit more accurate, it would have been a rotten title."  "That's propaganda 101," replies Ostrander.  He and Harshbarger say that no one knows whether sharks have an unusually low rate of cancer. "There has never been a definitive study," says Harshbarger.  "It is ridiculous to say that sharks don't get tumors, or get a lower rate of tumors, because nobody ever looked.  We believe many more tumors would be found if sharks were systematically surveyed."  The Registry is simply a repository that accepts all reports of tumors, including those noted by the layperson. He adds that he would not be surprised if sharks did have a lower incidence of cancer than many other fish.  Most sharks are pelagic, while fish that grub around at the bottom of the ocean, lakes, or ponds come in contact with sediment where carcinogens lie.  "People ask me if I eat the fish from Puget Sound or Boston Harbor," he says.  "And I tell them I don't eat the flounder and English sole [which feed on the bottom].  But I have no problem eating the salmon or rockfish." Melissa Hendricks, Predators promise, Johns Hopkins Magazine, June 2000 www.jhu.edu/~jhumag/0600web/shark.html

And cancer does attack cartilage

Sharks do get cancer, and sometimes, as noted in the block quote just above, their cancer even attacks their cartilage, as it sometimes attacks the cartilage of humans:

chondroma.  A benign tumor composed of cartilage. chondrosarcoma.  A malignant bone tumor derived from cartilage cells which erodes the bone and invades adjacent soft tissues. Ida Dox, Biagio John Melloni, and Gilbert M. Eisner, Melloni's Illustrated Medical Dictionary, The Williams & Wilkins Company, Baltimore, 1979.

Furthermore, if chondrosarcoma constitutes 11% of all malignant bone tumors in humans, and if cartilage constitutes less than 11% of the total mass of bone-plus-cartilage, this might suggest that cancer prefers to attack cartilage to bone, which would throw yet another monkey wrench into William Lane's theory that cartilage inhibits tumor formation (by blocking angiogenesis), and could spark the fad of eating bone powder instead of eating cartilage powder.

And cartilage does have some blood supply

Cartilage is relatively non-vascular and is nourished normally by tissue fluids.  The chondrocytes divide and grow within the cartilage but this interstitial growth is limited to a certain size by the need for diffusion of nutrients through the matrix.  Increase beyond this limiting size can only be achieved by penetration of blood vessels into the cartilage. G. J. Romanes, Cunningham's textbook of anatomy (Twelfth edition), Oxford University Press, Oxford New York Toronto, 1981, p. 78.

Scientific illiteracy is evident in William Lane's thinking

William Lane does demonstrate an awareness that sharks are reported in the Registry of Tumors in Lower Animals at the Smithsonian Institution, and does record this awareness on page 4 of his book, Sharks Don't Get Cancer, which leads to the supposition that even while broadcasting the opposite to your 60 Minutes viewers, you yourself must have known this — that sharks do get cancer — either from talking to William Lane or from reading his book.

However, Lane is dismissive of these Registry of Tumors reports, attributing more than half of them to "incorrect diagnoses," without explaining how he knows that so many of the shark diagnoses had been incorrect, or whether an equal proportion of the diagnoses of non-sharks had also been incorrect, or why the rate of false-positive diagnoses should be higher for sharks than it was for other fish.  And at two points, William Lane falls into the classical error of inferring a correlation from a single row of a fourfold table, the second and simpler of the two instances being the statement "The total number of shark tumors is less than a fraction of 1 percent of the total tumors reported for all fishes" (p. 4).

If for the sake of simplifying our discussion we round the shark tumors in William Lane's statement upward to 1 percent and at the same time assume that the total number of fish autopsied was exactly 100, then we end up with the black numbers in the upper row of the table shown below which constitute the data that William Lane proposes as helping establish his underlying thesis that Sharks Pretty Much Don't Get Cancer.

However, unless all four cell entries within the table are known, no correlation is established, and a wide range of underlying correlations remains possible, which we are able to demonstrate by filling in empty cells in such a way as to demonstrate that the data offered by William Lane is compatible with a conclusion opposite to the one that he recommends — for example, filling in the table with red numbers (paying not the least regard to whether the red numbers reflect reality, but striving only to produce a readily-graspable, anti-cartilage conclusion), I arrive at the red entries shown below in which the total number of sharks examined had been only 1, and with this one shark presenting cancer, and in which the total number of non-sharks examined had been 198, so that only half of these had presented cancer.  In other words, the William Lane statement shown in black numbers is compatible with the conclusion that Sharks Do Get Cancer (much more often than other kinds of fish do, and in fact invariably whereas other fish got them only half the time).  It is possible, in other words, that the reason that of 100 fish tumors examined, only one was a shark tumor was that so few of those fish were sharks.  This is perhaps what Harshbarger above had in mind when he said "It is ridiculous to say that sharks don't get tumors, or get a lower rate of tumors, because nobody ever looked.  We believe many more tumors would be found if sharks were systematically surveyed."

What we see William Lane doing, then, is making the classical error of attempting to infer a correlation from data in a single row of a fourfold table, the same error which at the bottom of my letter to Ezra Levant, titled Good Priests, Bad Rabbis, of 15-Apr-2002, I caught Cardinal Roger M. Mahony making.  Cardinal Mahoney's excuse is that he is a religious leader, and not a scientist; William Lane has no excuse, as he claims to be a scientist, and presents himself to the world as an interpreter, and as a gatherer, of scientific data, and in fact as a scientific genius who is spearheading "the most momentous medical breakthrough of the century" (p. 4 of his book).

It remains to be seen whether someone ignorant of the rudimentary error of the single row is capable of authoring such a grand medical advance, or in fact of making any contribution to medicine whatever.

		SHARK
		No	Yes
C A N C E R	Yes	99	1	100
	No	99	0	99
		198	1	199

One might comment further on the Registry of Tumors in Lower Animals that if it records only cases in which tumors are found, but fails to record cases in which tumors are sought and not found, then of course this Registry data is incapable of filling in any cells at all in the lower row of the table above, and thus incapable of establishing any correlation — whose practical significance to us would be that this Registry data would then be utterly incapable of telling us whether sharks get cancer more or less frequently than other animals.

One might comment further still that even if the Registry did faithfully record both every failure and every success in the hunt for a tumor, it still would not be able to determine differences in predisposition to cancer between man and other animals.  Consider that if man lived the way sharks live, only the fittest humans would survive, and life expectancy for the minority that made it through their first year of life might be 20 instead of 70, and so that cancer (being predominantly a disease of the old) would be almost unheard of.

Conversely, if sharks lived the way man lives, then sharks would have a much higher cancer rate than they do now — that is, if sharks were protected from every conceivable danger, and fed and cared for and provided medical assistance, and allowed to grow old and even put on life-support systems when they stood in danger of dying, then in all likelihood the incidence of cancer among them would skyrocket.

Thus, not only is it impossible to arrive at conclusions concerning cancer rates between man and other species from the data available, but it is even difficult to imagine what data one could practically gather that could answer such a question.  Perhaps any shark cancer rate that is ever computed should be compared to the cancer rate among humans selected to most resemble the sharks to which comparison is being made — which might be 15-year-old humans, and only those whose entire lives had been so healthy and strong that they would have survived an environment that mercilessly destroyed anyone at the first sign of weakness.  It can safely be expected that the cancer rate among these most sturdy of all 15-year-old humans would be infinitesimal.

One looks forward to the day when the teaching of scientific method is not as neglected as it is today, so that fallacies — especially elementary ones like that of the single row — are less often proposed by speakers, and less often fool listeners.

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Your viewers might have been interested to learn that Sharks Don't Live Long

William Lane credits sharks with long life in two senses — sharks as a group (about 300 species in the Order Squaliformes), he says, are "probably the longest-lived animal on Earth":

Dinosaurs once stalked the land.  Pterodactyl winged their way across the sky.  However, more than 200 million years before these creatures held dominion over land and sky, sharks swam in the seas.  And though the dinosaurs have vanished, the shark — probably the longest-lived animal on Earth — is still with us. Sharks are among the most primitive of any living vertebrates, untouched by the forces of evolution.  They have survived, and remained largely unchanged, for 400 million years simply because they are the creatures best suited for survival — perfectly outfitted in their structure, their senses, their mating habits, and their resistance to disease. Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993, p. 7.

And according to William Lane, individual sharks are able to survive for a century:

Many of the adaptations that have enabled the shark to long endure also enable individual shark species to be long-lived, attaining life spans that range from twenty-five to one hundred years.  It is believed that the spiny dogfish, for instance, lives seventy years, perhaps even a whole century.  There is more concrete information about the well-known Australian school shark, which has been fished for more than half a century.  Tagging of these sharks revealed several that were about sixty years old. Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993, p. 8.

However, scanning the comments of others suggests that William Lane may have selected only the highest guesses of shark longevity that he was able to find, or else that he's pulling high numbers out of thin air.  What is more typically found in the statements of others is, in the first place, that next to nothing is known about shark longevity:  referring to sharks generally, Bumpy Tail Ragged-Tooth Shark, Crocodile Shark, Swell Shark, Whale Shark, and another Whale Shark.

And when longevity estimates are offered, they tend to be less exciting than are those of William Lane, though it does seem to be the case that various species of dogfish are among the longest-lived of sharks, with the Spiny Dogfish perhaps walking away with the record, which, however, should not help William Lane sell much shark powder, as Spiny Dogfish are not among the sharks whose cartilage he powderizes:

• Dogfish (Harrisons) 46+, and (Southern) 50, and (Spiny) 75+,
  
• Great White Shark 30, 50, or 10-50,
  
• Horn Shark 25,
  
• Sandtiger Shark 17,
  
• School Shark (Australian) 32 and (New Zealand) 25,
  
• Tiger Shark 14-37,
  
  

But even if it were granted that the Spiny Dogfish is capable of reaching 70 or so years, this would not be a strong argument that eating Spiny Dogfish parts was the most efficient way to acquire longevity, as other fish — bony and not cartilaginous ones — live much longer than that.  Specifically, Table 2 of Kristen M. Munk (Maximum ages of groundfishes in waters off Alaska and British Columbia and considerations of age determination, Alaska Fishery Research Bulletin, Vol. 8, No. 1, Summer 2001 Alaska Department of Fish and Game) presents estimates of maximum ages of 48 groundfish species, the Spiny Dogfish being credited with a maximum age of 66 years, which is in line with our expectations.  However, of the 48 fish species in the table, 17 have maximum ages even greater than 66.  Of these 17 longer-lived species (none sharks), five have maximum ages exceeding one hundred years, and one of the five has a maximum age exceeding two hundred years: Redbanded Rockfish 106, Tiger Rockfish 116, Yelloweye Rockfish 118, Shortraker Rockfish 157, and Rougheye Rockfish 205.

A scanning of alternative opinions, then, gives the impression that William Lane's estimates of shark longevity are inflated, with the one hundred years he proposes as commonplace seeming instead to be rare or implausible.  More importantly, bony-fish species exist that greatly surpass sharks in longevity — some rockfish species, for example — such that if it were the case that man's eating the animal that lived longest inspired man himself with longevity, then it would make more sense to eat the bony-and-not-cartilaginous Rougheye Rockfish that is able to reach 205 years, than to eat cartilaginous-and-not-bony sharks that

• often manage to survive less than one-eighth as long (around 25 years),
  
  
• that in the case of the Spiny Dogfish may manage to survive for one-third as long (around 70 years),
  
  
• and that even according to William Lane's exaggerated estimates of the longevity of sharks, only manage to live half as long (around 100 years).
  
  

In any case, the rationale for increasing our own longevity by eating animals that have survived for 400 million years is shaky, as sharks might have survived that long by giving cancer to any predators who dared eat them.  The same could be said with respect to the individual longevity of any animal — if it does live to a ripe old age, that may be because its forebears have driven its predators to extinction by poisoning them with their own flesh.

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You should have warned your viewers that shark cartilage therapy has serious Side Effects

The standard claim is that shark-cartilage therapy is non-toxic and without side effects:

For patients with extremely advanced cancer, some doctors have nearly doubled the dosage to almost one gram of shark cartilage for each pound of body weight with good results and no observed toxicity or side effects. Interview With Dr. I. William Lane, Interviewed By Richard A. Passwater Ph.D., Shark Cartilage and Cancer, Revisited: A follow-up interview, Health World Online www.healthy.net/asp/templates/interview.asp?PageType=Interview&ID=182

And, unlike chemotherapy, shark cartilage is completely nontoxic and has no adverse side effects. Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993, p. 69.

Some physicians, like Renato Martinez, are so convinced of cartilage's harmlessness as to recommend throwing caution to the winds:

"Be sure not to underdose, but if anything overdose.  Remember there are no toxic effects whatsoever and very few minimal side effects." Commonweal www.commonweal.org/cartconflict.html

Which is pretty much in line with the attitude that you recommend in your 60 Minutes broadcast:

Dr. WILLIAM LANE ("Sharks Don't Get Cancer"):  It's non-toxic and it works. [...] WALLACE:  And the side effects here? Lt. MENENDEZ:  There are not side effects. WALLACE:  No loss of hair? Lt. MENENDEZ:  No loss of hair. WALLACE:  No anemia. Lt. MENENDEZ:  No nem — no anemia. Sharks Don't Get Cancer, CBS News, 60 Minutes, 28-Feb-1993, Volume XXV, Number 23, Burrelle's Information Services, p. 5.

However, perhaps shark cartilage should not be described as lacking side effects when it is occasionally observed that half of all patients are unable to tolerate it:

Human data: A phase II open-label trial evaluated the effects of shark cartilage in 49 psoriatic patients.  Twenty five patients dropped out, primarily due to unpleasant gastrointestinal side effects. Lana Dvorkin, PharmD, Thu Le, & Svetlana Gerzenshtein, Shark Cartilage, Massachusetts College of Pharmacy and Health Sciences, revised 14-Sep-1999 www.mcp.edu/herbal/sharkcartilage/sharkcartilage.pdf

The side effects may be more than just gastrointestinal:

Unlike most practitioners, he [Dr. Richard Kunin] does report of complaints of dizziness and breathing difficulties in patients receiving cartilage. Commonweal www.commonweal.org/cartconflict.html

Although the loss of hair and anemia that you mention in your broadcast have not as yet been reported as side effects of shark cartilage therapy, the list of side effects that have been reported is lengthy (reactions to bovine cartilage are retained in the quote below to demonstrate that cartilage of whatever origin may be expected to have side effects):

Adverse Effects The side effects associated with cartilage therapy are generally described as mild to moderate in severity.  Inflammation at injection sites, dysgeusia, fatigue, nausea, dyspepsia, fever, dizziness, and edema of the scrotum have been reported after treatment with the bovine cartilage product Catrix®.  Nausea, vomiting, abdominal cramping and/or bloating, constipation, hypotension, hyperglycemia, generalized weakness, and hypercalcemia have been associated with the use of powdered shark cartilage.  The high level of calcium in shark cartilage may contribute to the development of hypercalcemia.  In addition, one case of hepatitis has been associated with the use of powdered shark cartilage.  Nausea and vomiting are the most commonly reported side effects following treatment with AE-941/Neovastat®, the aqueous extract of shark cartilage. Cartilage (Bovine and Shark), National Cancer Institute, Updated 01-Apr-2002 www.cancer.gov/templates/doc.aspx?viewid=4AABA6FA-8A2E-4BF7-941F-7DC416B41233 (footnotes and links removed).  This is by far the the most accurate and thorough and up-to-date single source of information on cartilage therapy.

Reference above to the high level of calcium producing hypercalcemia is echoed below first in the caution that the calcium level is excessive, and then that it is dangerous:

A possible complication of shark cartilage could be the excessive amount of calcium at 22% which with a daily dose of 70 grams results in 14 grams of calcium, or 14 times that recommended by the USRDA. Cartilage, University of Texas Center for Alternative Medicine Research in Cancer, www.sph.uth.tmc.edu/utcam/therapies/crtlg.htm (blue emphasis added)

"Shark cartilage is stated to be an important source of calcium when, in fact, it is a dangerous source of too much calcium when taken in what is labeled the 'therapeutic' dose." (Prudden) British Columbia Cancer Agency, Unconventional Therapies, Revised February 2000 (blue emphasis added)

The list of side effects sometimes extends to suggest that shark cartilage interferes with Central Nervous System functioning:

Reported side effects include nausea, vomiting, constipation, hypotension, hyperglycemia, altered mental status, generalized weakness and decreased motor strength, sensation and performance.  Shark cartilage is contraindicated during pregnancy, lactation, childhood and in any condition in which impaired angiogenesis may be harmful. Lana Dvorkin, PharmD, Thu Le, & Svetlana Gerzenshtein, Shark Cartilage, Massachusetts College of Pharmacy and Health Sciences, revised 14-Sep-1999 www.mcp.edu/herbal/sharkcartilage/sharkcartilage.pdf

The last sentence in the above quote brings to mind the possibility that if shark cartilage acts as theorized — that is, by inhibiting angiogenesis (the creation of new blood vessels) — then this would necessarily be harmful in a situation where new blood vessels were needed (as in a growing fetus, or in a growing youngster, or in an adult in a region of injury).  Furthermore, if shark cartilage acted not to inhibit angiogenesis, but rather to destroy existing blood vessels, then it would have even greater potential to do damage, as it might fail to discriminate perfectly between the tumor-feeding blood vessels that it was supposed to destroy, and the healthy-tissue-feeding blood vessels that it was supposed to leave uninjured.

In the course of such speculation, we have to remind ourselves that shark cartilage eaten by humans has in fact not been shown to have either anti-angionic properties, or tumor-blood-vessel destroying properties.  The purpose of the present speculation is to demonstrate that if the theory of the shark-cartilage merchants were to be adopted, then eating shark cartilage should be expected to be dangerous.  The shark-cartilage merchants can be confident that shark cartilage is harmless to circulatory systems only if they are convinced that it does not work as theorized.

In short, shark-powder merchant William Lane does appear to have fallen short of obeying the leading Hippocratic injunction, "First, do no harm."

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You failed to detect William Lane's Symptoms Of Slovenliness

We have already seen plentiful evidence of William Lane's sloppiness, and the present section serves merely to reinforce that evidence with an example which leapt out at me from the computer screen.  Sometimes the smallest sample of a person's behavior is sufficient to establish his level of qualification in some field, and William Lane's inserting the graph below into one of his articles demonstrated to me that his level of scientific qualification is abysmal.

The example in question is the upper of the two graphs below, which appears on page 2 of an online article by William Lane.  At a glance, I take in the following defects, which I show corrected in my own version of the graph immediately below the original:

(1) Y-axis label missing.  The ordinate (Y-axis) is unlabelled, with my likely-wrong guess of "Median Tumor Diameter (mm)" serving to illustrate the nature of the label that is missed.

(2) X-axis spacing erroneous.  The intervals between days on the abscissa (X-axis) is sometimes 3, 4, or 7 days, and yet the spacing is equidistant; correct would be to space the positions tested in proportion to the days separating them.  And, incidentally, the repetition of the word "Day" is redundant, and serves only to clutter up the graph — one "Day" underneath the numbers would have done the trick, or a single label like my "Days of Treatment."

Tumor growth induced by MEXF514 human melanoma inhibited by orally administered shark cartilage.  Growth is geometric in controls from day 14 to 21.  Data of Atassi, Institut Jules Bordet (personal communication). Atassi graph upgraded with imagined details.  Confidence intervals around each data point are imaginary 25th and 75th percentiles.  Red data displaced slightly left, and blue data slightly right, to reduce overlap.  This version of the Atassi graph illustrates the sort of changes that are needed to make the graph interpretable, and to make its underlying research credible.

(3) Poor selection of testing days.  The best strategy is to test most often where most is happening.  Thus, as things don't start hopping until after Day 14 (and as it is often noted in this sort of research that results are delayed), it would have been better to test less frequently during the first two weeks, and more frequently after, as for example by substituting the following six testing days for the existing ones: 0, 10, 15, 18, 21, and 24.  To put it another way, 11/12 of the data points shown in the upper graph waste resources documenting that little if anything was happening, and only one data point out of the 12 measures the effect of interest — a misallocation of resources that a trained researcher would have known to avoid.

(4) Defective dosage specification.  Specifying dosage as "1200/kg of body weight" is missing a unit attached to "1200", as perhaps "mg".  Also, a hyphen or a dash immediately before a number is anathema — it is too readily taken for a minus sign (and is bad form even though in this particular instance it is unlikely to be mistaken for a minus sign).  Third, adding that this is the dosage per day would have made the specification more precise, although in the absence of such detail, per day would be the most reasonable guess.

(5) How many patients?  One needs to know how many patients there are per group.  Perhaps only one?  Perhaps a pitifully small number, like two or three?  My entering N=20 is high, and would be indicative of a quality effort.

(6) Show dispersion.  Good form would have been to plot in addition to the measure of central tendency (as the mean or median) some indication of dispersion (some confidence interval) around this mean or median.  Many options are available — I show plotted the 25th (bottom bar) and 75th (top bar) percentiles for the 20 values at each data point in the graph (imaginary percentiles, of course, and shown hugging the plotted dots so tightly that high statistical significance would be assured, meaning that no way could such divergence of functions have happened "by chance").

(7) "Geometric" used incorrectly.  The statement that "Growth is geometric in controls from day 14 to 21" succeeds in conveying "Wow! — Is that a big jump!" but use of the qualifier "geometric" nevertheless happens to be mathematically incorrect, simply because one cannot tell from looking at two numbers whether their growth is arithmetic (by addition), or geometric (by multiplication).  Thus, 40 to 80 could be arithmetic growth (add 40), or geometric growth (multiply by 2).  We need at least three numbers in sequence to determine whether growth is arithmetic or geometric: thus, 0, 40, 80 is arithmetic (add 40 each time); whereas 20, 40, 80 is geometric (multiply by 2 each time).  A perfectly adequate description of control-group behavior in the Atassi graph is that nothing much happened for two weeks, then in the third week some 60 mm was added (growth was arithmetic) to tumor diameter.

(8) Unpublished data is less convincing.  "Personal communication" elicits the question of why these results haven't been published, and elicits the accompanying answer that the research may have been of too poor quality to be accepted for publication (especially in a peer-reviewed journal).

(9) Low production values.  Low production values in graphing, or in preparation for online publication, such as those evident in the upper graph, bring to mind the possibility of low standards in other aspects of the project, such as laboratory procedure or fidelity of reporting.

In short, whoever prepared this graph (probably Belgian chemotherapist Dr. Ghanea Atassi of the Institute Jules Bordet in Brussels) flaunts multiple symptoms of a deficient education in scientific method, as does anybody who introduces this graph in evidence (probably American shark-cartilage merchant William Lane).  The slovenliness of this graph is not proof that eating shark cartilage fails to cure cancer, but it is reason to look at shark-cartilage claims originating from the same source with heightened skepticism.

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Shark-cartilage therapy marches toward Claiming Infinite Benefits

Real-world remedies offer finite benefits, and these often come at the price of what in medicine are known as side-effects.  Remedies from the world of fantasy come without the price of side-effects, and approach the infinite.

We have already seen above that shark-cartilage therapy comes with the false claim that it lacks side-effects, and we will see below that it also comes with a startlingly-long list of diverse conditions that it is supposed to alleviate or cure; it is even offered as being as beneficial to pets as it is to humans.  Thus, we see below that in twenty-two pages of his Sharks Don't Get Cancer, William Lane manages to credit shark cartilage with alleviating or curing 20 different conditions or diseases (that is, if we count dog arthritis as a separate disease from human arthritis):

But tumors and metastases are not the only conditions that can be controlled by shark cartilage.  Once shark cartilage is in a person's system, its anti-inflammatory and antiangiogenic characteristics begin to work on a variety of diseases.  Its effects on arthritis, psoriasis, and enteritis have already been demonstrated, and its probable effects on diabetic retinopathy, neovascular glaucoma, and macular degeneration have been discussed in a number of scientific journals.  (p. 111) My dog George, who at nine years of age was painfully arthritic and pitiful to see, was the first dog to whom shark-cartilage therapy was ever administered. George received a very crude early batch of shark cartilage given to him daily along with his food.  Within two weeks, he was a new dog, back to his original active self.  He lived to the age of fifteen, taking shark cartilage with food every day for the last six years of his life.  (p. 120) After three weeks of treating the patient, investigators noted that his spinal column had straightened and his pain had completely disappeared.  The patient now says, "My spine has straightened out; I am able to move my arms and legs without pain; my walk has improved; I am more agile.  I feel like working; I'm not tired and my constipation and gastritis have improved."  (p. 124) [R]esearchers have found that shark cartilage is successful in reducing pain in approximately 70 percent of osteoarthritis cases and 60 percent of rheumatoid arthritis cases.  (p. 126) Patients who suffered from eczema in addition to arthritis noted improvement in the skin condition.  Subsequent research demonstrated that shark cartilage is indeed effective against skin diseases such as psoriasis, poison oak and ivy, and acne.  (p. 127) Other "skin" conditions successfully treated with a cartilage preparation include acne; mandibular alveolitis ("dry socket"), an extremely painful gum condition that sometimes follows tooth extractions; and pruritis ani, intense chronic itching in the anal area.  In addition, suppositories prepared from bovine cartilage were successfully used to treat hemorrhoids.  (p. 130) Although I am just now pulling together the people to undertake a formal study of the effects of shark cartilage on blindness, many researchers feel the results are a foregone conclusion.  This is because many types of blindness are caused by angiogenesis.  Diabetic retinopathy, macular degeneration, and venous occlusion in the retinal circulatory system are a few of the ocular disorders characterized by the growth of new retinal blood vessels.  (p. 132) Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993, p. 101.  (blue emphasis added to each unique mention of a condition or disease.)

Another list of the benefits of shark cartilage adds five, for a total of 25:

Nutriveda, Inc., of Brooklyn, New York, had claimed that its product Cardilet was effective against cancer, rheumatism, arthritis, diabetes, fibroids, bursitis, circulatory problems, and cysts. Stephen Barrett, M.D., FDA and FTC Attack Shark Cartilage, QuackWatch, revised 09-Jun-2000 www.quackwatch.com/04ConsumerEducation/News/shark.html (blue emphasis added)

Then with something like five new ones below, the total soars to 30:

Investigations of cartilage to improve health began with a graduate student wondering whether cartilage could assist wound healing.  Physician-researcher John Prudden decided to find out, using a powdered and washed cartilage product.  There is now a long list of reported effects of cartilage preparations, including accelerating wound healing, possessing topical anti-inflammatory capability, alleviating autoimmune diseases, relieving osteoarthritic pain, alleviating scleroderma (a disease in which the skin hardens), easing skin symptoms of herpes virus infections, alleviating psoriasis (a chronic, scaly skin disease), and inhibiting a wide spectrum of cancers (Prudden, 1985). NIH Complementary/Traditional, HealthHelper.com www.healthhelper.com/complementary/book_alternative/research2.htm (blue emphasis added)

If we added pancreatic tumors in cats, that would bring the total to 31:

Ben Dow, D.V.M., a veterinarian in Putney, Vermont has used Cartilade extensively in his practice for three years with an estimated 30 cancer cases and 200 arthritis cases in dogs and cats.  Dow feels that cartilage is 90% effective in "curing" cancer and 100% effective with arthritis, the latter mostly in dogs.  Dow reports having seen two cases of complete regression of pancreatic tumors in cats as a result of cartilage therapy. Commonweal www.commonweal.org/cartconflict.html (blue emphasis added)

And mustn't forget Kaposi sarcoma, mentioned in William Lane's patent higher above, which makes 32.

No doubt we could keep on accumulating still other conditions claimed to be treatable with shark cartilage — but let's leave it at what we have, and add only that such public claims of therapeutic effect might be only the tip of the iceberg, and that claims made privately by charlatans to those turning to them for the relief of their own suffering, or the suffering of their pets, may be even broader.

Such excessively-broad claims, and made in the absence of empirical substantiation, invite the understanding that shark-cartilage therapy constitutes a regression from science to superstition.

Top Cuban Integrity Theory Sharks Longevity Unsafe Slovenliness Benefits God Pecuniary Experiment Damages Summary

You helped found the religion of Eating The Shark God

Although in our secular, and swiftly-changing, society, formal religions do not take root easily, and if they do begin to take root tend quickly to wither away, there nevertheless exists what might be viewed as incessant and brief flirtation with a series of religions.  Shark-worship is one such evanescent religion, and you are among its high priests.

Every religion needs one or more gods, and shark-worship offers the shark god.  A god is characterized by immortality, omniscience, omnipotence, and the ability and willingness to grant favors.

Immortality.  A god is often immortal, though remarkably long-lived will do in a pinch, and the shark-god claims a 400-million-year ancestry, and a 100-year individual longevity.

Omniscience.  A god is often omniscient, though remarkable powers of perception will do in a pinch:

Perhaps more than anything else, the sense organs, which are incredibly developed, set the shark apart as a successful — and terrifying — creature. Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993, p. 14.

Perhaps the most amazing of the sense organs are the ampullae of Lorenzi, which the shark utilizes just inches from its victim [to] detect weak electrical fields at short ranges, enabling sharks to find prey even without visual or olfactory clues. Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993, p. 15.

Sharks can smell blood a mile away, especially in a current.  They can sense one drop of blood in a million gallons of water; they can, in other words, smell half a teaspoon of blood in three swimming pools' worth of water.  This, combined with their ability to hear the abnormal beat of an old hurt fish half a mile away, makes sharks the perfect scavengers, feeding primarily on wounded fish. Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993, p. 16.

Omnipotence.  A god is often omnipotent, though awesome power will do in a pinch.  The shark, always an object of fear, has been transformed in our society into an object of phobia by the documentary film Blue Water, White Death (1971), and more especially by the movie Jaws (1975), and after that by a series of movies and documentaries that followed in their wake.  These have succeeded in inculcating the image of the shark as the animal before which man stands most powerless.  William Lane does his share in painting the picture of terrifying power, first on the dimension of size:

The most famous shark — or the most infamous, thanks to Jaws — is the white shark, which can be roughly as large as a city bus.  One thirty-eight-foot white shark weighed in at thirteen tons, but white sharks can be twice as large as this behemoth.  The largest shark ever caught was never weighed — there was no scale big enough. Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993, p. 26.

And also with respect to strength:

These are the most powerful jaws in the world.  A metal scale wrapped inside bait revealed that an eight-foot shark has a bite pressure of 18 tons per square inch.  When a Snodgrass Gnathodynamometer was used to measure the force exerted by the jaws, it registered 6,613.8 pounds per square centimeter. Dr. I. William Lane and Linda Comac, Sharks Don't Get Cancer, Avery Publishing Group, Garden City Park, New York, Copyright 1992, Updated edition 1993, p. 19.  We note the unprofessional mixing of British with metric units.

The exaggerated size of the shark in the poster at the top of the present page, as well as in the water-skiing poster just above, reflects not the shark's actual dimensions, but the dimensions that are commensurate with man's fear and awe.  Attempts in recent documentaries to calm shark phobia convey the limited reassurance not that the shark is less overwhelming than commonly thought, but only that its frightful power to overwhelm is not unleashed against man at every opportunity.

Granting favors.  And no religion will attract adherents unless it can offer a mechanism which will release the flow of benefits from god to man.  The traditional trigger of benefit-flow is prayer — which is to say discourse with the deity which relies on supplication, persuasion, enticement, bargaining, ingratiation, and even trickery or deception.  In the case of shark-worship, though, the mechanism is not prayer, but ingestion, which some might argue makes shark-worship more magic than religion, though it can be retorted that the Christian sacrament of Communion (by means of which the communicant symbolically eats the body of Christ, and drinks his blood, in order to acquire Christ's moral qualities) shows how elements of magic can be interwoven into a religion.

And as one advantage of religion in comparison to science is that where science promises only limited benefits, religion promises infinite benefits, the advantage of shark powder over scientific treatment is that where science offers to cure only a few of our ailments, shark powder offers to cure who knows if not pretty much all of them.

Your Sharks Don't Get Cancer broadcast, then, can be viewed as a manifestation of a primitive thought pattern by means of which frail man acquires the awesome power of the god-like shark through the sacrament of partaking of its flesh, a primitive thought pattern dissected by the incomparable Sir James George Frazer in his Golden Bough, some snippets from which are as follows:

The savage commonly believes that by eating the flesh of an animal or man he acquires not only the physical, but even the moral and intellectual qualities which were characteristic of that animal or man [...].  (pp. 648-649) When a serious disease has attacked a Zulu kraal, the medicine-man takes the bone of a very old dog, or the bone of an old cow, bull, or other very old animal, and administers it to the healthy as well as to the sick people, in order that they may live to be as old as the animal of whose bone they have partaken.  (p. 650) A Chinaman in Seoul bought and ate a whole tiger to make himself brave and fierce.  In Norse legend, Ingiald, son of King Aunund, was timid in his youth, but after eating the heart of a wolf he became very bold; Hialto gained strength and courage by eating the heart of a bear and drinking its blood.  (p. 651) When Basutos of the mountains have killed a very brave foe, they immediately cut out his heart and eat it, because this is supposed to give them his courage and strength in battle.  When Sir Charles M'Carthy was killed by the Ashantees in 1824, it is said that his heart was devoured by the chiefs of the Ashantee army, who hoped by this means to imbibe his courage.  His flesh was dried and parcelled out among the lower officers for the same purpose [...].  The Nauras Indians of New Granada ate the hearts of Spaniards when they had the opportunity, hoping thereby to make themselves as dauntless as the dreaded Castilian chivalry.  The Sioux Indians used to reduce to powder the heart of a valiant enemy and swallow the powder, hoping thus to appropriate the dead man's valour.  (pp. 652-653) With a like intent the Chinese swallow the bile of notorious bandits who have been executed.  (p. 653) Before every warlike expedition the people of Minahassa in Celebes used to take the locks of hair of a slain foe and dabble them in boiling water to extract the courage; this infusion of bravery was then drunk by the warriors.  (p. 654) Sir James George Frazer, The Golden Bough: A Study in Magic and Religion, MacMillan (Papermac edition, abridged), London, 1922 (reprinted 1971).

Frazer describes the committment to magic in our own day as being more suppressed or concealed than extinct, and as continuing to pose a threat to society:

This universal faith, this truly Catholic creed, is a belief in the efficacy of magic.  [...]  Among the ignorant and superstitious classes of modern Europe it is very much what it was thousands of years ago in Egypt and India, and what it now is among the lowest savages surviving in the remotest corners of the world.  If the test of truth lay in a show of hands or a counting of heads, the system of magic might appeal, with far more reason than the Catholic Church, to the proud motto, "Quod semper, quod ubique, quod ad omnibus," as the sure and certain credential of its own infallibility. It is not our business here to consider what bearing the permanent existence of such a solid layer of savagery beneath the surface of society [...] has upon the future of humanity.  The dispassionate observer, whose studies have led him to plumb its depths, can hardly regard it otherwise than as a standing menace to civilisation.  We seem to move on a thin crust which may at any moment be rent by the subterranean forces slumbering below.  From time to time a hollow murmer underground or a sudden spirt of flame in the air tells of what is going on beneath our feet.  Now and then the polite world is startled by a paragraph in a newspaper which tells how in Scotland an image has been found stuck full of pins for the purpose of killing an obnoxious laird or minister, how a woman has been slowly roasted to death as a witch in Ireland, or how a girl has been murdered and chopped up in Russia to make those candles of human tallow by whose light thieves hope to pursue their midnight trade unseen. Sir James George Frazer, The Golden Bough: A Study in Magic and Religion, MacMillan (Papermac edition, abridged), London, 1922 (reprinted 1971), pp. 73-74.

One does not need to rely on Frazer's Golden Bough written in 1922 for support of the picture of subterranean forces slumbering below repeatedly erupting and threatening civilization — one can read the BBC in 2002:

Ritual killings 'pushing double figures' Police investigating the suspected ritual killing of a boy whose torso was found in the Thames, believe such murders could be "pushing double figures" across Europe. The comment from a senior Scotland Yard officer comes as police forces exchange information at the first-ever conference into such killings.  [...] Britain's first suspected case emerged last September when the torso of a still unidentified African boy was found near Tower Bridge. Black magic The boy, dubbed Adam, was thought to have been five or six years' old when he died after his throat was cut and his head and limbs cut off. Police in South Africa have estimated that hundreds of children may have been killed by witchdoctors practising a perversion of traditional "muti" medicine, using body parts to make life enhancing ointments and potions. But an expert on African ritual practices, who has been advising the Metropolitan Police on the case, has said it might also be linked to West African voodoo. BBC News, 27-May-2002 news.bbc.co.uk/hi/english/uk/england/newsid_2009000/2009876.stm (blue font added)

It is not surprising that unprincipled opportunists like William Lane will find some way to profit even from the spread of superstition; it is surprising that investigative journalism should abandon its role of fighting superstition, and instead throw its support behind the unprincipled opportunists.

This line of thinking permits us to recognize that the illustration of the shark homing in on the swimmer at the top of the present page can be understood not just literally as a predator approaching its next meal, but figuratively as well, and in two senses:

• as the god whose destructive power can be harnessed to heal, and
  
  
• as the scientifically-illiterate mass about to make its destructive appearance at the surface, where its brute strength will overwhelm intelligence embodied in a weak frame.
  
  

From Frazer's point of view as well, the Office of Alternative Medicine referred to below might more accurately be renamed the Office of Medical Superstition, not because it considers alternatives to conventional medicine (our health-delivery system does indeed stand in need of repair), but rather because it refuses to put its cause-effect speculations to the one and only test known to man — the test of formal, scientific experimentation (which is what is meant below by the "clinical trial"):

In l992, "true believers" in Congress created the Office of Alternative Medicine at the NIH.  Its mandate, they said, was the verification of the effectiveness of alternative treatments.  As was pointed out earlier, any appropriately designed clinical trial must contain the means to show that a given treatment might be worthless.  Perhaps this is why no attempt has as yet been made by the OAM to clinically evaluate the effectiveness of any alternative treatment. Saul Green, Ph.D., The Realities of Alternative Medicine for Serious Illness: A Guide for Laymen, Health Care Reality Check www.hcrc.org/contrib/green/layman.html

Thus both your 60 Minutes broadcast Sharks Don't Get Cancer, and the creation of the Office of Alternative Medicine (given its aversion to verification by experiment), can be viewed as parallel manifestations of the same phenomenon — the awakening of subterranean forces slumbering beneath which constitute a standing menace to civilisation, or more briefly, can be viewed as an eruption of superstition.

If the abandonment of science in favor of magic expands, then Golden-Bough-style remediation of ills can be expected to spread as well.  The myopic will drink extract of eagle eyes.  Competitive swimmers will swallow seal tablets.  Runners will seek swiftness through cheetah potion.  Physics students will drink tea said to be steeped in Einstein's hair, especially before final examinations.  Amputees will measure limb growth after eating octopus.  The Secretary of Defense will order the implantation of slow-release lion heart under the skins of American soldiers.  Stand-up comics will wear skin patches for the transdermal absorption of essence of Jack Benny or Bob Hope.  The bodies of those who have excelled will no longer be wasted in burial — rather, they will find themselves on the dinner tables of the living who possess the triple qualities of affluence, ambition, and superstition.  Such scenarios will seem implausible to anyone who assumes that mankind is capable only of evolution, but will seem plausible to those who recognize man's capacity for devolution as well.  Such scenes have appeared on earth before, and they can appear again, and your staging of Sharks Don't Get Cancer augers that the actors who will perform such scenes may have crawled out into the open through the cracks in the thin crust, and may this moment be laying out the silver in their dining rooms.

If sharks were able to reason, and did so as badly as some humans do, then they might notice that for every human killed by sharks, ten million sharks are killed by humans (that is the estimate!), and from that conclude that by eating killers as successful as humans evidently are, sharks could acquire man's awesome powers.  Sharks would read such books as Humans don't get caught in fishing nets, and would attribute humans' uncanny ability to their bony skeletons, and sharks seeking protection from fishing nets would chew human skeletons into a powder and swallow the powder, and those who found human bone unpalatable would instead introduce the bone powder into their cloacas, and shark bone-powder merchants would narrate the harrowing tales of sharks who had gotten trapped in fishing nets, but when given human-bone-powder tablets to swallow had managed to escape the nets, and would describe also how other sharks that had swallowed a prophylactic dose of human bone powder daily tended to avoid getting caught in fish nets in the first place.

A thought experiment that demonstrates the central role played by magical-religious thinking in luring the public toward purchasing shark powder is to imagine your 60 Minutes presentation being repeated in every detail except one — the animal credited with containing the cancer-curing agent.  Specifically, let us suppose that instead of a shark, the creature offered as containing cancer-curing body parts was a worm.  A slow-crawling worm sucking scum off the ocean floor with its toothless mouth.  Deaf, blind, limp, stupid, defenceless, disgusting, surviving perhaps one month before expiring.  From a scientific point of view, there is not the slightest reason to suppose that the shark is more likely to contain a cancer-curing agent than is this lowly worm, and yet from a business point of view, shark powder is saleable, but worm powder is not.  How to explain this except by the public's sympathizing with the primitive notion that in fact we do acquire the mental and behavioral and physical and aesthetic characteristics of the animals we eat, and by the public's preferring to acquire the characteristics of the shark to those of the worm?

Top Cuban Integrity Theory Sharks Longevity Unsafe Slovenliness Benefits God Pecuniary Experiment Damages Summary

It is to your credit that you had no Pecuniary Interests

William Lane Did Have Pecuniary Interests

William Lane holds key patents, so that no matter who is actually manufacturing or selling shark powder, William Lane is guaranteed to cash in:

On December 26, 1991. Dr. William Lane, the author of the book, Sharks Don't Get Cancer was granted a U.S. Patent covering the use of shark cartilage to inhibit angiogenesis.  This patent was fully supported by a CAM assay and by showing the inhibition of angiogenesis by Shark Cartilage.  Additional patents are underway. Dr. Larry J. Milam H.M.D., Shark Cartilage & Antiangiogenesis members.aol.com/greenmagik/shark.html

Which is not to say that William Lane was content to leave the manufacturing to others, as indicated in the blue-emphasized sentence below, the rest of the quotation serving to underscore other points made in the present letter:

Shark cartilage came to public attention in February 1993 when CBS TV's "60 Minutes" aired a program promoting the claims of biochemist/entrepreneur I. William Lane, Ph.D., co-author of the book Sharks Don't Get Cancer.  The program highlighted a Cuban study of allegedly "terminal" cancer patients who received shark-cartilage preparations.  Narrator Mike Wallace filmed several of the patients doing exercise and reported that most of them felt better several weeks after the treatment had begun.  The fact that "feeling better" does not indicate whether a cancer treatment is effective was not mentioned.  Nor was the fact that sharks do get cancer, even of their cartilage.  NCI officials subsequently reviewed the Cuban data and concluded that they were "incomplete and unimpressive."  Nevertheless, a large market was created for shark cartilage products as a "cancer treatment."  One of the major manufacturers, Lane Labs-USA, of Allendale, New York, which was founded in 1994.  Its president is Dr. Lane's son Andrew J. Lane. Stephen Barrett, M.D., FDA and FTC Attack Shark Cartilage, QuackWatch, revised 09-Jun-2000 www.quackwatch.com/04ConsumerEducation/News/shark.html (footnote numbers removed and blue font added)

Nor was getting in on the manufacturing an after-thought — William Lane was hard at work on it at least nine years before your 1993 60 Minutes broadcast:

I began developing this alternative treatment in 1984, when I brought in 200 pounds of shark cartilage from Panama.  With the help of friends in the processing industry, I created a successful method for the difficult process of drying, pulverizing, and encapsulating the substance. I. William Lane, Ph.D., Sharks Don't Get Cancer, Catholic Digest, February 1996 members.aol.com/RobinJoker/sharksdont.html

You did make a show of nailing William Lane on his pecuniary interest, but you let him slide off unscathed, leaving in the minds of your viewers a lie:

WALLACE:  (Voiceover)  While doctors like Eli Glatstein are looking for something that makes tumors shrink, Bill Lane continues traveling around the world marketing shark cartilage. There are those, you well know, Bill Lane, that say, "He's just in it for the buck, and he's a little bit of a mountebank, and he's a great salesman, and he's a nut about shark cartilage."  You've heard all of this. Dr. LANE:  I've heard it all, and in part they're true.  In terms of the money... WALLACE:  In what part? Dr. LANE:  Well, I think it's true that I'm a nut.  I think it's true that I'm a driving force.  Maybe I am a fairly good salesman in something I believe. WALLACE:  All right. Dr. LANE:  But in terms of the money aspect — yes, I'll make some money out of this.  It's not going to be megabucks.  I don't need megabucks.  But what will I get out of it?  If I can even be a part of helping cancer, this is a tremendous reward. Sharks Don't Get Cancer, CBS News, 60 Minutes, 28-Feb-1993, Volume XXV, Number 23, Burrelle's Information Services, p. 8.

The lie was that William Lane did not expect to make megabucks.  Come on!  Despite your feeble disclaimers and qualifications, the message conveyed by your program to tens of millions of viewers — and by osmosis in the days following, one might expect, to every cancer victim in the world — was that William Lane had discovered a cure for cancer.  As William Lane had positioned himself to take advantage of this perception, he certainly did expect to make megabucks, and must have been expected by those around him to make megabucks.

Expectations of megabucks follow naturally from an appreciation of the size of the potential market which in the United States alone is outlined as follows:

Over 500,000 people will die of from all types of cancer this year.  About one million men who are over 50 years old today will eventually die from prostate cancer.  If a person is dying, they will go to any extremes that offer any glimmer of hope.  If they are dying of cancer money is of no consequence.  The quacks know this, and much like a vulture, will pick the person's wallet clean.  The quackery business generates billions of dollars annually. Aubrey Pilgrim, Quackery, Prostate Pointers www.prostatepointers.org/prostate/lay/apilgrim/chapter19.html

Given such a vast market, and given the strength of the 60 Minutes recommendation, sales did not build gradually following the broadcast — they exploded immediately, and they brought instant wealth.  If the 1994 conference referred to below estimates 50,000 Americans using shark cartilage at $7,000 or more annually, then that means that not long after your 60 Minutes broadcast, Americans began spending $350 million or more annually on shark cartilage.  And multiplying William Lane's 1995 monthly gross sales of $500,000 by 12 gives $6 million in annual gross sales for him alone:

Shark cartilage is widely used.  In 1994 Chantilly conference, a special conference sponsored by the NIH on alternative therapies, researchers reported that some 50,000 Americans were using shark cartilage at costs of about $7,000 or more annually; those figures are expected to be much higher now.  [...] Although there are numerous brands on the market now, representative sales and cost estimates can be judged by the gross sales of Dr. Lane’s shark cartilage which are estimated at $500,000 per month as of 1995. Cartilage, University of Texas Center for Alternative Medicine Research in Cancer, www.sph.uth.tmc.edu/utcam/therapies/crtlg.htm (footnote numbers removed)

Figures such as the above of course do not include royalties from William Lane's book Sharks Don't Get Cancer whose success can be measured by its having been translated into 16 languages, nor patent revenues which might be substantial, as the world-wide shark-cartilage business is much larger than Lane by himself is able to supply:

Through tireless and savvy marketing, Lane has helped to build a $150 million per year world-wide cartilage business, which is currently 99 percent shark cartilage. Botanical Research Bulletin, Vol. 1, No. 12 www.anaturalpharmacy.com/Articles/botan-r1.htm

Though estimates do not always correspond, they are all astronomical.  The quotation below serves to reinforce the notion that Lane might make vast amounts from royalty payments from the large number of his competitors, even though he makes a show of complaining about them.  Also called to mind below is that the amounts to be made overseas dwarf the amounts to be made in the domestic market:

Lane: The "60 Minutes" show did my research a lot of good, but it had a bad side as well.  Bad because it suddenly brought in about 30 new competitors.  Some of them are good products but some of them are not.  It seems odd that something that took me years of research to develop took others less than two weeks.  You can't even run tests in two weeks!  Yet, there were 30 new products on the market in about two weeks.  Half of these "overnight" products were half sugar.  There seem to be more sharks on the land than there are in the ocean.  [...] Lane: I estimate that twenty to twenty-five thousand people are using shark cartilage therapeutically around the world.  Japan and the entire Far East have become a gigantic market for shark cartilage.  As big as the United States is, it can't hold a candle on a per capita basis to some of these other markets. Interview With Dr. I. William Lane, Interviewed By Richard A. Passwater Ph.D., Shark Cartilage and Cancer, Revisited: A follow-up interview, Health World Online www.healthy.net/asp/templates/interview.asp?PageType=Interview&ID=182

As might be expected, a more current estimate of the number of brand names is even higher:

Cartilage products are sold commercially in the United States as dietary supplements.  More than 40 different brand names of shark cartilage alone are available to consumers. Cartilage (Bovine and Shark), National Cancer Institute, Updated 01-Apr-2002 www.cancer.gov/templates/doc.aspx?viewid=4AABA6FA-8A2E-4BF7-941F-7DC416B41233 (footnotes and links removed).  This is by far the the most accurate and thorough and up-to-date single source of information on cartilage therapy.

Wasn't It You Who Made William Lane a Rich Man?

William Lane recollects your enthusiasm, and your generous coverage:

The "60 Minutes" team was so excited about these results that it broadcast the show within 10 days after their tape was finished; and they showed it twice, something that is rarely done.  The team also promoted the story each time for four days prior to each broadcast. I. William Lane, Ph.D., Shark cartilage therapy: A personal history of its development, p. 3 www.publishedresearch.net/sharkcartilage/book_shark_cartilage_therapy_page3.htm

And William Lane credits you with making his Cuban study a legend:

The Cuban study has, as a result of the extensive coverage and story by Mike Wallace and "60 Minutes," become a legend. I. William Lane, Ph.D., Shark cartilage therapy: A personal history of its development, p. 3 www.publishedresearch.net/sharkcartilage/book_shark_cartilage_therapy_page3.htm

Creating the legend was the least of it — what was really important is that your broadcast generated sales:

Also, as a result of the "60 Minutes" story, many patients have been buying shark cartilage capsules and taking three to five a day. I. William Lane, MS, PhD, Shark Cartilage Therapy Evaluated, ChiroWeb.com www.chiroweb.com/archives/12/05/11.html

William Lane takes every opportunity to credit the explosion of interest in shark cartilage to 60 Minutes:

Unfortunately, following the landmark broadcasts on 60 Minutes, imitation shark cartilage products sprang up everywhere. I. William Lane, Ph.D., Sharks Don't Get Cancer, Catholic Digest, February 1996 members.aol.com/RobinJoker/sharksdont.html

Others appear to follow suit in ascribing the popularity of shark cartilage to 60 Minutes:

In 1993, the TV show "60 Minutes" popularized Lanes's book, Sharks Don't Get Cancer, and made shark cartilage a leading contender among alternative cancer therapies. Botanical Research Bulletin, Vol. 1, No. 12 www.anaturalpharmacy.com/Articles/botan-r1.htm

Were it not for journalistic ethics, CBS would have been able to charge royalties for the use of "As featured on 60 Minutes":

However, a much less favorable article appearing in the August 1993 issue of the same journal [Journal of the National Cancer Institute] described the "unimpressive results" of the Cuban study and quoted John Renner, M.D., a member of the American Cancer Society Subcommittee on Questionable Methods, who studies "quackery, misinformation, and fraud full-time," as saying, "The '60 Minutes' show has done the nation a great disservice because we've got people with cancer walking into health food stores and buying [shark cartilage pills] at prices up to $115 a bottle, with the label 'as featured on 60 Minutes.'  The Cuban study was presented to the public as reliable research, which it was not." Commonweal www.commonweal.org/cartconflict.html (blue emphasis added)

And So It Is To Your Credit That You Resisted Temptation

That something like the above was sure to follow your 60 Minutes broadcast must have been evident to you, and to other members of your team, and not only the prominent and closely-connected members, as for example executive producer of 60 Minutes, Don Hewitt, or the producer of this particular story, Sharks Don't Get Cancer, Gail Eisen, but also the entire CBS establishment, right from the cameraman focussing his lens on Lieutenant Colonel Jose Menendez in the secret shark-cartilage research facility just outside Havana to the president of CBS sitting in corporate headquarters in New York city.

And the overpowering realization that all of them would have been conscious of was that their efforts were about to make William Lane filthy rich, and that these efforts required not just a substantial outlay on the part of CBS, but more importantly entailed a substantial risk — after all, if the story turned out to be false, then there would follow not only embarrassment and loss of credibility to yourself personally to 60 Minutes to CBS, but maybe also law suits.

Perhaps also the thought occurred to some that risk deserves compensation, and perhaps also the thought that investment was integral to the American way of life and to the building of the American economy, and perhaps also the thought that the chief effect of a personal investment in William Lane's business would be no more harmful than speeding the delivery of a cancer cure to the public.  And then there might have been added the thought that after all, some investors were going to make a lot of money out of this cancer cure, so why should it be only outsiders who had contributed nothing to the project, who jumped aboard the wagon only after others had gone to the trouble of getting it rolling?  Why should it be only newcomers who made money rather than the people who had first learned of the cancer cure, who had laboriously investigated it, and who had gone out on a limb in broadcasting it?

And so it is to your credit that you were not influenced by such corrupting thoughts, and that not you or Don Hewitt or Gail Eisen, or any of your friends or relatives, or your cameraman or the president of CBS — not any of you — invested money with William Lane.  William Lane certainly needed money, as despite his years of preparation, the production of a shark cartilage powder that does not make everybody vomit is far from a simple matter, and requires factories and machinery and workers and fishing boats, and so no matter how extensive the preparations had been up to that moment, exploding demand for shark cartilage was sure to exceed supply for quite some time following the 60 Minutes broadcasts, and without a massive and early investment in infrastructure, deserved profits were sure to be lost, and as an experienced business man, William Lane would have foreseen all this, and would have been applying for loans and soliciting investors and propositioning venture capitalists.

That your broadcast turns out to have been irresponsible and negligent is bad enough, but at least it was not mercenary as well, and if not mercenary, then it still remains in your power to partially salvage your reputation by demonstrating that it was not mercenary.

All that remains is for you and Don Hewitt and Gail Eisen to take credit for your exemplary and admirable renunciation of windfall profits in favor of journalistic integrity by issuing a public statement that not you and not anybody connected with you received any benefit for having broadcast William Lane's shark-cartilage infommercial or reaped any profit from investing in William Lane's shark-cartilage business.  And from William Lane's direction it remains to disclose what investors were savvy enough to get in on his venture in its early stages.

Top Cuban Integrity Theory Sharks Longevity Unsafe Slovenliness Benefits God Pecuniary Experiment Damages Summary

What everybody seems to be ignorant of is the nature of An Experiment

What is the Remedy for Superstition?

In exploring primitive thought, Frazer recognizes the difficulty of extricating oneself from it.  The problem man faced was not an easy one to solve — how exactly was one to know what causes what when nature is intent on deceiving us?

The reader may well be tempted to ask, How was it that intelligent men did not sooner detect the fallacy of magic?  How could they continue to cherish expectations that were invariably doomed to disappointment?  With what heart persist in playing venerable antics that led to nothing, and mumbling solemn balderdash that remained without effect?  Why cling to beliefs which were so flatly contradicted by experience?  How dare to repeat experiments that had failed so often?  The answer seems to be that the fallacy was far from easy to detect, the failure by no means obvious, since in many, perhaps in most, cases the desired event did actually follow, at a longer or shorter interval, the performance of the rite which was designed to bring it about; and a mind of more than common acuteness was needed to perceive that, even in these cases, the rite was not necessarily the cause of the event.  A ceremony intended to make the wind blow or the rain to fall, or to work the death of an enemy, will always be followed, sooner or later, by the occurrence it is meant to bring to pass; and primitive man may be excused for regarding the occurrence as a direct result of the ceremony, and the best possible proof of its efficacy. Sir James George Frazer, The Golden Bough: A Study in Magic and Religion, MacMillan (Papermac edition, abridged), London, 1922 (reprinted 1971), pp. 77-78.

Illnesses are among the predicaments where the success of remedies is hard to gauge, first because many illnesses do end up being cured with or without intervention, leading to the confusion described by Frazer above, and even those illnesses that are inexorably terminal are marked by uneven progress toward the final end, marked that is by intervals of deterioration and intervals of improvement, such that the improvement is readily attributable to the proper application of the remedy, and the deterioration to its improper application, or else simply to more powerful forces overwhelming a remedy that was nevertheless conferring a benefit.

To the question of treatment effectiveness, the pre-scientific mind will tend to assume that a traditional remedy is effective as evidenced by observations such as the following:

• If the patient gets better, the treatment caused him to get better.
  
  
• If the patient stays the same, the treatment prevented him from getting worse.
  
  
• If the patient gets worse, the treatment slowed his decline, and was responsible for intervals of remission that were observed.

With a readiness to interpret the world as above, treatments that have no effect whatever, or that even have a harmful effect, will be accepted as beneficial, and will remain in venerated tradition.

How, indeed, to break out of this trap and begin truly distinguishing cause and effect?

The Remedy for Superstition is the Experiment

There is an answer, and that answer points to the single greatest discovery of the twentieth century — the experiment!  The experiment has, more than anything else, increased crop yield and eradicated disease and bridged canyons.  It has brought wealth and power to peoples that have learned how to harness it, and it has left in poverty and weakness peoples who have remained ignorant of it.  We know with something close to absolute certainty that most alternative medicine has nothing to offer us by one simple and infallible sign — that it fails to utilize the all-powerful tool which permits the sorting of true beliefs from false — the tool of the experiment.  The alternative systems of medicine trust to tradition or to intuition to distinguish the true remedies from the false, but not to experiment.  Alternative medicine shares with magic and with religion and with superstition the one characteristic of being a stranger to the experiment.

Having an approximate idea of what a "control group" is, or what a "double-blind" study is, does not constitute an education in scientific method, and does not bestow a high probability of being able either to conduct a valid experiment or to distinguish whether someone else has succeeded in conducting one.  A researcher claiming that he has a "control group" is insufficient to qualify his research as a genuine experiment, as the term "control group" is applied loosely and casually to a number of things which are not in fact real control groups, and even an educated attempt to constitute a genuine control group can be vitiated by subtle undermining factors.  As training in scientific method is not an integral part of medical education, few physicians know how to conduct a valid experiment (though many think they know), and as a result, most of the research published even in peer-review medical journals is so flawed as to be worthless.

Any medical system that is unaware of the experiment, and that does not rest on the bedrock of the experiment, can safely be rejected as superstition.  Traditional Chinese medicine, to take one example, can safely be dismissed as superstition because over the millenia of its existence, it never discovered the experiment, and it never saw a reason to put the experiment to use when others discovered it.  To the question, But how do you know that this remedy is effective? traditional Chinese medicine offers the reply, We see that it is effective all the time — an answer which is the unmistakable symptom of methodological backwardness and of treatment ineffectiveness; an answer which if not improved upon dooms a society to a life expectancy that is forty years lower than our own; an answer which is the signal to every educated person to flee from an unprofitable relationship; an answer that is little better than having a bone-in-the-nose shaman justify his craft by blowing smoke in your face and shaking a rattle in your ear.

The Cuban Study Was Not an Experiment

This is not the place to begin explaining exactly what an experiment is, and the miraculous mechanism that gives it its power.  This is the place to point out that the 1993 Cuban study was not an experiment, and therefore incapable of discovering what effect shark cartilage has on cancer.  This is the place to point out that no experiment has been ever been conducted on the effect of shark cartilage therapy on human cancer.  This is the place to point out that the Office of Alternative Medicine (OAM) has not once since its inception in 1992 conducted a single experiment.

It would have been quite inadequate to look up a table of five-year death rates for a certain cancer and to compare it to Cuban patients in the study having that cancer as we began to do above — for an endless number of reasons.  For example, suppose that a five-year survival rate for Stage III Cuban patients was observed to be 70%, whereas an American table stated that it should be only 50% — would that mean that the shark cartilage given the Cuban patients had helped?  The answer would have to be that we had no way of knowing.  There could be reasons other than the shark cartilage why the Cubans did better, a lot of reasons, of which the following are only a few:

• The Cubans might have been younger than the Americans who contributed data to the probability-of-survival table, and so might have survived longer because of the strength that comes with youth.
  
  
• The Cuban method of categorization could have attributed more advanced stages of disease to patients than were attributed to the patients in the American table, making the Cubans look sicker than they really were, as already discussed above.
  
  
• The male-female composition of the Cuban patients might not have been the same as that of the Americans in the table, and that difference might have raised survival.
  
  
• The Cuban patients might have smoked less, or drunk alcohol less, or taken drugs less than the Americans in the table.
  
  
• The Cubans might have been more active and less sedentary, might have engaged more in prolonged physical exertion.
  
  
• The Cubans might have carried less body fat.
  
  
• The Cubans might have eaten less junk food, might have drunk less pop, might have devoted more of their diet to fresh fruits and vegetables, less red meat, and so on.
  
  
• The Cuban patients that were selected for the study might have been atypically vigorous, also as discussed above.
  
  
• The Cubans may have had genetic backgrounds offering them stronger resistance to cancer.
  
  
• The Cubans may have been exposed to less stress.
  
  
• The Cubans may have been exposed to fewer toxins.
  
  
• The Cubans may have had better sleep habits.
  
  

And so it is the presence of an endless list of potential differences between the Cuban patients and the patients in any survival table that would make it impossible to interpret any differences in longevity that were observed.  To appreciate fully our inability to conclude anything from the Cuban study as it was conducted, we must recognize that it would even be possible for shark cartilage to be an effective treatment for cancer, and yet for the Cuban study to turn up a five-year survival probability lower than in an American table.  This could happen if many extraneous factors such as those listed above conspired to shorten the lives of the Cuban patients even while the one factor of shark cartilage worked to lengthened them.

Experiments Can Be Cheap

How much money would it have taken to turn the Cuban study (which was incapable of discovering the effect of shark cartilage on cancer) into a Cuban experiment (which would have been capable of discovering the effect of shark cartilage on cancer)?  The answer is that the experiment could have been conducted at less cost than the study.  The only cash outlay for the experiment would have been that required to purchase the shark cartilage, and that required to pay the salary of a single administrator to run the experiment.  As William Lane would be getting the shark cartilage wholesale, and as the administrator could have been a local Cuban, these two costs would have been negligible.

William Lane could have found thirty Cubans with cancer, randomly divided them into two groups of 15, given one group the shark-cartilage enemas, and the other group placebo enemas which were indistinguishable except that in reality they contained no shark cartilage.  Assuming that Lane was simply re-doing the Cuban study, but getting it right so as to make it a Cuban experiment, we imagine him doing this for sixteen weeks.  All the while, the administrator's responsibility would be simply to see that everybody got the right enema, that neither the patient nor anybody who came in contact with the patient knew what was in the enema, and to write down the dates of any deaths.  After the sixteen weeks of the experiment, and for the next five years, the administrator would periodically look up the patients and record which of them had died.

Assuming that funds would be tight for William Lane, he could dispense with all measures of effectiveness except time of death.  The Cuban X-rays are murky anyway, and their interpretation is subjective, so scrap them.  Palpation is even more unreliable — so who needs it?  Just record deaths.

Did I just describe anything that sounded like it was going to be expensive?  I don't believe I did.  This proper experiment to conclusively determine the effect of shark cartilage on cancer could be conducted for a tenth of what it cost CBS to produce Sharks Don't Get Cancer.  If shark cartilage really does cure cancer, then that's all that it would have taken for William Lane to prove it to the world.  And if shark cartilage really doesn't cure cancer, then that's all that it would have taken to protect cancer victims over the years from handing billions of dollars over to fraud artists, and that's all that it would have taken to keep cancer victims from losing their lives in the pursuit of worthless therapies.

What's right with this imaginary experiment, and what's wrong with it?  What's right with it is very right and very important — it tells us the effect of shark cartilage on cancer.  What's wrong with it is that it doesn't tell us everything — a rather small price to pay, since all those other things that it doesn't tell us can be found out later.  It doesn't tell us, for example, what it is about shark cartilage — what protien or chemical within shark cartilage — that produces any effect that is observed.  And it doesn't tell us exactly what is going on in the patient's body during the sixteen weeks, or during the five years — like are the tumors shrinking or necrosing or what, and how fast, and what is happening to body chemistry, and so on?  But again, these are things that can be found out in later experiments — that is if the demonstrated effectiveness of shark cartilage justifies any later experiments.  This approach answers the big question first at next to no cost, and defers the details for later examination which is going to cost a lot.

It's so simple, so inexpensive, so powerful, that the question has to be asked why it wasn't done, and why, generally, it isn't done?

I think that the answer is that neither of the two controlling parties wants it done — the two controlling parties being the innovator who advocates the treatment, and the government that supervises research.  William Lane doesn't want a real experiment because it has a good chance of demonstrating that shark cartilage is ineffective.  He is aware, though, that a non-experiment will produce uninterpretable results over which he can force an interpretation that will favor his venture.  The government in turn — say the National Cancer Institute — does want an experiment, but not the cheap and fast one that I propose above.  The government wants an expensive experiment or nothing.  It doesn't want to answer the questions sequentially of does shark cartilage work, and if it does work then what is it about shark cartilage that makes it work?  No, the government insists that right from the beginning the innovator should be testing some pure component of shark cartilage to see what effect it has.  That isn't going to be cheap.  And the government also wants detailed monitoring of what's going on in the patient's' body — X-rays, scans, biopsies, lab tests, the whole gamut.  That isn't going to be cheap either.

What is the result of the government policy?  It is to drive the cost of research through the roof, and essentially to put beyond the innovator's reach the possibility of answering the simple question that he wants to ask first — in this case, does shark cartilage prolong life?  An article that I have at my elbow estimates that it costs $3 million to run ten patients at UCLA, and William Lane estimates that the testing necessary to win FDA approval for a drug costs approximately $231 million (p. 61 of his book).

In any case, I seem to have digressed into the question of government policy with respect to scientific research, and rather than wandering still farther down this road, maybe it would be better to bring this particular discussion to an abrupt close by re-focussing on the alternative-medicine advocates and pointing out that it is well within their power to test their claims by means of genuine experiments.  If they aren't allowed to do it in the United States or Canada, they can do it in Cuba or Mexico or Costa Rica, or any of a number of other places.  If they are not running proper experiments then they are either incompetent, or they lack the courage to put their beliefs to a test which might prove them wrong, or — let's face the possibility — they're charlatans.

More relevant to our discussion — if your education had included scientific method, you would have been able to grasp instantly that William Lane's Cuban study was not an experiment, and that its ability to determine the effect of shark cartilage was zilch, which recognition might have saved you from your present disgrace, and might have protected cancer sufferers from loss of money and of life.

Top Cuban Integrity Theory Sharks Longevity Unsafe Slovenliness Benefits God Pecuniary Experiment Damages Summary

You may have inflicted harm, and you may yet have to pay Damages

The Harm You May Have Inflicted

Your 60 Minutes broadcast may have cost lives:

Further, while no one has shown that shark cartilage can be toxic, Brem and other oncologists worry that it could do harm in other ways.  "If patients choose shark cartilage instead of treatments that have proven benefits," he says, "then those patients are potentially shortening their lives."  A letter sent to the New England Journal of Medicine a few years ago from a Canadian physician described just such a case.  After their 9-year-old daughter had surgery to remove a brain tumor, the girl's parents opted to treat her with shark cartilage, against the advice of physicians who had recommended follow-up radiation and chemotherapy, which the physicians said would accord a 50 percent survival rate.  The girl died. Melissa Hendricks, Predators promise, Johns Hopkins Magazine, June 2000 www.jhu.edu/~jhumag/0600web/shark.html

Although the media may not be featuring the lives lost to shark-cartilage (SC) therapy, or the contribution of your Sharks Don't Get Cancer broadcast toward this loss of life, perhaps those close to the action are able to document that the number lost is substantial, and that your role was pivotal:

Date: Sun, 22 Dec 1996 13:28:38-0500 From: MSLP Subject: Re: Shark Cartilage Aubrey. …we had a YOUNG man in our support group, 42 years old, with PC to bone.  He traded his Eulexin to the Shark Cartilage dealer since he couldn't afford both..  He died, leaving two small children.  There were others in our group who tried SC, and the only one it helped was the man selling it.  Who by the way, now wears a port for pain management.  SC didn't work for him either...  I hate it when I see money grubbing people preying on the fears of ill, for personal gain.  Some of the material we get in the mail, for "Cures" would make you sick..  Sorry Mike Wallace feels the way he does, perhaps he should come to a few PC support group meetings.."  Mr. Wallace, I am not sure that you realize how much damage you did with the Lane interview.  You are primarily responsible for Lane because of the publicity you gave him.  Because of that you must share some of the responsibility for the known death of this one person and possibly many more.  You must also take some responsibility for the large amount of money that others have spent for nothing but false hopes. In the Los Angeles area, there are over 1000 men who attend our various support group meetings.  I have tried to convince many of them that shark cartilage cannot help them in their fight for survival.  But to little avail. If you have any data whatsoever that proves shark cartilage is of any benefit, please let me and the thousands of others know. Aubrey Pilgrim, Quackery, Prostate Pointers www.prostatepointers.org/prostate/lay/apilgrim/chapter19.html

Let's connect your work to a face, Mr. Wallace — the face of Tyrell Dueck.  At around his 13th birthday, Tyrell was diagnosed with osteosarcoma in his leg, at which time conventional medicine offered him a 65% chance of surviving one year.  However, his parents refused partial amputation of his leg and chemotherapy, and opted for alternative medicine in Tijuana, costing $5,900 per week:

Pale, thin and bald, 13-year-old Tyrell Dueck lay in bed yesterday watching television while hooked up to a yellow intravenous bag of laetrile, the widely discredited cancer therapy. The youngster from Martensville, Sask., is at a Tijuana cancer clinic receiving a grab bag of treatment, including shark cartilage, an untried form of gene therapy, vitamins, enzymes and amino acids. David Roberts and Sean Fine, Can shark cartilage save the life of Tyrell Dueck? Part of a grab bag of therapy youngster is receiving at Mexican clinic; conventional medicine skeptical but not entirely dismissive of effort, The Globe and Mail, 27-Mar-1999

As a result of his Mexican treatment, Tyrell made great progress on the subjective measures that you yourself expressed no dissatisfaction with in your Cuban study:

During an interview at the Saskatoon airport, Tyrell's father said since beginning the treatment in Mexico, Tyrell had experienced a sharp drop-off in pain, a reduction in the size of the tumour and a huge boost in morale. Leslie Perreaux and Brigette Jobin, Tyrell Dueck dies: Young cancer victim who refused treatment succumbs to disease, The StarPhoenix, 02-Jul-1999

Although laetrile and shark cartilage were able to deliver on the subjective measures of reported pain, apparent tumor size, and inferred morale, they could not deliver on the objective measure of survival — Tyrell Dueck died on 30-Jun-1999.  As the Tijuana quacks had not provided a money-back guarantee, his parents lost not only their son, but the $50,000 cost of their Mexican quest for something better than mainstream medicine.

Some of the ensuing recriminations were scathing:

In my opinion on Wednesday night June 30th Tyrell Dueck was murdered by his parents who were fundamentalists and by alternative medicine led by crack pot companies such as American Biologics. Alternative Medicine and faith claims another victim www.valleyskeptic.com/tyrell~1.htm

The accusation above that "alternative medicine" bears some of the blame can be elaborated — alternative medicine encompasses all those who played a leading role in promoting it, which includes you and Don Hewitt and Gail Eisen, and most certainly William Lane.  You all helped murder Tyrell Dueck.  Ultimately, all you murderers could have been stopped, or at least persuaded to proceed less recklessly, by a knowledge of scientific method, and more particularly by the ability to read a research report and know whether its conclusions were justified or unjustified.  Lacking the most rudimentary skills of independent evaluation, however, nothing stood in the way of your chasing your individual dreams:

• William Lane was able to pursue his dream of wealth, perhaps only dimly aware that he would have to climb a mountain of corpses to reach it;
  
  
• you were able to pursue your dream of a good story, with nothing stronger than weak qualms to inform you that your story was a lie;
  
  
• the Dueck family was able to pursue its dream of a living son with whole limbs, with no way of seeing that mainstream medicine offered them something almost as good, and quackery offered them much worse;
  
  
• the public in general was able to pursue its dream of miracle cures, but with no way of recognizing that it wasn't getting any.
  
  

And young Tyrell Dueck, the victim of the many adults blindly pursuing their individual dreams at his expense, is described in his last days as glued to the television screen, never recognizing for a moment that his life had been forfeited by the lies that had been broadcast on that same screen.

Had even a few of the many who are complicit in Tyrell Dueck's death possessed rudimentary education in scientific method, then an hour's probing into the Cuban study would have convinced them that it was trash, and a few hours' further reading of the rest of the meagre shark-cartilage literature would have convinced them that it had nothing to offer the cancer sufferer either.

It does not exculpate you and Don Hewitt and Gail Eisen and CBS that shark cartilage was only one component of Tyrell Dueck's alternative treatment.  The harm done by CBS is not limited to recommending shark cartilage as an effective treatment for cancer — it extends to strengthening the more general view that alternative treatment can be more effective than mainstream medicine, a view whose effect can be expected to be a stampeding to alternative treatments of several kinds.  Thus, some viewers of your broadcast, Sharks Don't Get Cancer, would indeed have been moved by the narrow conclusion that shark cartilage cures cancer to turn to shark cartilage, but surely others might have been moved by the broader conclusion that alternative treatment can give better results than conventional medicine to embrace whatever alternative was being offered by a local quack or by a Tijuana clinic.  It is impossible to gauge the full harm that a lie will produce as it ramifies over time.

Whatever our conclusions concerning the details of Tyrell Dueck's case, at bottom we are forced to admit that were it not for your broadcast, Sharks Don't Get Cancer, Tyrell Dueck might still be alive today.

CBS May Yet Have to Pay Damages

First, a low estimate — if it could be demonstrated that one thousand cancer victims relied on your Sharks Don't Get Cancer broadcasts, and as a result either suffered avoidable damage, or else needlessly lost their lives, and if litigation awarded these thousand victims or their survivors an average of $100,000 each, then total CBS liability, excluding litigation costs, would be $100 million.

A higher estimate might be as follows — if a more methodical search for those injured by your broadcasts turned up 10,000 of them, and if more zealous prosecution led to awards averaging one million dollars each, then total CBS liability, again excluding litigation costs, would be $10 billion.

Thus, it may be supposed that your Sharks Don't Get Cancer broadcasts have opened CBS up to a potential liability of somewhere in the vicinity of $100 million to $10 billion.

Top Cuban Integrity Theory Sharks Longevity Unsafe Slovenliness Benefits God Pecuniary Experiment Damages Summary

And so we arrive at the final Summary

I can make it short.

The Cuban study is a fraud.  William Lane is a charlatan, his theory is gibberish, and he is unacquainted with scientific method.  Sharks don't live particularly long, and they do get cancer, including cancer of the cartilage.  Shark cartilage therapy has serious side effects.  Your broadcast is an eruption of superstition, not an explication of science.  You made William Lane rich, and the public awaits your statement that he did not reciprocate.  No experiment has ever been conducted to determine the effectiveness of shark cartilage therapy on cancer in humans.  If education in scientific method were more widespread, then many things would not, or might not, have taken place — among these being your damaging broadcast and the death of Tyrell Dueck.  Your broadcast has cost lives, not to mention wiped out savings, for which CBS could conceivably be sued.

Although many of the statements cited above postdate your 1993 broadcast, they are statements of evidence most of which was within your power to discover yourself in 1993.  In any case, whatever their date, they are all statements that have been unable to move you to broadcast any Sharks Do Get Cancer between 1993 and 2002 to attenuate the damage caused by your original Sharks Don't Get Cancer.

If an award were given for the broadcast that, from the very birth of television until today, had inflicted the greatest damage — both in wealth diverted from the pockets of the suffering into the pockets of the rapacious, and in lives lost — then perhaps your 60 Minutes story Sharks Don't Get Cancer would stand a chance of walking away with the prize.



Lubomyr Prytulak