Glioblastoma Stage IV - Should you remove shark cartilage or squalamine

	Asked by mhogan1 (Male ) on Thu 03, Apr 2008 07:41am :
	If you had a patient with Glioblastoma Stage IV,age 66, and you had done survery to remove a part of the tumor would you let them take shark cartilage or squalamine?
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	Answer by Dr Heinrik M, MD (oncologist) on Thu 03, Apr 2008 12:50pm: Hi, It would depend on the indication for the squalamine. If the intention was for the Glioblastoma, there is no clear proof that this would be beneficial. There are theories that fighting the cancer by controlling the blood vessels will improve outcomes. There are some studies involving a drug called bevacizumab for glioblastoma, there are some promising results but this was done in a setting where no surgery was done. Extending the results of such experience to a post-surgical case cannot be done. If the intention is for ophthalmogic conditions like age related macular degeneration or diabetic retinopathy - then there is a role for squalamine. This is actually beyond my specialty, but I think the experience for these diseases is in the testing stages. Treatment may be best deferred until at least 2 months from surgery. The drug used here is usually given intravenously. There are some supplements taken orally (this is likely what you are talking about) - and while there may not be a specific contraindication to their use (for as long as a recovery period for the surgery is allowed - again usually around 2 months) there is also no compelling reason to ascribe a benefit. Hence, no recommendation can be made for or against it. If the drug is being tested in a clinical trial - inquire from the trialists how good is their preliminary data, in terms of benefit and safety, and then decide to participate or not. Thank you for using our service.  If you are satisfied with the answer or if you want a detailed answer for your question, please make a donation and request for further clarifications.  Our oncologists will provide an elaborate answer for your clarification.   Please make a donation by clicking the button below. You may donate using funds from your PayPal account or Credit Card. Please rate my answer (select the stars below, no need to log in.)
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	Follow up: Clarification / Comment by mhogan1 on Thu 03, Apr 2008 01:08pm: What about the shark cartilage or flax seed to cottage cheese? Clarification / Comment by mhogan1 on Thu 03, Apr 2008 01:27pm: What about the shark cartilage or flax seed to cottage cheese? Clarification / Comment by Dr Heinrik M, MD on Fri 04, Apr 2008 10:29am: Flax seed has undergone small studies, but these are not enough to make robust recommendations. Access to such items are through dietary supplements, but the concerns with these are unknown reactions when combined with medications, and the quality may not be as strict since it is not monitored as a drug. The actual amount of the active agent may vary. There are components of flax that are poisonous, so faulty preparation is potentially hazardous. You may want to check the ACS website http://www.cancer.org/docroot/ETO/conte nt/ETO_5_3x_Flaxseed.asp The components of Shark cartilage are undergoing evaluation for its ability to limit blood vessel growth (needed by the cancer), so it is too early to make conclusions. This refers to drugs extracted out of the cartilage. It is unknown if the supplements made out of the cartilage carry a biologically active form and proper dose, and hence the concerns with interactions with medications are there. You may like to check the ACS site again http://www.cancer.o rg/docroot/ETO/content/ETO_5_3X_Shark_Cartilage.asp?sitearea=ETO Hence, if you are talking about talking supplements, no recommendation can be made to support their use outside of a clinical trial.
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