Monday, July 21, 2008

Stem Cell Snake Oil? When a rotten apple spoils the whole barrel

There's no need to tell me that this blog site seems to be gathering a rather thick layer of dust since we last posted in April. It certainly isn't for the lack of interest but simply the lack of time and sleep!

Well, there's been lots happening in the stem cell world and if you've been keeping up with the news (and if you've been doing that, you definitely have had more time than I have) you'll have seen the many various promotions by new companies, the new technological adoptions and the wide-scale criticism of certain organizations who offer purported stem cell treatments without credible medical data or volunteer themselves for western methods of accreditation and inspection.

There has been most unfortunate reports the media, highlighting the cases of families being "conned" into stem cell treatments and spending hard-earned or hard-raised cash flying to exotic countries for injections. The media certainly portray these families as having no money and no idea as to what they are getting into and are therefore considered "victims" of scams.

It does seem to me that some of these criticisms of the various centers, while valid, give too much credit and sympathy to the patient. Patients who are willing to spend that amount of money should certainly conduct their own research first and opt to try something experimental, knowing that the outcome at best may be to return home safely after a vacation from their usual drudgery and hopefully no worse than what conventional drugs or palliative treatment can offer.

Some of these centers have claims of miraculous cures and patients who have shown remarkable improvements in their conditions. What I'm wondering is whether these centers have been invited to the table to present their work and explain why they think a particular treatment worked in some patients and not in others.

The stem cell world is still new and many issues surrounding the understanding of how stem cells migrate and assist in tissue regeneration have yet to be elucidated.

In any case, the jury is still out and therefore it all depends on whether you believe in "innocent until proven guilty" or "guilty until proven innocent". Criticism is always easier when you haven't got a sick child or a parent with an incurable disease. Desperation itself is a powerful motivating factor to try anything or to try nothing, and is the individual's or family's decision.

One of the biggest problems that a patient faces is access to information and doctors who are really willing to discuss the issues knowledgeably and openly. Doctors could also inform the patients that there are no guarantees in any medical treatment and in the cases of the currently "incurable", inform the parents of the basis of the disease and why stem cells may or may not be able to help.

A short list of questions that might be useful for potential patient to ask are:

1) Are these treatments performed in licensed hospitals?
2) Who are the doctors performing the treatments?
3) How are the stem cells applied?
4) What is the source of the stem cells?
5) Can I see your laboratory facility? (sterility controls, infectious disease etc)
6) Can my medical doctor speak with your medical director?
7) What is the track record of your patients? (success vs. failures, how many still alive?)
8) What other therapies/ treatments do I have to undergo?
9) Adequate back-up facilities for complications?

There are no right or wrong answers but its good to understand the main motives of the providing organization to know whether it is purely for profit and the injections may only be saline.

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