Saturday, 28 April 2012

Stem cell therapy: still science fiction



I will stay on the thread of things that you inject or implant, before getting stuck into some meatier surgical operations. But there are so many targets, I was wondering which one to shoot first.

Then I got the email, with a link to this. Stem cells: is there anything that invokes a feeling of hope for the future and the wonders of modern technology and medicine more than this?  This isn’t a drug we found in some mouldy bread by mistake, this is something that is so high-tech that it is literally what was considered science fiction in the recent past. If you scan any links related to stem cells you will see that scientists are growing all sorts of tissues from stem cells. Does this hold promise? You bet. Is the technology amazing? Again: yes. Does it actually work now? For anything? Well, considering people are selling the technology to use in patients, we had better find out.

Firstly, before you hit the send button on your comment, let me exclude bone marrow transplants. They have been around since before they started growing stem cells into human ears. Drawing up some bone marrow from someone’s pelvis, spinning it down and later injecting it isn’t science fiction, and we transplant tissues all the time. I am talking about using stem cells to grow new tissues and treat  a variety of conditions. The list is long, but I am only going to target the conditions for which stem cell therapy is actually being sold.

The South Koreans were the first to claim that they could actually grow stem cells that were identical to the recipient, but even that was shown to be a fraud. There is a lot at stake in the stem cell game.

To find out what is out there, Google “stem cell therapy” and look down the page to see the websites that are selling therapy. They are often outside the wealthy countries, and positioned in places like Mexico, Panama, Ukraine and East Asia, to get medical tourists from countries where it is not permitted. Not because of a conspiracy by the FDA and similar bodies, as some websites tell you, but for a more obvious reason: they don’t work. The clinics claim to be able to treat respiratory disease, heart disease, joint disease, Parkinson’s disease, multiple sclerosis, spinal cord injury, eye disease, stroke, kidney disease, cerebral palsy, autism, AIDS/HIV and, of course, cancer.

The scientific evidence? I was not able to find any on the websites, mainly because of all the patient testimonials.

This was one of my easiest searches for the truth behind the hype. There is no good scientific evidence for stem cell therapy for any of the diseases listed above. There are small pilot studies with mixed results, but even the ones that show no difference between the treatment groups have conclusions like “very encouraging”, “shows promise”, and “stem cell therapy can be effective treatment”. Maybe it can, but you just showed that it wasn’t. Why didn’t you conclude that?

More trials will be done, and you will hear about it when one of them actually shows up a positive result. And when that positive study hits the news, I will revisit the topic.

For now, if you are sick and you go to one of these off-shore clinics as a medical tourist, spend your money on sight-seeing, not stem cells.

Addit (5 June 2012): For an idea of money and politics that goes on behind the scenes of the stem cell industry, try the Stem Cell Treatment Monitor.

10 comments:

  1. The best alternate medical procedure that can provide you a solution with out any kind of side effects. whether it is about the factor of aging or any chronic or hereditary disease. In this regard i am completely satisfy with the stem cell therapy.

    Stem Cell Therapies

    ReplyDelete
    Replies
    1. Thanks,
      I am sure that many of the patients who attend your clinic are also completely satisfied, but there is no properly controlled evidence for many of the treatments you are offering. This makes it hard to untangle the specific effects of your treatment from the placebo effect.

      Delete
  2. Loved your tweeted reply, Dr S, to arthritis_community question to rheumatologist asking him when stem cells will outperform total knee replacement. Let's curb our enthusiasm until they outperform placebo first.

    Allow our knees to take one step at a time.

    Dr Justin Coleman

    ReplyDelete
    Replies
    1. Thanks, I like that: One step at a time. I might "borrow" that line from you some time.

      Delete
  3. Any update on this in the last two years?

    ReplyDelete
    Replies
    1. A pilot study comparing stem cell injections to sham for knee OA was conducted and reported at the 2013 Australian Rheumatology Association Annual Scientific Meeting. No clinical difference between the two groups. I am waiting for it to appear in print.

      Delete
    2. What do you mean by 'sham'?

      Delete
    3. Sham = placebo. A similar injection, but not containing stem cells.

      Delete
    4. Hi. I've read this:
      http://www.tennisworldusa.org/Janko-Tipsarevic-Im-playing-again-thanks-to-Rafael-Nadal-articolo33060.html

      Do you think they got 'placebo'-ed?

      Delete
    5. Yes I do. When someone like a world class tennis player says that they literally could not get out of bed, I get suspicious. Without having a fracture or something major, I can't see that he could have had any condition severe enough that he could not get out of bed. He may have had pain in the knee, but without any pathology to go on (nothing is mentioned) pain in the knee gets better anyway.

      Delete