The journal Cell Stem Cell recently reported that the number of clinics offering stem cell treatments in the United States has grown dramatically from 25 to nearly 600 in just five years. Physicians groups such as the Cell Surgical Network are offering a treatment menu that includes everything from arthritis to Alzheimer’s. Regenerative medicine physicians are being looked upon as miracle workers, and there is an increasing belief that stem cells can ameliorate just about any malady that afflicts the human body. But does stem cell therapy work?
The underlying principle of regenerative medicine is that when stem cells obtained from a patient’s fat cells are reintroduced back into the blood, they can help treat a degenerative disease. Exactly how this occurs is not completely understood. However, stem cell treatments have shown success in the treatment of arthritis and torn ligaments and muscles in the knees and shoulders. Evidence that stem cells can help paralyzed people walk remains anecdotal. Most stem cell treatments are not approved by the FDA in the United States.
In New York City, Dr. David Borenstein, an integrative physician, treats patients for a smorgasbord of medical problems. His appointment book is a study in versatility and includes patients with conditions of the heart, the lungs, the brain, the gastrointestinal tract, and the musculoskeletal system. Dr. Borenstein likens stem cell therapy to a goldmine. “It’s all there,” he says. “You’ve just got to go and get it.”
In a tiny treatment room, patients undergo what is essentially a mini-liposuction procedure. Yellowish sludge-like fat is sucked into a thick syringe through a cannula inserted into the patient’s torso. This sludge is centrifuged and treated with enzymes. The resultant “magic cocktail” of stem cells and cytokines (growth factors, interferons, and interleukins) is delivered back to the patient’s bloodstream intravenously. Co-founder of the Cell Surgical Network, Dr. Elliot Lander, a urologist in Palm Springs, likens injured tissue to a beacon that sends out SOS signals. “Stem cells pick up these signals and float to the area that needs fixing,” he says.
Stem cell treatments typically cost thousands of dollars. Because these are investigational therapies, they are not covered by insurance. The technology used to extract and deliver the stem cells has been streamlined by early adopters, but the FDA has, surprisingly, remained on the sidelines. As a result, stem cell clinics have mushroomed. Traditionally, progress in the biomedical sciences is controlled by Big Pharma, large research universities, and the National Institutes of Health. Academics are understandably skeptical of these cure-all panaceas. Stem cell clinicians, on the other hand, feel they are safe and effective, even though there are no controlled studies to prove this. “Until I have the money to conduct a large double-blind placebo-controlled study, I’m going to rely on what I’m seeing with my own eyes. Patients confined to wheelchairs are walking again,” says Kristin Comella of U.S. Stem Cells, a company that trains physicians in stem cell therapies.
Because these procedures are so expensive, typically costing between $4000 and $12000, scams are not unheard of. A search of online stem cell forums reveals many patients who paid considerable amounts of money and saw no results. On the other hand, desperate patients and their families are often willing to try anything, hoping for a miracle. They simply do not have the time for academic research to better understand stem cells.
Experts suggest that it is always preferable to receive stem cell treatment as part of a clinical trial at no cost to the patient. However, if this is not an option, then patients should carefully check the credentials of the for-profit stem cell clinic and involve a specialist in their care.