Ten Things About Stem Cell Transplants Potential Recipients Need To Know

Patients Don't Usually Pay to Participate in "Experimental Trials"

Bone marrow transplants, which are essentially transplants of the stem cells that make blood cells, have been done since 1968. Embryonic stem cells have been used, mostly unsuccessfully and sometimes with disastrous consequences, to treat diseases of aging since the 1980's. And Rick Perry's Texas is becoming a center for treatment with adult stem cells—harvested from the same person to whom they are given—for a variety of age-related conditions.

If you have extraordinary health insurance coverage, or if you can afford $10,000 to $50,000 per treatment, you might consider stem cell treatment for a bad back, memory loss, heart muscle damage, or many other conditions. Here are 10 things every potential stem cell recipient needs to know about the procedure.

1. There really is something to lose by trying an unproven treatment

In one sensational case, a nine-year-old boy developed brain tumors after receiving stem cell treatment. But even if stem cells do not turn into cancer cells, there can be other complications.

• Receiving stem cells probably will disqualify you from any other more promising experimental treatments.
• Receiving stem cells definitely will disqualify for new health insurance coverage, except from state risk pools or the Obamacare risk pools set up in 2010 (if you live in the United States).
• If the first treatment does not work, patients usually will want to try more treatments, at $10,000 to $50,000 for each injection.
• Most adult stem cell clinics are located in Texas or Thailand. Travel costs can be high. Separation from family and friends can make the stay difficult.

2. Patients usually pay to get stem cell treatments. Patients usually do not pay to participate in clinical trials

Participating in clinical trials, contrasted to receiving unproven treatments, has other advantages. Clinical trials do not begin until two separate prior research studies have established that the treatment is not likely to have any negative side effects. Clinical trials are supervised by ethics boards to make sure no participant is exposed to undue harm in the course of treatment.

The downside of participating in a clinical trial is the possibility of being assigned to the control group, which receives a placebo rather than the active treatment or drug.

3. Just because stem cells came from your body, they are not necessarily safe

Stem cells are found in very small numbers in the human body. They have to be extracted from blood, fat tissue, or bone and then cultured in the lab to grow sufficient numbers to repair tissues. While your cells are in the lab, they can be contaminated with viruses or bacteria. And genes that cause cancer can be switched on while genes that prevent cancer are switched off before the cells are placed back in your body.

4. To be useful in treatment, stem cells will be coded to behave in certain ways

The genetic manipulation of stem cells is not yet a highly reliable science. Doctors cannot tell you with any certainty that a stem cell will morph into any particular kind of cell without observing the transformation in the tissue culture in the lab. Beware promises of that large numbers of stem cells put into your body while they are still stem cells will behave in any certain way.

5. Make sure your stem cell therapist thoroughly understands all medications you have to take

Certain diabetes drugs, Actos (pioglitazone) and Avandia (rosiglitazone) for example, turn nearly all the body's bone and blood stem cells into fat cells. This is not a good thing when you are receiving stem cells to repair your brain or your heart.

Understanding the Limitations of Stem Cell Therapy

Simply knowing the fundamental limitations of stem cell therapy can help patients make the right choices.

6. There are many types of adult stem cells, and each type of adult stem cell has its own purpose

In the embryo, stem cells can become almost any kind of cell in the body. In adults, stem cells can form a limited number of different kinds of tissue. Heart stem cells become heart tissue, blood stem cells become blood, and so on.

As mentioned earlier, some common medications have the unintended side effect of changing the programming of stem cells, causing baby bone cells to become baby fat cells, for example, but it is very difficult to change the programming of stem cells intentionally. Beware any claims that just scraping the inside of your mouth or taking a blood sample will provide unlimited stem cells for repairing body tissues.

7. One kind of stem cell treatment typically treats one kind of tissue damage

It is highly unlikely that any one stem cell clinic can treat multiple health conditions. The Scandinavian stem cell researchers who transformed skin cells into insulin-producing beta cells cannot treat pulmonary fibrosis.

The back surgeon who treated Texas Governor Rick Perry does not offer stem cell treatment for heart disease. The heart repair clinic in Thailand does not treat sickle cell anemia patients, and so on. Beware of claims that a single procedure result in many different kinds of benefits in adults.

8. Very few kinds of stem cell treatments are widely accepted

Bone marrow transplants have become standard, if risky, medical care. Injuries to bones, skin, and the corneas of the eyes can be treated with certain stem cell procedures. There is not, however, wide agreement on stem cell treatment for the heart and central nervous system.

9. Just because someone says a stem cell treatment helped them does not mean it did

Many people contemplating a $50,000-per-shot treatment make rational and positive changes to lifestyle to support good health. Many people who have spent their life savings on an unproven procedure have an enormous emotional investment in its success. Just because someone tells you that a stem cell treatment was a miraculous cure does not mean their cure was miraculous. It may even be due to their own hard work.

10. Science is a long, tedious, hard process, and stem cell science will take time to work out

It takes years or decades of painstaking research to know with scientific certainty what causes an illness or how to repair an injury. It takes years of careful clinical testing to know with scientific certainty that a procedure or medication will reliably produce beneficial results with a minimum of side effects, or at least with a limited range of side effects that can be explained so patients can make informed choices for their health. A treatment that looks promising in the laboratory or with animals may not work when it is tested with people, and a treatment that is a "miracle" for some people may be a catastrophe for others.

The process of peer review and publication in medical journals is not just a method for professors of medicine to justify their tenure and salary increases. Making scientific data public for the whole world to inspect is an essential step in making sure that treatments are truly helpful. Beware any clinic that uses procedures that have been found to be harmful in peer-reviewed research, and beware any doctor who claims to be smarter than "the system".