Stem cell treatment

Last year, American golfing legend Jack Nicklaus, 79, revealed that he found relief for his long-standing, debilitating back pain through stem cell therapy.

With its potential to repair and replace all types of bodily tissues, this treatment has been hailed as the modern-day “fountain of youth” – and could change the way we age.

However, as much as our health-and youth-conscious society would like to seize upon this panacea, some questions remain unanswered, as evidenced by the continuation of clinical trials. Can it, for example, truly help ambitious nonagenerians remain spry and energetic, as well as look as youthful as individuals two decades younger?

We look into stem cell therapy, and separate the facts from the hype.

What’s all the fuss?

While most cells in our bodies have their functions – the ones in the heart, lung, muscle, blood, or nerve, for example, each have their own size and structure – stem cells have the unique ability to multiply or replenish other cell types.

This means that they have the potential to repair and rebuild all kinds of tissues and organs. And, as far-fetched as creating a new body part sounds, it has been done.

In 2013, a two-year-old born without a windpipe had stem cells harvested from her bone marrow and wrapped over plastic fibres to form a trachea that was then implanted, so she could breathe, drink and swallow on her own.

Not all stem cells are the same

Stem cells are found in various parts of the body. The most common sources for blood stem cells – or haematopoietic stem cells in medical-speak – are bone marrow, peripheral blood and umbilical cord blood. There are also mesenchymal stem cells in bone marrow, fat, placenta and umbilical cord tissue, as well as epithelial stem cells from placenta and umbilical cord tissue.

The different stem cells all have their own purposes, says Dr Ivor Lim, chief medical officer of local stem cell research company CellResearch Corporation. Proceed with caution if a clinic claims it can treat a host of diseases using a single stem cell treatment.

According to Dr Lim, one cannot use haematopoietic stem cells to repair bone. And neither can mesenchymal stem cells be used to repopulate blood after, say, treatment for leukaemia. Additionally, the older the stem cell, the less potent it is. Thus, the best stem cells come from ‘young’ sources like the umbilical cord.

Singapore-based research

Although commercial treatments are yet to be available here, the country is currently leading stem cell clinical trials in South-east Asia, especially in the use of haematopoietic stem cells from bone marrow to treat diseases like leukaemia. Research into the application of mesenchymal stem cells and those extracted from umbilical cord lining is also ongoing.

CellResearch Corporation itself is looking into umbilical cord lining stem cells in collaborations with institutions such as National University of Singapore, National Cancer Centre, and Agency for Science, Technology and Research.

One trial is being conducted with the United States Food and Drug Administration, and uses stem cells from umbilical cord lining to heal chronic diabetic foot ulcers. “As the results of these trials are revealed, more and more stem cell treatments will be made available, not just in Singapore but also around the world,” says Dr Lim.

Beyond our shores

Two of the most sought-after destinations for commercial stem cell therapy are Thailand and Malaysia, says Daniel Choo, CEO of The Medical Concierge. However, he does not work with such clinics as the treatment is currently not mainstream medical practice.

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Still, a growing number of clinics in the region are offering stem cell therapy to treat ailments ranging from stroke and orthopaedic as well as sports injuries to hair loss and erectile dysfunction. According to comparison website, there are 37 clinics in Malaysia and 10 in Bangkok alone offering the treatment. A clinic in a private Kuala Lumpur hospital, for instance, offers the therapy for autism spectrum disorder that starts at US$10,000 and anti-ageing treatments from US$18,000. For those for whom price is of no concern, a week’s retreat coupled with stem cell therapy at the prestigious Clinique La Prairie in Switzerland costs over $35,000.

How they work

Some overseas centres transplant stem cells from a person’s bone marrow or fat into other parts of the body. According to Dr Lim, the cells used in these treatments are usually of the mesenchymal variety. To retrieve them, doctors either collect the cells from pelvic bone marrow – a procedure which can be quite painful – or extract fat that is the source of the cells through liposuction.

They are processed to remove other cells and tissue, and then injected back into the areas where they are needed. The stem cell treatment done on Jack Nicklaus, for instance, reportedly involved liposuction around his tummy, and then reintroduction of the processed stem cells into his back and neck.

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Know the risks

Even if the treatment uses your own stem cells, there are risks. Some individuals have reported that their medical conditions worsened post-treatment. According to Dr Lim, a sterile environment is needed to extract the cells, process them and inject them back into the body. “A breakdown in this sterile environment can mean infection, treatment failure and compromised patient safety.” Note that regulations as well as good manufacturing practices to produce the stem cells differ around the world.

Taking the plunge

Dr Lim believes that stem cells will one day be “a panacea for many ills”. But in the interest of patient safety, he says all treatments should be tested in clinical trials before claims are made. “In medicine, ‘nothing is always, and nothing is never’,” he says. “Centres claim excellent results from case studies, but the final test is still a controlled clinical trial to assess results.”

He advises patients seeking stem cell therapy to check with the clinic offering the treatment. “If it claims results with clinical trials, ask to see the paper the claims are based on. If you do not understand the contents of the paper, ask your family doctor to interpret the information for you.”

And if nothing makes sense? “Take a step back and have a long, hard look because something is not right.”

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