Stem Cell Tourists Take Costa Rica Off the Agenda 206
An anonymous reader writes "Stem cell tourism is a booming and troubling industry, in which clinics in places like Mexico, China, and India offer rich tourists experimental stem-cell-based treatments, none of which have been approved by the FDA here in the US. (Check out some of these creepy sites that offer treatments for everything from autism to MS, and even the 'very common ailment called aging.') But in one positive development, Costa Rica just shut down its top stem cell clinic. Said the country's health minister, 'This isn't allowed in any serious country in the world.'"
How is this a good thing? (Score:5, Interesting)
Human trials before approval on people who have the money to fund it... it might be incredibly dangerous and questionable ethically but these people who get these treatments pay themselves and take all the risks. Why not study them instead of stop them?
I wonder... (Score:5, Interesting)
1. Scientists/research MDs whose interpretation of risk/reward tradeoffs differs from that of the FDA. In this category I would put more or less orthodox researchers who are of the position that the risks of stem cell use(cancer, infection, immune responses, etc.) are either just not that serious compared to the potential benefits and/or are the individual's choice to make.
2. Sincere cranks. In this category would go the various flavors of nutter who have gone straight off the deep end in terms of actual research about what stem cells are capable of, and how to make them do it; but are fully sincere in their belief that stem cells are the magic bullet against autism or aging, or whatever they are selling them as.
3. Cynical hucksters: All the research seriousness of the above; but without the slightly wild-eyed sincerity. However, they know that lying to desperate sick people is both easy and lucrative.
Re:How is this a good thing? (Score:4, Interesting)
Eh? Says who? Fraud is on the short list of things most libertarians (aside from the anarchist variety) believe is within the legitimate realm of the state to prevent.
Of course, in the real world we live in, some people are free to defraud us all they want (because the cost of doing anything about it through the legal system is prohibitive) while others have to walk the straight and narrow (because their opponents have lawyers on retainer) and sometimes even that isn't safe.
What makes you think we can't have both? In fact, the "nanny" state follows from the "corporate" (fascist) state when insurance companies are some of the more powerful corporations.
Separting the potential from the snake oil (Score:5, Interesting)
While many of the current stem cell clinics overseas do fall into the snake oil category one should not cast out the baby with the bathwater. If one understands the following probable guidelines, then one may be able to navigate the field.
1) Non-autologous (non-self) stem cells are likely to be extremely problematic for therapeutic purposes because there have been a number of reports showing that the immune system will eliminate those cells over time (without immune system suppression). If you view them as "organ transplants" from other individuals which require drug protocols to suppress Natural Killer Cells and other arms of the immune system with significant probabilities of rejection then therapies which involve non-self embryonic stem cells or non-self iPSC cells might be useful. But they are never going to be a "good" solution. (This means that the debate over "embryonic stem cells" which blocked a significant amount of progress in stem cell research in the U.S. over 8 years was useless "noise".)
2) Autologous (self) stem cell therapies *are* useful. One already effectively uses them in cases of storing sperm, eggs, blood and skin for future use. There have been common uses for decades such as for blood storage before a major surgery, growing skin grafts for burn victims breast reconstruction surgery, etc. Common heart bypass operations are another example of transplanting tissue from one region of the body to another. There has been a "Holy Grail" search to obtain embryonic or totipotent stem cells over the last decade due to the press/hype that they can "grow into any tissue". While we have the knowledge to do this for some tissues we do not have it for many more. Indeed one doesn't need totipotent cells for most therapies. Partially differentiated stem cells which are very close to the target tissue types will work as well, perhaps even better, than totipotent undifferentiated cells.
3) While injecting stem cells into the blood and hoping that they end up in the right place and will do the right thing works in some cases (e.g. bone marrow transplants) it is *not* likely to work for most applications of stem cells. Each type of therapy where stem cells may be used is going to have to be a precise tissue specific (heart, brain, lung, hair follicle, joint, tendon, muscle, blood vessel, skin, etc.) therapeutic protocol. That is why one is likely to see dozens of companies with specific expertise and not "one size fits all" solutions. There isn't going to be a "magic bullet" -- therapies are largely going to have to replicate, typically through cell culture in a laboratory, many of the natural processes which occur during fetal development in order for therapies to be effective.
4) There are on the order of 2300+ clinical trials in stem cells going on around the world (according to the NIH clinical trials database). Some of them are likely to be useless. But some of them might be quite useful.
5) There are companies in the U.S. that are doing autologous stem cell therapies with a fair amount of success. Three that I'm aware of are VetStem, Regenexx and BioHeart.
6) There has not been a widespread understanding yet within the stem cell R&D and therapy communities that stem cells *do* age. Simply, stem cells accumulate mutations in their genetic code with age which will cause them to function less well if sourced from elderly individuals compared with young individuals. [Everyone should have cryopreserved pools of stem cells when they were 10-15 years old.] So a stem cell therapy that might work very well in a young individual (say 20-30) may not work as well (or at all) in an older individual (say 60-70). There are methods that may be used to address this problem (disclaimer: I am the author of a pending patent on one of these methods) but they have yet to be put into practice by *any* stem cell clinic to the best of my knowledge.
So one can "dis" current stem cell therapies as being snake oil, often with some basis for the feelings, but you should
Also, something you touch on (Score:4, Interesting)
There are real risks here. If you are talking something that is no risk then ok, more or less let people go to it provided they aren't misrepresenting it. However medical treatments carry risks. Even well tested, established ones carry risks. Wild, untested, nutball ones carry more risks and worse, unknown risks. With proper medicine the doctor can do two very important things:
1) Tell you what the risks are, so you can weigh them against the benefits. You can know what could happen and how likely it is to happen. You can then make an informed decision as to if it is worth it.
2) Monitor you for signs of the risks, and let you know what to look for. Many times the risks can be mitigated, so long as you are aware what to look for and deal with them.
As an example, when I was a kid I went on Acutane to treat my Acne. It is a heavy hitter medicine with rare, but serious side effects. Namely, it can shut your liver down. However, despite that, it is generally worth the risk. Reason is that the liver problems can be picked up early with a blood test, and medicine discontinued, treatment started, and you are generally fine. So while on it I had my blood taken every other week.
However, the reason they knew to do that was extensive testing and trials before it went on the market. They had a wealth of data that showed that this could result, and they had a remediation strategy ready. Still wasn't perfectly safe, but was pretty safe and I was aware of the risks. Had it been untested, well then maybe my liver would have just shut down and I'd have not known until I had frank symptoms, when it was far too late.
Medicine carries real risks at the best of times. You certainly don't want it done half-assed.
Can't wait to see the teratomas (Score:3, Interesting)
This is a matter of contract enforcement. These clinics are claiming things that are patently untrue. The only thing that injecting yourself with stem cells will give you is a teratoma, a particularly nasty form of cancer with hair and teeth inside it. Making false claims is not okay. Scamming people is not okay, nobody wants to be scammed, nobody wants to be lied to, and nobody wants hair and teeth growing out of their innards.
Joe Scammed does not want to be scammed, he wants a cure. These clinics are not selling cures, they are selling hairy, toothy cancer, labeled as a cure. Your argument is laughable. But at least it is novel. I don't think I've ever heard anyone seriously argue for the 'right' to be taken advantage of. Did anyone ask for that? Do YOU even want that?
Re:Like US in 1800s (Score:2, Interesting)
Oh dude, you're not kidding about Reglan.
I was recently hospitalized for major surgery, and they put me on that drug when I went home to help "wake up" my bowels after all of the narcotics administered in the hospital.
I straight up lost my fucking mind, "fear and loathing" style. My living room was "bat country" for like three days, until we figured out (on our own, -- thanks google --) that the Reglan might causing it.
Scariest three days of my life, dude.
Re:'serious country' (Score:5, Interesting)
At the same time they were stealing from the pension funds, setting a blockade to the neighbouring country Uruguay (where I come from), and lots of other stuff (just search for the words of the ad, and you'll find lots of criticism). Not to mention they had just defaulted from their debt and all that.
And actually, Costa Rica is one of the most serious countries in Latin America, and way more credible than their "joke" neighbours.