Stem Cell Tourism Risks, Precautions, and Warning Signs. A growing number of Canadians are leaving their country for stem cell treatments abroad that are expensive, unproven—and may even be risky, public health experts warn in an article published in the Canadian Medical Association Journal.
Unproven — and potentially unsafe — stem cell treatments are being performed in Mexico, Panama, China, the Ukraine, India and Thailand, and actively marketed via the Internet to Canadians, warns Dr. Dominique McMahon, a postdoctoral fellow at the University of Toronto’s Dalla Lana School of Public Health.
In China alone, there are more than 200 hospitals offering stem cell therapies, she tells the CMAJ.
Concerned over the health risks this thriving “stem cell tourism” poses to Canadians, health experts are now developing guidance and talking points that Canadian physicians can use when faced with patients who are considering going overseas to receive stem cell treatment.
Because stem cells can produce new cells of various types, they have the potential to revolutionize medicine and treat many diseases and conditions that are still incurable.
Being precursor cells or “building blocks” of the body that can develop into blood, brain, bones and all body organs cells, scientists believe that stem cells can be used as a renewable source of cells to replace the ones damaged by cancer and other deadly diseases.
It’s in this way that stem cells offer hope to people who suffer from painful and severely debilitating conditions like Parkinson’s disease, amyotrophic lateral sclerosis (ALS), spinal cord injury, burns, heart disease, diabetes and arthritis.
The pain and suffering makes some patients desperate enough to try even unproven treatments—making them vulnerable to unscrupulous providers of stem cell treatments that are illegal and potentially harmful.
Right now, Canadians should be aware that stem cells are only used effectively in Canada only for bone marrow transplant, skin grafting and treating blood diseases (particularly, lymphoid and myeloid leukemias, Fanconi anemia, aplastic anemia, β-thalassemia, sickle cell disease and Hurler syndrome), says Canada’s Stem Cell Network, a National Centre of Excellence.
Stem Cell Tourism Among Canadians. Still many Canadians venture abroad—although it’s difficult to estimate exactly how many, Dr. McMahon laments.
She cites a recent study (Regen Med 2010;5:35–44) in which Beijing’s Xishan Institute for Neuroregeneration and Functional Recovery estimates that it has treated about 1,000 foreign patients. Another company, Shenzhen Beike Biotechnology Co Ltd, which offers stem cell therapy in 26 hospitals in China and Thailand, says it has treated an estimated 900 foreign patients.
Dr. McMahon cites as an example one Canadian couple that traveled in 2007 to Shenyang, China, seeking treatment for multiple system atrophy. The woman received six stem cell injections, as well as acupuncture and physiotherapy five to six times per week for four weeks. For this she shelled out CA$30,000, not including travel and living expenses for her and husband.
According to the Toronto University public health expert, the Shenyang facility offers to arrange treatment for a wide variety of conditions, including ataxia, brain injury, cerebral palsy, diabetic foot disease, lower limb ischemia, multiple sclerosis, muscular dystrophy, spinal cord injury and optic nerve damage.
At the Shenyang facility, the Canadian couple also noted that another Canadian, as well as patients from Ireland, Spain, Mexico and Trinidad and Tobago were at the hospital receiving treatment for conditions ranging from spinal cord injuries to Alzheimer disease and ALS.
The couple said Shenyang doctors didn’t warn them of serious health risks, except for the possibility of a headache following lumbar puncture.
But serious complications of stem cell therapies do exist and have been documented, Dr. McMahon warns, citing cases of:
• meningitis (Neurorehabil Neural Repair 2006;20:5–13)
• a boy in Russia injected with fetal neural stem cells who later on developed brain and spinal tumors (PLoS Med 2009; 6:e1000029)
• a stem cell transplant led to serious lesions (J Am Soc Nephrl 2010;21: 1218–22)
Guidance for doctors. Prompted by the growing numbers of Canadians seeking unproven stem cell treatments abroad, a team of Canadian health care professionals and researchers is now developing some manner of guidance for physicians.
The team is led by Dr. Timothy Caulfield, research director at the University of Alberta in Edmonton’s Health Law Institute.
After conducting a workshop on the issue in Toronto, Ontario in 2011, the team plans to publish talking points for stem cell tourism, says Dr. Amy Zarzeczny, an assistant professor at the University of Regina in Saskatchewan’s Johnson-Shoyama Graduate School of Public Policy.
“We’re trying to distill a complex issue in a user-friendly way,” she says. “Physicians and patients would likely need to go further, depending on their circumstances.”
The International Society for Stem Cell Research has already published a handbook that counsels patients to watch for warning signs of potentially unsafe stem cell treatments:
• “claims based on patient testimonials”
• claims that there are no risks
• Undetermined or unspecified source of stem cells
• Type of treatment offered doesn’t correlate to the disease
• hidden treatment costs
“In some cases, it is not clear what is being injected,” Dr. McMahon says. “Some facilities use a patient’s own stem cells, while others use embryonic or fetal cells, which can create a risk of rejection.
“There’s no proof of safety and efficacy,” she continues. “The quality of facilities vary. The protocols are poorly documented and not available to the patients. Even in the best-case scenarios, the doctor doesn’t know whether it’s safe or efficacious because of a lack of data,” she adds.
The Canadian public health expert says, “patients are not at fault for seeking these treatments…They have the right to decide the care options available for them.”
“The problem is the regulatory systems that allow these treatments to be available without proof of safety or efficacy.”
China Stem Cell Tourism Regulation. Early last year, China’s health ministry announced that it would halt new applications for clinical trials of stem cell products until July 1.
The move was part of a bid to regulate the thriving industry to ensure the safety of stem cell products and therapies.
Speaking in a webcast by China.com.cn, Deng Haihua, Ministry of Health representative, said the year-long campaign to regulate the stem cell industry would be overseen by his ministry and the State Food and Drug Administration. The statement is in posted the government website.
Under the campaign, medical institutions that have approved stem cell studies underway shouldn’t alter them or charge volunteers for tests and trials that haven’t been approved should be stopped.
According to the minister, Beijing has never approved any stem cell therapy in China, largely because providers of stem cell products and therapies haven’t been able to address concerns over ethics and efficacy adequately.
But in reality, says Yang Jian, CEO of the Shanghai Medical Tourism Products and Promotion Platform, the demand for the treatments has driven practice for a long time, and the industry has been growing rapidly.
At least 10,000 people from around the world travel to China every year seeking experimental stem cell therapies for various ailments, forming part of a thriving but unregulated global trade in unproven stem cell treatments.
Stem Cell Tourism Risks, Precautions, and Warning Signs. Posted 20 February 2012. Updated 14 November 2017.