Last month, Costa Rica's health ministry halted treatments at the country's largest stem cell clinic, arguing that the treatments are unproven and possibly unsafe. Though the Obama administration has expanded federal funding of stem cell research and there are ongoing clinical trials, there are currently no FDA-approved stem cell treatments. So some Americans, suffering from conditions ranging from cancer to spinal injuries, have looked elsewhere for experimental stem cell-based remedies, and clinics in countries such as Costa Rica, China, India, and Mexico have grown into stem cell tourist destinations. Costa Rica's largest clinic, the Institute of Cellular Medicine in San Jose, was operated by American entrepreneur Neil Riordan; it attracted about 400 patients for these treatments. The clinic used adult stem cells, which Costa Rica's government had allowed the clinic to take from patients' fat and bone marrow. The government had not authorized the clinic to use these cells for treatment.
"If (stem cell treatment's) efficiency and safety has not been proven, we don't believe it should be used," said Dr. Ileana Herrera, chief of the ministry's research council. "As a health ministry, we must always protect the human being." [Reuters]
Researchers argue that such clinics neither provide reliable treatment nor advance research since they use anecdotal evidence for a treatment's efficacy and don't safeguard against other variables in their testing. Given the dire conditions of many patients seeking these clinics, many worry that desperate patients make easy targets.
The International Society of Stem Cell research has cautioned against so-called stem cell tourism. "The (U.S.) clinical trials are ambiguous at the moment," said Dr. David Scadden, co-director of the Harvard Stem Cell Institute in Boston. "When these kinds of treatments are proposed, they're being essentially marketed by virtue of the anecdotal report. I feel the danger of exploitation is extremely high." [Reuters]
Despite Costa Rica's halt on treatments, other countries continue to host stem cell tourists. Clinics in China mostly use fetal stem cells from miscarriages--which are neither adult stem cells nor the more controversial embryonic stem cells. Embryonic stem cells, which can develop into any type of tissue, have the potential to more easily treat a variety of conditions, but given the ease with which they grow and replicate they may also cause tumors.
Cheng Bo, deputy director of the [Wu Stem Cells Medical Center in China], said doctors there offer potential patients realistic assessments of the risks and benefits. "We tell them it's impossible to cure patients completely," he said. "Our goal is to improve the quality of their life or to extend their life." Many patients--about a third are children--come from developed countries where medical treatment is in general considered superior to China's, although they may lag behind China in stem cell research. [Washington Post]
But many experts argue that there is currently no way to realistically assess such risks, given that clinical trials are ongoing. As Costa Rica Health Minister Maria Luisa Avila said while discussing the shut-down of the Costa Rica clinic:
"This isn't allowed in any serious country in the world." [Reuters]
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Image: flickr / Armando Maynez