You can't keep a good thing down. When the US restricted stem cell research in the early part of the century that research didn't die, it emigrated. All over the world, scientists continued to explore the efficacies of embryonic and adult stem cells with astonishing results. Now, as the public becomes increasingly aware of these "miracle" treatments, the demand for stem cell therapies has increased far beyond what institutionalized Western medicine seems able to immediately provide. The result is both exhilarating and terrifying: more and more patients from the US and Europe are traveling abroad to seek stem cell treatments. This is just a tiny fraction of the ever increasing flood of medical tourism that has struck the West. Companies like Atlanta based Global Surgery Providers (GSP) are marketing directly to patients, facilitating travel for medical procedures including stem cell transplants. While governments, doctors, and patients are still struggling to understand the dangers and advantages of medical tourism, it continues to grow. One thing is for certain, no matter what any one institution may try to do to control the use of stem cells, the demand for this technology is too strong to be stopped.
While many researchers are working overtime to get stem cell therapies safely to market, the public perception in the US is that this technology is stalled. It doesn't help that big name studies, like the first US embryonic test by Geron, have run into bureaucratic roadblocks even after the political ones were pulled away. When the US allows stem cell treatments for animals, but not humans, this is seen as backwards, not as a necessary result of the stringent review applied to new medicine. It takes time for any new product to pass FDA approval, but patients want stem cells now.
And why wouldn't they - have you seen some of the amazing things that stem cells can do? First there's the eye-popping pictures of new organs grown in labs. We've even seen a new windpipe created and implanted in just weeks thanks to a technique that used a patient's own stem cells. Add to that the promising results seen with diabetes and blindness...well, if I was in need of such a treatment, I would be demanding access to stem cells, too.
Which is where medical tourism comes in. Why wait years for the resolution of clinical trials and bureaucratic red tape when you can jump on a plane and get treated in a manner of weeks? Atlanta's GSP is just one of many medical travel agencies that has picked up on the stem cell trend. They offer consultations (via phone only at this time) that could help you find a stem cell therapy center somewhere across the world. Similar agencies cater to the UK, Canada, and many different locations in Europe.
When you see a company offering to take you to a foreign country for a miraculous new medical procedure, it can all seem new and untested. Parts of it are. Yet the medical tourism industry has been growing strong for years now. Once the province of cosmetic surgeries and dental procedures, medical tourism now includes those looking for hip/joint replacement, heart surgery, even organ transplant. Some 750,000 Americans were thought to have traveled outside the US for medical treatment in 2007. A survey published by Deloitte in 2009 found that 3% of those 3000 18 to 75 year old Americans polled had used some form of medical tourism and that 27% would consider it (see page 13 of the results). A significant 40% would pursue medical travel if they could save 50% or more on costs.
Cost and availability top the list of reasons why people seek healthcare travel. In the US, a heart valve operation might run you $200k, but the same procedure in India could be done for $10k, including travel and accommodations. In countries with socialized medicine, waiting for months on necessary (but not "critical") surgery pushes many to seek help outside their borders.
It's no wonder that different agencies have arisen to promote medical tourism and address the concerns of its detractors. The most well known of these is the Joint Commission International which seeks to certify hospitals and other medical facilities around the world. A JCI certificate is often seen as a guarantee that a facility will live up to Western medical standards. Other organizations, like the Medical Tourism Association, offer their own certification while serving as a business networking opportunity for those institutions that want to grow the industry.
Yet if medical tourism is increasingly seen as legitimate, "foreign" stem cell therapies are still stigmatized by the established medical profession. The International Society for Stem Cell Research (ISSCR) has called for greater transparency and open evaluation of stem cell therapies. They worry about clinics directly marketing to patients and using anecdotal evidence to support their medical claims. Even those medical travel agencies (like GSP) that are venturing into stem cell treatments are quick to advise patients that many treatments are untested, and that not all therapies will work for all people.
The problem with venturing outside the (painfully) slow review process that plagues the West is the presence of crippling uncertainty. For every clinic in Germany that seems to have somewhat reputable results, there's some clinic shut down in Hungary for being untested and unlicensed. Patients cannot know for sure if the treatments they receive as part of stem cell medical tourism will work. Or even be safe.
I don't think that's going to stop anything. As I said in the beginning, you can't keep a good thing down. That's true even if you're uncertain about how good it really is. Stem cells therapies hold such amazing promise that they are going to be used no matter what. Years before the medical community as a whole would be comfortable with their use, stem cells have captured the hopes of patients the world over. In a sense, it doesn't matter if medical review processes are unnecessarily slow or not. It doesn't matter if stem cell therapies in different parts of the world are legitimate or not. Patients in need will seek out untested technologies as soon as the promised benefits outweigh the perceived risks. We've already passed that point. For better or for worse.
In a few years stem cell research is likely to be complete enough to produce clinically proven and nationally licensed therapies. But a few years can be a lifetime. I'm still doubtful as to whether stem cell clinics anywhere in the world really possess effective and safe treatments. Yet I know that dire situations force many to choose hope over doubt. Good luck to everyone, no matter which side of the coin you land on. And rest assured: one day recognized stem cell treatments will be available. Can't be stopped.
[image credit: Stem Cell Blog]