A scientific conference we can all enjoy

Scientific conferences are fascinating events. You get a chance to mingle with some of the leading researchers and thinkers in the field, and to learn about the latest advances. But, to be honest, for those of us who don’t have a scientific background, they can also be a little bit intimidating.

That’s where the World Stem Cell Summit comes in. It’s an annual event that brings together researchers, companies, scientists and patient advocates to talk about the progress being made in stem cell research and to explore ways to advance the field even further, and faster by working together.

Changing the tone

The patient advocate role is a critical one here. It makes the voice of the patient a key element in every discussion and changes the tone of the event from talking about what is being done to or for patients, to what is being done with patients. It’s a small but tremendously important difference.

Dr. Evan Snyder, Director of the Stem Cells and Regenerative Medicine program at Sanford – Burnham Medical Research Institute captures that feel when he says:

“We’re looking forward to the valuable information-sharing opportunities and discussions that only occur when stem cell researchers, patient advocates, and representatives of many other stakeholder groups converge at the World Stem Cell Summit. Occasions like these help us advance our research on the basic biology of stem cells and spur the development of new, and more personalized, medical applications for this science.”

Because more than ten percent of those attending are patient advocates the talks are given at a level that someone without a science background can generally understand. The presentations are no less fascinating; they are just a lot more accessible.

Stephen Rose, the Chief Research Officer with the Foundation Fighting Blindness says it brings different groups together in a way other conferences usually don’t:

“Policy experts learned about researchers’ needs. Advocates learn about policy and legislation. It also brought ethical issues to the table, which is critical if we’re going to resolve them and keep the research moving forward.”

Researchers have a lot of opportunities throughout the year to meet with other scientists but patient advocates don’t, so the World Stem Cell Summit is a great chance for them to meet with their colleagues and counterparts from all over the US. It gives them a chance to share ideas, offer support and explore ways they can collaborate.

More than just a meeting

For many advocates who are focused on diseases that affect relatively small numbers of people these events are a great way to recharge their batteries and to remind themselves they are not alone in this fight.

If you are thinking about going to one conference this year, this is a great one to chose. This year the World Stem Cell Summit is being held December 10 – 12 in Atlanta, Georgia.

We’ll be there and we’d love to see you there too.

Alzheimer’s Nightmare Spurs Comedy Fundraiser to Help Caregivers – New Video

You could have heard a pin drop in the auditorium. The audience of young stem cell researchers was gripped by every word of Lauren Miller’s heartbreaking story about the impact that Alzheimer’s disease has had on her family. Only a child when her grandfather was diagnosed with and later died of Alzheimer’s, she mistook his symptoms, like repeating stories over and over, as his way of making her laugh.

Lauren was fifteen and much more aware of the brutality of the disease when her grandmother, the vibrant family matriarch, was diagnosed with Alzheimer’s and soon, ”stopped talking, stopped walking and eventually curled up in a ball and stayed that way for the last, many months of her life.”

Miller, a screenwriter and film actress, is the Alzheimer’s patient advocate member of CIRM’s Board. Last month, she was the opening speaker at the 2015 CIRM Bridges Trainee Meeting, a two-day event which showcases the work of undergraduate and Master’s level students who, through the support of the Bridges program, conducted stem cell research at world class research institutes in California. This video recording of Lauren’s talk is a great watch but keep a hanky near by:

Her presentation clearly resonated with the students, likely because their internships were mostly centered around the laboratory bench, and Lauren’s story provided a personal, first-hand account of a disease that could one day be treated by stem cell-based therapies. Also, Lauren was just about their age when, sadly, she first realized that her mom was showing the signs of early onset Alzheimer’s. Her memory of this moment is crushing:

“I first noticed it the weekend of my college graduation. She told me the same stories a few times and deep down inside I was devastated. I said nothing to anyone. Maybe if I pretended it didn’t happen, it wouldn’t be real. Maybe it was a one-time thing and it would just go away. Of course, it didn’t go away.”

Out of this darkness, Lauren has become a source of unwavering support for other families and caregivers who are beaten down by this disease on a daily basis. She and her husband Seth Rogen founded Hilarity for Charity which she says aims, “to raise awareness about Alzheimer’s among young adults and to support those who are going through it.” In only three and a half years, Hilarity for Charity has raised almost $3 million. Recently they launched a partnership with Home Instead Senior Care and in the past six months have funded 8000 hours of free at home care to give Alzheimer’s caregivers a much needed break. For me, one of the most poignant sections of Lauren’s talk is when she read a note from one of the recipients of these grants:

“The words, ‘thank you’, just don’t seem to be enough to express my heartfelt appreciation. I’ve barely been out of Sue’s sight since 2006 and our world has shrunk to the size of her bedroom and bath with conversations from babbling to hysteria. Please accept my total gratitude for this chance to join humanity again.”

At CIRM, our Board has awarded close to $55 million to stem cell related Alzheimer’s research. These cutting edge research projects aim to gain a better understanding of the disease and to progress stem cell-based treatments into clinical trials. Here’s hoping for an accelerated cure for Alzheimer’s to end the suffering of both patients and caregivers.


Related Links:

Stories of Hope: Lauren Miller
Stories of Hope: Dick Mora
CIRM Alzheimer’s Disease Program Fact Sheet
Video: Alzheimer’s Stem Cell Research: Ask the Expert – Larry Goldstein, UCSD
Video: Neural Stem Cells Reverse Alzheimer’s-Like Symptoms

Pushing, pulling and dragging stem cell research forward

Government agencies are known for many things, but generally speaking a willingness to do some voluntary, deep self-examination is not one of them. However, for the last few weeks CIRM has been doing a lot of introspection as we develop a new Strategic Plan, a kind of road map for where we are heading.

Patient Advocate meeting in Los Angeles: Photo courtesy Cristy Lytal USC

Patient Advocate meeting in Los Angeles:
Photo courtesy Cristy Lytal USC

But we haven’t been alone. We’ve gone to San Diego, Los Angeles and San Francisco to talk to Patient Advocates in each city, to get their thoughts on what we need to focus on for the future. Why Patient Advocates? Because they are the ones with most skin in the game. They are why we do this work so it’s important they have a say in how we do it.

As Chris Stiehl, a Patient Advocate for type 1 diabetes, said in San Diego: “Let the patient be in the room, let them be part of the conversation about these therapies. They are the ones in need, so let them help make decisions about them right from the start, not at the end.”

A Strategic Plan is, on the surface, a pretty straightforward thing to put together. You look at where you are, identify where you want to go, and figure out the best way to get from here to there. But as with many things, what seems simple on the surface often turns out to be a lot more complicated when looked at in more depth.

The second bit, figuring out where you want to go, is easy. We want to live up to our mission of accelerating the development of stem cells therapies to patients with unmet medical needs. We don’t want to be good at this. We want to be great at this.

Dr. C. Randal Mills talking to Patient Advocates in LA: Photo courtesy Cristy Lytal, USC

Dr. C. Randal Mills talking to Patient Advocates in LA: Photo courtesy Cristy Lytal, USC

The first part, seeing where you are, is a little tougher: it involves what our President and CEO, Dr. Randy Mills, “confronting some brutal facts”, being really honest in assessing where you are because without that honesty you can’t achieve anything.

So where are we as an agency? Well, we have close to one billion dollars left in the bank, we have 12 projects in clinical trials and more on the way, we have helped advance stem cells from a fledgling field to a science on the brink of what we hope will be some remarkable treatments, and we have a remarkable team ready to help drive the field still further.

But how do we do that, how do we identify the third part of the puzzle, getting from where we are to where we want to be? CIRM 2.0 is part of the answer – developing a process to fund research that is easier, faster and more responsive to the needs of the scientists and companies developing new therapies. But that’s just part of the answer.

Some of the Patient Advocates asked if we considered focusing on just a few diseases, such as the ten largest killers of Americans, and devoting our remaining resources to fixing them. And the answer is yes, we looked at every single option. But we quickly decided against that because, as Randy Mills said:

“This is not a popularity contest, you can’t judge need by numbers, deciding the worth of something by how many people have it. We are disease agnostic. What we do is find the best science, and fund it.”

Another necessary element is developing better ways to attract greater investment from big pharmaceutical companies and venture capital to really help move the most promising projects through clinical trials and into patients. That is starting to happen, not as fast as we would like, but as our blog yesterday shows things are moving in this direction.

And the third piece of the pie is getting these treatments through the regulatory process, getting the Food and Drug Administration (FDA) to approve therapies for clinical trials. And this last piece clearly hit a nerve.

Many Patient Advocates expressed frustration at the slow pace of approval for any therapy by the FDA, some saying it felt like they just kept piling up obstacles in the way.

Dr. Mills said the FDA is caught between a rock and a hard place; criticized if it approves too slowly and chastised if it approves too fast, green lighting a therapy that later proves to have problems. But he agreed that changes are needed:

“The regulatory framework works well for things like drugs and small molecules that can be taken in pills but it doesn’t work well for cellular therapies like stem cells. It needs to do better at that.”

One Advocate suggested a Boot Camp for researchers, drilling them in the skills they’ll need to get FDA approval. Others suggested applying political pressure from Patient Advocacy groups to push for change.

As always there are no easy answers, but the meeting certainly raised many great questions. Those are all helping us focus our thinking on what needs to be in the Strategic Plan.

Randy ended the Patient Advocate events by saying the stem cell agency “is in the time business. What we do is time sensitive.” For too many people that time is already running out. We have to do everything we can to change that.

Share your voice, shape our future

shutterstock_201440705There is power in a single voice. I am always reminded of that whenever I meet a patient advocate and hear them talk about the need for treatments and cures – and not just for their particular disease but for everyone.

The passion and commitment they display in advocating for more research funding reflects the fact that everyday, they live with the consequences of the lack of effective therapies. So as we at CIRM, think about the stem cell agency’s future and are putting together a new Strategic Plan to help shape the direction we take, it only makes sense for us to turn to the patient advocate community for their thoughts and ideas on what that future should look like.

That’s why we are setting up three meetings in the next ten days in San Diego, Los Angeles and San Francisco to give our patient advocates a chance to let us know what they think, in person.

We have already sent our key stakeholders a survey to get their thoughts on the general direction for the Strategic Plan, but there is a big difference between ticking a box and having a conversation. These upcoming meetings are a chance to talk together, to explore ideas and really flesh out the details of what this Strategic Plan could be and should be.

Our President and CEO, Dr. C. Randal Mills wants each of those meetings to be an opportunity to hear, first hand, what people would like to see as we enter our second decade. We have close to one billion dollars left to invest in research so there’s a lot at stake and this is a great chance for patient advocates to help shape our next five years.

Every voice counts, so join us and make sure that yours is heard.

The events are:

San Diego, Monday, July 13th at noon at Sanford Consortium for Regenerative Medicine, 2880 Torrey Pines Scenic Drive, La Jolla, CA 92037

Los Angeles: Tuesday, July 14th at noon at Eli and Edythe Broad CIRM Center for Regenerative Medicine and Stem Cell Research at USC, 1425 San Pablo Street, 1st floor conf. room Los Angeles, CA 90033

San Francisco: Wednesday, July 15th at noon at CIRM, 210 King Street (3rd floor), San Francisco, CA 94107

There will be parking at each event and a light lunch will be served.

We hope to see you at one of them and if you do plan on coming please RSVP to info@cirm.ca.gov

And of course please feel free to share this invitation to anyone you think might be interested in having their voice heard. We all have a stake in this.

The best tools to be the best advocate

It’s hard to do a good job if you don’t have the right tools. And that doesn’t just apply to fixing things around the house, it applies to all aspects of life. So, in launching our new website this week we didn’t just want to provide visitors to the site with a more enjoyable and engaging experience – though we hope we have done that – we also wanted to provide a more informative and helpful experience. That’s why we have created a whole new section call the Patient Advocate Toolbox. shutterstock_150769385

The goal of the Toolbox is simple; to give patients and patient advocates help in learning the skills they need to be as effective as possible about raising awareness for their particular cause.

As an advocate for a disease or condition you may be asked to speak at public events, to be part of a panel discussion at a conference, or to do an interview with a reporter. Each of those requires a particular set of skills, in areas that many of us may have little, if any, experience in.

That’s where the Toolbox comes in. Each section deals with a different opportunity for you to share your story and raise awareness about your cause.

In the section on “Media Interviews”, for example, we walk you through the things you need to think about as you prepare to talk to a reporter; the questions to ask ahead of time, how to prepare a series of key messages, even how to dress if you are going to be on TV. The idea is to break down some of the mystique surrounding the interview, to let you know what to expect and to help you prepare as fully as possible.

If you are going to be asked questions about stem cell research there’s a section in the Toolbox called “Jargon-Free Glossary” that translates scientific terms into every-day English, so you can talk about this work in a way that anyone can understand.

There’s also a really wonderfully visual infographic on the things you need to know when thinking about taking part in a clinical trial. It lays out in simple, easy-to-follow steps the questions you should ask, the potential benefits and problems of being in a trial, including the risks of going overseas for unproven therapies.

The Toolbox is by no means an exhaustive list of all the things you will need to know to be an effective advocate, either for yourself or a friend or loved one, but it is a start.

We would love to hear from you on ways we can improve the content, on other elements that would be useful to include, on links to other sites that you think would be helpful to add. Our goal is to make this as comprehensive and useful as possible. Your support, your ideas and thoughts will help us do just that. If you have any comments please send them to info@cirm.ca.gov

Thomas Carlyle, the Scottish philosopher, once wrote: “Man is a tool-using animal. Without tools he is nothing, with tools he is all.” That’s why we want to give you the tools you need to be as effective as you can. Because the more powerful your voice, the more we all benefit.

Stem Cell Awareness Day and the Stem Cell Person of the Year

Today is Stem Cell Awareness Day, an event that seeks to bring together individuals and organizations around the world working to celebrate and raise awareness about the tremendous progress being made in stem cell research, and to ensure we remain focused on keeping that progress going until we have cures or treatments for people in need.

Paul Knoepfler

Paul Knoepfler

Today is also the day that our colleague, U.C. Davis stem cell researcher and avid blogger, Paul Knoepfler reveals the nominations for his annual Stem Cell Person of the Year award. It’s perfect timing, because many of those nominated have been pivotal in helping move the research forward, and in helping raise awareness about the field in general.

The rules for the competition are pretty simple. In Paul’s own words: “Who has been the single most important, influential person in the world of stem cells this year? Who has made the biggest positive contribution in 2014?”

This is the third year of the competition and Paul is not just a tireless champion of stem cell research, he’s also someone who puts his money where his mouth is. The prize for this year’s winner is $2,000, double that of the previous two years, and all that cash comes out of Paul’s own pocket. It’s a generous gesture from a tireless advocate. In fact those two qualities alone would suggest Paul qualifies to win his own competition. But he has too much integrity to ever even consider that.

So without further ado here is the list of nominations with quotes from some of the people who nominated them in green.

*Spoiler alert: a couple of those nominated are colleagues of mine here at the stem cell agency. I didn’t nominate them, but I can certainly testify to the fact that they deserve it.

Bernie Siegel – a long-time stem cell advocate who runs the yearly World Stem Cell Summit. “Has any one single person done more for the stem cell field?”

Chris Fasano: A principal investigator at the Neural Stem Cell Institute where he uses stem cells to study early nervous system development. Chris stands out for his energy, enthusiasm, dedication to the field, creativity and accomplishments.”

Diana DeGette, the Democratic Congresswoman from Colorado: a politician who has been working to pass important stem cell legislation. “Long time supporter of legislation to support stem cell research and regenerative medicine.”

Don Reed: long-time stem cell research advocate who played a key role in the success of Prop 71 and the creation of CIRM. “A tireless stem cell advocate always there to make a positive difference.”

Emmanuel (Ed) Baetge: Head of Nestlé Institute of Health Sciences at Nestlé Health Science and formerly CSO of Novocell/ViaCyte. “Ed was the driving force behind the development of Novocell (Viacyte’s) diabetes program using hESCs to develop a cell therapy for T1/2 patients…the phase 1 trial is enrolling this year. It has huge potential and Ed deserves the credit for his leadership and development of the technology as well as the company.”

Ellen Feigal; Vice President, Research and Development at the California Institute for Regenerative Medicine (CIRM). “At CIRM Dr. Feigal makes the Development Program happen.”

Ian mcNiece: Professor, Department of Stem Cell Transplantation,
Division of Cancer Medicine, The University of Texas MD Anderson
Cancer Center.

Janet Rossant: Senior Scientist in the Developmental & Stem Cell Biology Program and Chief of Research at The Hospital for Sick Children, Toronto

Jeanne Loring: Stem cell researcher and scholar, leading iPS cell clinical work in the pipeline for Parkinson’s Disease, and patient advocate. “Supportive to the advocacy community. Courage in supporting the challenge to WARF patents. Excellent scientist engaged in policy discussions.”

John Sinden: The co-founder of ReNeuron, a biotech company based in UK. “Thanks to his determination, and drive ReNeuron has a clinical approved stem cell product currently tested in two clinical trials.”

Judy Roberson: Long-time Huntington’s Disease patient advocate. “She makes concrete positive developments happen such as millions of dollars in research funding for HD.”

Leigh Turner: Outspoken advocate of evidence-based medicine in the stem cell field. “Gave an inspiringly frank talk about for-profit stem cell clinics flouting FDA regulations at ISSCR 2014.”

Malin Parmer: Associate Professor, Developmental and Regenerative Neurobiology, Lund University. Top neural regeneration scientist. “Young, hard worker who is doing very well”.

Masayo Takahashi: Stem cell researcher leading the team that is doing the first ever clinical study based on human iPS cells. “Creative and courageous clinical stem cell researcher.”

Mike West: He founded Geron and was CSO of Advanced Cell Technology before his current position as head of BioTime. “He has been a leader in our regen field for many years but he made a bold decision to resurrect Geron’s cell therapy for spinal cord injury this year and hopefully confirm the promise of hESC technology clinically.”

Patricia Olson: Executive Director of Scientific Activities at CIRM and active in CIRM scientific leadership from day 1. “A driving force in the stem cell field.”

Peter Zandstra: Professor at University of Toronto. Stem cell researcher. Canada Research Chair of Stem Cell Bioengineering. “Peter is a recognized pioneer and respected world leader at bringing concepts of scale-up, regulation, and industrialization to stem cell-derived cell therapy technologies.”

Pope Francis: Leader of Worldwide Catholic Church. “Strong supporter of adult stem cell biotechs and research”.

Richard Cohen: An MS patient in a clinical trial who has chronicled his experiences. An author and Meredith Vieira’s husband, father of three children. “Mr. Cohen is an inspiration to me and others because he’s very honest and doesn’t sugar-coat his struggles, losses, frustrations, anger, embarrassments, and he also shares his gains.”

Richard Garr: CEO of Neuralstem, conducting work on using stem cells for ALS and advocate of Right To Try laws. “Richard does two excellent things at once: making a treatment for ALS and connecting with ALS patients.”

Robert Lanza: CEO of Advanced Cell Technology, which has multiple ES cell-based clinical trials ongoing. “Visionary and practical so makes the impossible possible”.

Shoukhrat Mitalipov: Stem cell researcher who first successfully made nuclear transfer human ES cells by therapeutic cloning and developing oocyte transfer-based therapies for mitochondrial disorders. “Gutsy pioneer of new, game changing technologies.”

Susan Solomon: Co-Founder and CEO of The New York Stem Cell Foundation (NYSCF). Remarkably effective advocate for stem cell research. “not many leaders have created their own research laboratories and raised $100 million plus. Seriously, what an accomplishment!”

Takaho Endo: Senior Researcher at the Riken Center for Integrative Medical Sciences in Yokohama who published key genetic work on the possible origin of STAP cells. “Courage to publish this being from RIKEN.”

Ted Harada: Leading stem cell research advocate and very effective ALS patient advocate. “An Energizer Bunny for the ALS community and stem cell advocate”

Tory Williams: Stem cell advocate and author of the 2014 book, Inevitable Collision. Co-Founder and Executive Director of the Alabama Institute of Medicine (AIM). “A true hero who inspires and makes concrete things happen like AIM”.

When Hope Runs up against Reality: Balancing Patient Optimism with Medical Evidence

One of the big concerns among scientists – including many at the International Society for Stem Cell Research (ISSCR) conference in Vancouver, Canada – is that patient expectations about stem cells are often greater than researchers are able to deliver today. That can result in patients in search of a cure heading to overseas clinics that offer unproven therapies.

Megan Munsie – head of the Education, Ethics, Law and Community Awareness Unit at the University of Melbourne in Australia – wanted to find out what happens when patients’ hopes for new treatments come into conflict with scientific views on medical evidence. So she started with a small survey of 16 Australians, patients and patient-caretakers, who had travelled outside Australia for stem cell treatments for a variety of diseases including MS and cerebral palsy.

She says there were a number of interesting findings:

  • They all considered themselves pro-active and well-informed
  • They rejected advice from their own doctor but instead relied on the overseas doctor selling them the treatment for advice
  • They felt they had no choice but to travel overseas because they were running out of time and options in Australia
  • They didn’t consider the health risks, believing that the worst that would happen is that the “treatment” wouldn’t work and they would have spent a lot of money for nothing

Perhaps the most surprising finding was that all of them talked about the “benefits” they gained from going abroad for the treatment, that it gave them a sense of hope even if there was no evidence of medical benefit.

What happens when patients’ hopes for new treatments come into conflict with scientific views on medical evidence?

What happens when patients’ hopes for new treatments come into conflict with scientific views on medical evidence?

This led to a bigger study where Munsie surveyed patients and patient advocates but also stem cell scientists and physicians. Not surprisingly the researchers had a very different view of the subject than the patients.

Researchers/doctors said they felt that patients don’t understand science and don’t appreciate the subtleties of clinical trials

  • They said patients were basing their decisions not on science but desperation
  • They considered overseas providers as dubious, selling hope and taking advantage of a vulnerable patient population

What was interesting, however, is that many doctors said they didn’t try to persuade their patients not to go, instead they chose to respect their autonomy but did at least try to give them the facts so that they could make a decision based on knowledge not ignorance.

When asked why they didn’t tell patients not to go, they said they respected the patients’ need for hope and didn’t want to take that away from them because they had nothing they could offer to replace it.

Munsie says recently some doctors have started offering these kinds of unproven therapies in Australia. She talked to four of them asking how they could justify it. All four said there is a huge unmet medical need and it was better to offer these therapies in Australia than have patients travel to other countries for them. They also said that they felt competent to provide treatment because they had undergone some kind of training or had a license to use equipment needed for the therapy.

Ironically while they all considered themselves legitimate providers of a needed medical therapy – albeit an unproven one – and only interested in the science, they regarded others doing the same as “cowboys” and only interested in the money.

When asked if they would support more regulation of the kinds of therapies they were already offering they said yes, saying that the other doctors who claimed they were “self-regulating” is like “giving the keys to the asylum to the lunatics.”

Munsie says it’s clear that it’s not just patients who could benefit from some guidance on expectations about stem cell therapies.

She says we need to do a better job of managing patient expectations without robbing them of a sense of hope, perhaps by offering them information that is more tailored to their particular needs.

We also need to manage what she called “the unbridled enthusiasm of providers” who are offering speculative treatments as “medical practice”. That might take regulatory change by the government.

She says it’s difficult to strike a balance between hope and scientific evidence, in maintaining a patient’s sense of optimism while acknowledging the reality of the science and the risks posed by unproven treatments.

Kevin McCormack

When Hope Runs up against Reality: Balancing Patient Optimism with Medical Evidence

One of the big concerns among scientists – including many at the International Society for Stem Cell Research (ISSCR) conference in Vancouver, Canada – is that patient expectations about stem cells are often greater than researchers are able to deliver today. That can result in patients in search of a cure heading to overseas clinics that offer unproven therapies.

Megan Munsie – head of the Education, Ethics, Law and Community Awareness Unit at the University of Melbourne in Australia – wanted to find out what happens when patients’ hopes for new treatments come into conflict with scientific views on medical evidence. So she started with a small survey of 16 Australians, patients and patient-caretakers, who had travelled outside Australia for stem cell treatments for a variety of diseases including MS and cerebral palsy.

She says there were a number of interesting findings:

  • They all considered themselves pro-active and well-informed
  • They rejected advice from their own doctor but instead relied on the overseas doctor selling them the treatment for advice
  • They felt they had no choice but to travel overseas because they were running out of time and options in Australia
  • They didn’t consider the health risks, believing that the worst that would happen is that the “treatment” wouldn’t work and they would have spent a lot of money for nothing

Perhaps the most surprising finding was that all of them talked about the “benefits” they gained from going abroad for the treatment, that it gave them a sense of hope even if there was no evidence of medical benefit.

What happens when patients’ hopes for new treatments come into conflict with scientific views on medical evidence?

What happens when patients’ hopes for new treatments come into conflict with scientific views on medical evidence?

This led to a bigger study where Munsie surveyed patients and patient advocates but also stem cell scientists and physicians. Not surprisingly the researchers had a very different view of the subject than the patients.

Researchers/doctors said they felt that patients don’t understand science and don’t appreciate the subtleties of clinical trials

  • They said patients were basing their decisions not on science but desperation
  • They considered overseas providers as dubious, selling hope and taking advantage of a vulnerable patient population

What was interesting, however, is that many doctors said they didn’t try to persuade their patients not to go, instead they chose to respect their autonomy but did at least try to give them the facts so that they could make a decision based on knowledge not ignorance.

When asked why they didn’t tell patients not to go, they said they respected the patients’ need for hope and didn’t want to take that away from them because they had nothing they could offer to replace it.

Munsie says recently some doctors have started offering these kinds of unproven therapies in Australia. She talked to four of them asking how they could justify it. All four said there is a huge unmet medical need and it was better to offer these therapies in Australia than have patients travel to other countries for them. They also said that they felt competent to provide treatment because they had undergone some kind of training or had a license to use equipment needed for the therapy.

Ironically while they all considered themselves legitimate providers of a needed medical therapy – albeit an unproven one – and only interested in the science, they regarded others doing the same as “cowboys” and only interested in the money.

When asked if they would support more regulation of the kinds of therapies they were already offering they said yes, saying that the other doctors who claimed they were “self-regulating” is like “giving the keys to the asylum to the lunatics.”

Munsie says it’s clear that it’s not just patients who could benefit from some guidance on expectations about stem cell therapies.

She says we need to do a better job of managing patient expectations without robbing them of a sense of hope, perhaps by offering them information that is more tailored to their particular needs.

We also need to manage what she called “the unbridled enthusiasm of providers” who are offering speculative treatments as “medical practice”. That might take regulatory change by the government.

She says it’s difficult to strike a balance between hope and scientific evidence, in maintaining a patient’s sense of optimism while acknowledging the reality of the science and the risks posed by unproven treatments.

Kevin McCormack