HIGH HOPES, HIGH RISKS

Posted: June 11th, 2014 
By: Dr Casimir MacGregor 
Sociology researcher, Monash University

Monash researchers investigate stem cell ‘tourism’Stem cells

Stem cell science has been widely touted as a field of revolutionary possibilities ranging from treating currently incurable diseases to restoring function for individuals with disabilities.

But what are stem cells and why are they important?

The human body is made up of a vast array of cells, most of which are specialised, such as nerve cells or skin cells. However all cells within the body originate as stem cells.

Stem cells are cells not yet specialised and have different levels of potential. A stem cell that can become any type of cell in the human body is called pluripotent; whereas a stem cell that can only become a certain type of type of cell is called multipotent.

Stem cells can be divided into two main groups. First, tissue specific stem cells or adult stem cells that are found throughout the adult human body, such as in blood, the brain and fat; but these cells can usually only give rise to the cells of the tissue from which they are derived from. Second, are pluripotent stem cells, such as embryonic stem cells which are a small group of cells from an early embryo (often only 5-7 days old) and can become every type of cell in the body. In 2007 scientists discovered a new way that could turn a mature fully specialised cell, such as a skin cell, into mimicking the pluripotent character of an embryonic stem cell – these types of cells are known as induced pluripotent stem cells or iPS cells.

Stem cells have the capacity for self-renewal and are important for developing new cell and tissues as we grow. Stem cells are also responsible for the repair and regeneration of our tissues as we age or in response to disease. In recent years scientists have been trying to understand this process of how stem cells turn into specific types of body cells such as nerves or muscle – a process of specialisation called differentiation. Despite the potential of stem cells to grow into new cells, such as the dopamine producing nerves that are lost in Parkinson’s disease, there remain many challenges. Scientists need to identify the type of stem cells best suited to address the cause of Parkinson’s disease and determine how to grow dopamine producing nerve cells in sufficient qualities and at a high enough safety standards to treat patients. Finally, researchers have to determine how and where to transplant the stem cells, so they reach the desired target and do not cause any other complications.

At the moment clinically recognised stem cell treatments available in Australia are limited to support for patients with haematological malignancies, immune deficiencies and more recently tissue engineered products such as skin grafts or bone repair. However, some clinics and companies overseas and in Australia have begun to capitalise on the promise of stem cell science and market a range of ‘treatments’ direct to consumers for large sums of money with little, if any, medically recognised evidence. Given the high profile of stem cell science and growing community acceptance of stem cell research, people considering such options are often confronted with conflicting claims about stem cell-based treatments and their benefits.

Anecdotal reports suggest that a growing number of Australians are electing to purchase unproven stem cell treatments, but little is known about the views and experiences of people undertaking these journeys. To address this, a team of researchers based at Monash University are currently undertaking research into the phenomenon of “stem cell tourism” in order to help provide better support and information for people and carers who may be considering travel, or who have travelled overseas for treatment. The sociology project, titled High hopes, high risks: a sociological study of stem cell tourism, is funded by the Australian Research Council and builds on a pilot study, Hopeful Journeys: experiences of stem cell treatments offered outside Australia, that involved interviews with 16 people who had travelled overseas for stem cell treatments. Findings from “Hopeful Journeys” indicated that people must navigate a complicated range of information about the benefits and risks of overseas treatments when weighing up whether or not to travel. The study also found that patients and carers were well aware of the reported limitations and possible risks of stem cell treatments, given that it is a relatively new and experimental medical treatment. Most patients and carers didn’t hope for miracles, but rather for small, yet significant improvements, as one interviewee explained:

“I never thought it was going to be a miracle. I mean, you just have to do the research and know that that’s not going to happen and people who go with that thought in mind are going to be disappointed every time.”

While some patients have reported improvements in their health, evidence on experiences is sparse and inconclusive. There is evidence that some patients who have travelled overseas for such treatments have experienced adverse outcomes, and some reports from patient groups that individuals may have suffered stigmatisation upon their return. However, there are many gaps in current understandings of this phenomenon.

The project team is currently recruiting people who have considered travelling overseas for stem cell treatment, or who have travelled for treatment, for the study. Participation involves an audiotaped phone interview of 30-45 minutes. If you would like to share your story or find out more about the project, please visit the Monash project website: http://artsonline.monash.edu.au/stem-cell-tourism-research-project/ or contact Dr Casimir MacGregor on 0420523587 or via email at casimir.macgregor@monash.edu.

What to know more about stem cells?

Stem Cells Australia is an excellent place to find out the latest information about stem cell science: (http://www.stemcellsaustralia.edu.au/). Stem Cells Australia and the National Stem Cell Foundation of Australia have also published an information handbook to help inform those considering stem cell treatments in Australia and abroad (http://www.stemcellfoundation.net.au/patient-information/handbook).

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