at academic centers. Additional specific stem cells required in conditions such as diabetes, kidney failure, Parkinson’s, ALS, lung disease, and several others are in the process of being developed. When it comes to stem cell treatments, “one type does not fit all.” Many conditions will require their own types of stem cells and their own treatment protocols. This can get very confusing very quickly. If there is no good mainstream treatment option for your condition, you should explore whether stem cell therapy can benefit you. However, beware of the snake oil salesman. Plenty of clinics advertise and claim they have stem cell treatments for various conditions, but there is no proof that the treatments work.
10. Are there conditions where stem cells may not be helpful?
Even though we would like to think of stem cells as the holy grail of medicine, they have their limitations. At such an early stage of stem cell knowledge, we are still trying to grasp their full potential. Also we have little understanding of their limitations. Our current understanding is that stem cells can help regenerate and repair your damaged cells. They are not going to fundamentally alter why you suffered from the disease in the first place. Clearly there are certain genetic or congenital conditions in which stem cells may not have a significant role to play. Future treatments such as gene therapy are investigating why some of us are more likely to suffer from a particular condition than others.
11. How are stem cells prepared for treatment?
A lot depends on the source. If they are your own stem cells, they can be harvested or collected from your body by doing a minor procedure. The next step is breaking your tissue down to filter out your own stem cells. They are then ready to be put back into your body. This entire process can be done in the same day at the same sitting. You have the ability to utilize your own fresh stem cells the same day. Alternatively your tissues can be collected and then sent to a laboratory for isolation. Sometimes this involves expansion and or programming of your own stem cells. Your own stem cells are then administered to you at a later date.
Stem cells from foreign sources (those obtained from sources other than your own body) are collected from another individual. This could be from a baby or even another adult. Stem cells acquired from foreign sources require laboratory processing, cleaning, and sometimes expansion and/or programming. Foreign stem cells are frozen in storage until needed for your treatment. Laboratory processing of foreign stem cells should be properly performed in order to minimize the risk of introducing any new disease into your body. Laboratory processing can kill many cells. The steps involved are critical to have enough live cells for an effective treatment.
12. How are my own stem cells collected from my body?
Every part of your body, every organ system, possesses stem cells. You can get your own stem cells from any part of your body. However, the goal is to collect them safely in a way that does not harm your body. Commonly used sites to collect your own stem cells are bone marrow, fat, muscle, tendon, dental pulp, lining of your joints (synovium), skin, and liver. It is hoped that in the near future many more sites will serve as a safe source of collection. Surprisingly, your blood does not contain stem cells. It is a good source of platelets (platelet-rich plasma or PRP) but not stem cells.
13. How are stem cells delivered into my body?
It depends on the intended site of delivery of stem cells, which in turn depends on the condition being treated. Precise delivery of stem cells at the site of disease and injury in your body is critically important in order for you to see results. Stem cells regenerate and repair. Although they secrete valuable growth factors, unless they make it to the site of damage, you are unlikely to see robust results. Currently most stem cells have to be delivered through a targeted injection using very small needles under imaging guidance such as ultrasound or X-rays, videoscope, blood flow, or a direct injection. The important goal is that a sufficient number of live stem cells reach areas where help is needed. Other potential routes such as intravenous, intranasal, intra-arterial, intrathecal (CSF), and inhalational are important to consider. The efficacy and the safety of each one of these routes are still being evaluated in clinical trials.
14. What are the potential risks of stem cell therapy?
Again, it depends upon what kind of stem cells you are getting and how the stem cells are delivered into your body. Your own stem cells carry the least risk. Any manipulation of stem cells in a laboratory or foreign source of stem cells can carry the risk of infection, disease transmission, rejection, and tumor formation. Delivery methods themselves can cause bleeding and additional trauma, although collateral damage is minimal when small needles are used.
15. How many stem cells do I need? Is there a specific number?
Not yet! Unlike the dosage of medications, the exact number of stem cells needed to treat a particular condition in a particular patient is yet unknown. Clearly the greater the extent and severity of damage, the more stem cells that would be needed. No matter what, it would be unreasonable to expect that a single treatment or injection will cure your condition completely. This also depends on how healthy you are otherwise. Several factors may play a role in determining the number of cells and/or number of stem cell treatments you may need.
16. Besides the number of cells, what else is important in a stem cell treatment?
Viability—how many stem cells are alive at the time of your treatment. You can have a high total cell count, but if a significant number of stem cells are dead, you may not see results. This is especially important when a foreign source of stem cells is being used or if the stem cells are being processed in the laboratory. Whenever laboratory processing and cleaning are involved, a certain number of stem cells are bound to be lost. How many live stem cells you get at the time of treatment is important. Another important aspect is the quality of the stem cells. Testing can determine their quality. The hope is that we will also be able to detect any changes in the structure of stem cells and predict how they will behave in your body. The count, quality, and structure of stem cells are all important criteria in minimizing risks and predicting a desired outcome.
17. How many stem cell treatments will I need?
It comes down to what your condition is and how much help your local cells need. For example, an 18-year-old kid playing basketball and suffering his first knee injury is going to heal very differently compared with a 60-year-old skier who has suffered a knee injury and has endured multiple previous knee surgeries. Furthermore, those 60-year-old skiers with similar multiple prior knee injuries and surgeries will heal differently from each other. We are just starting to learn how our cells behave and why patients don’t heal the same way. How your stem cell treatment was performed will also determine how many treatments you will need. There are many variables that can affect the efficacy of a stem cell treatment.
18. What is the success rate with stem cell treatment?
This depends on your condition, the source of the stem cells, and the way they are delivered. There are so many different ways of doing stem cell treatments that there can be no apples-to-apples comparison. At least not yet. Due to a lack of standardization, the results are varied. When the treatments are performed correctly for the right reasons, success rates can be around 60% to 70% for joint pain, back pain, and sports injuries. For other conditions, very little is known about how effective the treatments will be. Ongoing research will provide answers in the near future.
19. Why don’t some patients see results after stem cell therapy?
No single treatment of any kind is effective in all patients with the same condition. We believe the same is true of stem cell therapy. Our hope is that, in time,
