Misconceptions about stem cells and stem cell sciences have run rampant since their discovery in the early 1980s. Their origin, application, and capabilities have been misunderstood or simply misreported in the decades since they were first conceived.
Given these false impressions and all of the myth surrounding stem cells, Dr. Matthew Otten sat down for an interview to clear the air and give our readers the facts about this incredible medical tool.
We’ve heard that stem cells are somewhat of a miracle medical discovery, but can Stem Cells really heal any medical condition?
“Although we hope this to be the case in the next 20-50 years, currently this is not the case. As of 2019, there are over 700 active clinical studies investigating the uses of stem cells in the United States. The hope is that stem cells will be a solution to a variety of medical conditions, but currently, science has not yet caught up to the hype and rumors.”
Well, that’s understandable, the “hype and rumors” have always seemed excessive. I’ve heard, though, that IV Stem Cell treatments can help many conditions including heart failure and kidney failure. Some even claim that it can reverse the aging process. Are these validated medical treatments?
“No. Although it sounds very promising, there is no science at this time showing real changes by injecting stem cells through an IV. Just the opposite, in July 2018, some cases began to surface of complications. There were reports of contaminated stem cells. Genetech, the parent company of Livyeon, in fact is quietly settling over six dozen cases involving serious complications from their stem cell products. These stem cells were injected into joints, spine and through IV’s into patients. Patients required surgeries, hospitalizations and lengthy recoveries from these tainted products. New start-up companies (that are only lightly regulated by the FDA) are being created solely for profit are forming rapidly in the United States. These companies have very little oversight because this field of medicine is so new. Complications, such at the Livyeon cases, will undoubtedly continue to appear in the news.”
Well that’s certainly unnerving. I still see many different clinics offering stem cell treatments though, so where do the safest and most studied Stem Cells Come from?
“Two major sources, both of which are from your own body, referred to as “autologous stem cells.” Both adipose tissue (fat) and bone marrow are our own body’s reservoir for stem cells – our bodies store stem cells in these locations. These stem cells typically stay dormant until they are called to action.
Most clinics are now currently marketing cord blood stem cells. These stem cells are extracted during the delivery process at birth. A multitude of newly formed companies are isolating stem cells from cord blood otherwise known as “donor stem cells”. These are then frozen and sold to physicians for treatments.”
I’ve heard of donor stem cells or “cord stem cells,” they’ve been in the news a lot recently. So are these cord blood stem cells better than your own?
“The top physicians nationally will vastly answer “No. Your own stem cells are the best option.” Using your own stem cells is safer, more controlled and side effects are virtually non-existent in medical literature. Harvesting your own stem cells can happen through extraction of your bone marrow or your fat (known as adipose tissue). Your own stem cells can self-replicate (otherwise known as expansion) anywhere from 5-8 times before becoming a specific cell; like a cartilage or tendon cells. For example, if 1,000,000 stem cells are harvested and injected into a tendon they can replicate to 5,000,000-8,000,000 tendon cells.”
Okay, so is culturing, or “expanding” your own stem cells outside the body important?
“No. Some clinics will “expand” your cells before injecting them. Most leading physicians in this field agree that this does not matter in patients’ outcomes. Your stem cells innately self-replicate a certain number of times. For example, bone marrow stem cells with self-replicate about 5 times and adipose about 8 times. Pre-programmed self-replication will occur regardless of whether it is in your own body or a lab. Thus, it is generally agreed upon by the experts that “expanding” your stem cells outside the body offers no medical benefit.”
So you talked about freezing stem cells earlier. Is there a way that I can freeze my stem cells for later use?
“No. The FDA does not allow this to occur within the USA. Although you can preserve your stem cells through cryopreservation at a third party facility, you cannot use them under FDA guidelines. Facilities that cryopreserve your stem cells charge an annual fee which is on average about $500.00-1500.00. Preserving your stem cells is legal, but you are basically not allowed to do anything with them within the USA. There are some specific exceptions to this, but they are rare and for very specific medical conditions. So in general, if you are wanting to preserve your stem cells for later use this is not allowed in the USA.”
That’s unfortunate, but I’ll have to trust the FDA on this one. Speaking of the FDA, do they allow any licensed medical Physician to perform Stem Cell or Regenerative Procedures?
“Yes. However, most physicians have only been performing these procedures less than 2 years. Outcomes are directly related to a physician’s experience and years performing these procedures, this is well documented. It is widely accepted amongst medical professionals that at least 5 years of experience is required to have the best outcomes. Using live ultrasound or X-ray is imperative in order to get the best results. If the affected tissue is not injected directly, the full benefits will not be obtained, if at all. That is to say, if a procedure is performed on a Rotator Cuff tendon, the exact location of the affected tendon needs to be injected, not just the “shoulder.” The best outcomes occur with a qualified, experienced physician with more than 5 years’ experience in this specific field.”
Does this mean that there are different treatment plans for different types of pain?
“Yes. Researchers and clinics around the country have slowly begun to compile their data in order to comply with new FDA regulations. The findings from all of this data have led to many advancements in the field of stem cell therapy and have created a foundation for treatment plans for specific pain areas.”
Given that there are specific plans being set in place, can we talk about specific types of pain and how you treat them? For instance, which treatment is the best for Arthritic Pain?
“For major joints (knees, hips, shoulders etc.) adipose tissue stem cells tends to have the most favorable results. This has also been well documented in medical literature. This procedure is actually covered globally by insurances because of it benefits, however, not in the United States.”
What about specific pain zones? Can Stem Cells improve Neck or back pain?
“Yes. Some of the earliest clinical data in the USA came from Hospital for Special Surgery in NY, NY. Bone Marrow Stem Cells have been the most studied therapy for neck and back pain. These procedures have shown clinical improvements ranging from 50-80% improvement in pain and function. These improvements have been long term improvements, not short term which cortisone offers. More patients are seeking these therapies as an alternative to spine surgery. In fact, spine surgeons are now recognizing the benefits in these procedures and these procedures are often discussed at the major conferences.”
Very interesting, I had no idea they’d developed treatments for the spine already. So which stem cell therapy is safest and most commonly used for Spinal Procedures?
“The consensus from the experts performing these procedures is bone marrow derived stem cells. Safety is the first consideration when interventions are performed on the spine. Bone marrow stem cells have been the most studied stem cell therapy in the spine and thus, experts in this field use bone marrow for spinal procedures.”
Well, besides the back, shoulder pain is one of the things I hear most people complain about. If a person has shoulder pain what is their best option?
“Shoulders are a complex joint, because of this either adipose or bone marrow stem cells have the best outcomes in clinical studies. An MRI is crucial to appropriately diagnose the pain source and decide which therapy will have the most benefit. For example, if the problem is only from the rotator cuff, bone marrow may be the best option. If the pain source is from a combination of issues including early arthritis, rotator cuff injuries, and a labrum tear, adipose tissue stem cells are often your best option. An experienced physician will be able to give you your options and explain the benefits of your choice of therapies.”
So we’ve established that specific pain areas have targeted regimens, but how long do the benefits of these regimens and procedures last?
“Benefits from stem cell procedures are long lasting, hence their popularity. The most published data is specially about fat stem or bone marrow cells. The newer frozen cord stem cells from a donor do not have long term data yet. If tendons, ligaments or muscle are the treatment location then the improvements can be permanent. If the procedure is performed for arthritic pain, the normal duration of the benefits last on average 3-7 years. The definitive answer to this, however, obviously depends in the body part, the amount of damage, and the chronicity of the problem. Speaking to a qualified physician with at least 5 years of experience will give you the best answer to these questions and more detailed answers.”
Does age matter whether or not these procedures are successful?
“No. However, in general, most physicians prefer to perform these procedures on patients at least 18 years old. The average age for patients receiving these procedures ranges from the mid-’30s to mid-’80s. A common myth is that your stem cells decrease as you age. This is not true. The most common patients are in their 50s and 60s for low back pain, shoulder pain, knee pain, and hip pain.”
How long is the recovery time from these procedures?
“Most patients recover within 3-7 days, although mild swelling and soreness can persist for about 4 weeks. Patients normally return to work in 3 days after the procedure. Patients having adipose stem cell undergo a mini-liposuction which can leave the area uncomfortable for about 3-7 days. Bone marrow candidates typically recover faster because of the minimally invasive procedure. Spine patients however tend to have more pain than orthopedic patients. Spinal patients can have discomfort for typically 2-6 weeks, decreasing each day. Personally, I had an adipose stem cell procedure performed on my left knee. My down time was about 2 days, I was in the gym on the third day, albeit, I was very careful and not 100%. Three weeks afterwards I was hiking, surfing and playing tag with my 3 year old daughter at normal speed with virtually no pain.”
Well that isn’t all that long given the longevity of the benefits. Speaking of benefits, what are the success rates of Stem Cell procedures – how many people actually benefit from them?
“Success rates are directly dependent on the physician’s experience just as any other procedure in medicine. The national and international success rates, performed by experienced physicians, on average are 80-85% for knee and shoulder pain, 70-80% for hip pain, 80-90% for tendon/ligament pain, and 60-80% neck and low back pain. Neck and low back pain are the most difficult to quantify because of the high degree of variability in the injury. Just like anything in medicine, a qualified physician can consult with you regarding your specific success rates depending upon your individual case.”
Well, that all sounds phenomenal, but are these procedures covered by insurance?
“Unfortunately, not in the USA. These procedures are covered in over 100 countries around the world, but not currently in the USA. They are, however, covered by some select medical insurances, such as Workman’s Compensation, Legal Liens, NFL/UFC/NHL/NBA and other professional athlete coverage policies. Medicare does not cover these procedures.”
Thank you for sitting down with us and clearing some things up Dr. Otten. For our readers who wish to do their own research regarding Stem Cells, where has the most clinical research been performed and what were the medical applications?
“For the past 29 years, Sports Medicine has been the field most interested in the benefits of stem cells and other “Orthobiologics.” Following suit was interventional spine specialists to heal back and neck pain. Sports Medicine and Interventional Spine specialists have been studying and applying stem cells to their practice more than any other field in medicine. These specialists have been utilizing regenerative medicine therapies to heal joint, orthopedic and spine pain for many years. Sports Medicine specialists have been investigating alternatives to surgical interventions to keep their patients active without the lengthy downtime that surgery causes. Professional athletes began utilizing these therapies due to their regenerative properties, minimal downtime and excellent outcomes. The likes of Payton Manning, Tiger Woods, Alex Rodriguez and Kobe Bryant have all had various types of stem cell therapies. Western Europe (Germany in particular) has been on the forefront of regenerative medicine procedures. Professional athletes have been receiving these advanced procedures in the United States for years now. Very few physicians are qualified in the United States to perform these procedures appropriately, but the doctors here at CELLAXYS have all been selected specifically for their experience in the field.”
Dr. Otten is part of the specialized team at CELLAXYS. With over 20 years of experience between them, they are sure to be able to provide the most up to date, specific information for any stem cell therapy you may be interested in pursuing. Contact their offices for a consultation today.