Tuesday, 9 June 2015

Dalal Salamah

In early May, local media outlets carried a news report, saying that a Jordanian medical team had managed to treat diabetic patients by using stem cell transplant. The report said that this technique helps "revive the pancreas," which leads to complete healing and a patient becoming normal again.

According to the report, taken from Al Jazeera Net, a Jordanian medical team had announced its success, based on this technique, in treating four type 1 diabetes patients.  The patients are three men and a 13-year-old girl, who used to take three doses of insulin a day, ranging from 20 to 80 units. The story confirms that three of the four patients were completely cured six months after the stem cell transplant, while the fourth is still under observation.

The previous report called this technique "Jordanian experiment," saying that it is expected to universalize the treatment. The story also estimated the cost of the treatment at 42,000 U.S. dollars for those wishing to benefit from it.   

By following and verifying the above report, it contained scientific fallacies and committed ethical violations, according to specialists. The story raised a technique, which is still being researched globally. The technique has not yet been adopted as a successful treatment. The story also depicted it as a safe treatment method without side effects. Experts say this is untrue as the treatment could have complications that cause death.

It is noteworthy that stem cells are primitive cells that are capable of dividing, growing, renewing, and turning into specialized cells, depending on the environment in which they are transplanted. For example, they develop into muscular, hepatic, neural, dermatological, pancreatic, and other cells. This could allow for using them in repairing damaged organs. Theoretically, if they are transplanted into a damaged heart, they could form healthy heart cells. This will cure patients. The same thing applies to neural cells, as well as cells of the pancreas, liver, and other organs.

According to the specialized scientific website Biotechnology Learning Hub, the technique of stem cell transplant started practically in 1956 when the first successful bone marrow transplant operation was carried out in New York on a patient who had leukemia. He received the bone marrow from an identical twin. Afterward, scientific research and experiments on this technique followed to treat various diseases.

Dr. Mohammed Zaheri, president of the Jordanian Society for the Care of Diabetes, thinks that using the technique of stem cell transplant to treat diabetes, especially type 1 (juvenile diabetes), is still globally within the domain of experimentation and research. International research centers have not advanced enough in this field to allow for using this technique as a successful method for treating this disease.  

According to him, what was hailed as a Jordanian achievement in this field is nothing more than preliminary research, and not a scientific achievement that can be applied clinically to treat patients. The number of patients announced thus far is not sufficient to judge the validity of the treatment. Nor is the observation period sufficient to know the complications that could result from such procedures.

Three days after Al Jazeera"s report, Al-Rai newspaper covered the same issue, publishing the same information included in Al Jazeera"s report. However, Al Rai added a statement by one of the members of the medical team, in which he said that treatment by this technique "is still under study and research to develop it and has not yet been adopted as treatment in Jordan." The coverage cited the same doctor as saying that this technique is "safe and has no negative effects on patients. Diabetic patients could benefit from it." This conflicts with the notion that it is still under study.

One of the major shortcomings of media coverage of this issue is that it has almost neglected the complications that could arise from this technique, while it has potential complications, which differ in severity. According to the website of King Hussein Cancer Foundation, the complications could include mouth ulcerations, nausea, and vomiting, and could result in liver toxicity, blood stream infections, or graft versus host disease.

As for the U.S.-based Mayo Clinic, it says on its website that the procedure poses many risks, some potentially fatal, depending on the type of disease or condition, the type of transplant, and the age and health of the person receiving the transplant. The complications that can arise, according to the center, include cancer, organ damage, cataracts, infertility, and death. 

Zaheri says that adopting a certain technique to be a method of treatment must go through several stages, most important of which is presenting research at scientific conferences to be discussed by specialists. Once it is proven to be valid, it is published in refereed scientific journals to be applied at other research centers afterward. When these research centers reach the same results, it is adopted then as a method of treatment after licensing it from official health authorities. All of this, Zaheri says, has not been done in this case.

Zaheri"s statement is confirmed by a report published by the Harvard Stem Cell Institute (HSCI), which is affiliated with the U.S.-based Harvard University, titled "Stem Cell Tourism…False Hope for Real Money." It talks about the proliferation of medical centers that claim to offer treatment by the technique of stem cell transplant.

According to the above report, the technique of stem cell transplant is a valid treatment method for one disease only, which is cancer. This is the only category of diseases on which valid scientific evidence has been published, proving that the technique of stem cell transplant helps in the treatment. As for other diseases, the matter is confined to "clinical trials." The report says that there is great skepticism as to whether we have the scientific knowledge even to predict that this technique will be effective, which could take decades.

Zaheri says that the patient and his family must be aware of the true picture; namely, that what he is going to experience is not therapy, but "treatment experiment with unknown complications. He must be aware that he is going through this experiment at his own risk."

The above Harvard report cites specialists as accusing the medical centers that promote this technique as effective of "exploiting" people financially. Zaheri notes this, saying: The people undergoing such a procedure must not be made to pay. As long as the technique has not been adopted as treatment, this means that its procedures are "medical experiments." Like any other medical experiments, they are part of scientific research, which is supposed to be funded by governmental and nongovernmental entities. The people undergoing these experiments must not be charged at all.

Based on the above, it becomes clear that the way media outlets handled this issue undermined one of the fundamental professional principles, which is accuracy. This standard states that errors of information must be avoided. This is something that could mislead the public and promote groups and individuals who make money at the expense of the health and needs of people.