No need for patients to flock to Geneva, Beverly Hills and New York for stem cell therapy anymore
By Dr Max Sawaf
A very prominent Emirati VIP contacted me recently asking if I could refer him to a doctor in the USA for a stem cell treatment. He was referring to a Stromal Vascular Fraction or SVF infiltrate derived from the patient’s own fat and injected intravenously over one hour to improve his “sexual performance”.
About 50% of diabetic patients do have at least some degree of Erectile Dysfunction (ED) but hate to admit it. So many say: “we need to improve” our sexual energy or performance. While such discussions are a taboo in our conservative society, they are part of life and daily discussions in social gatherings.
I started offering stem cell therapy in my Novomed Beverly Hills Center in 2014. My very first patient was my 16-year-old son who had a soccer injury to his foot that did not heal with physical therapy and cortisone injections. He went back to playing soccer two months after the stem cell injection. The practice has gained momentum in USA even though it is still not FDA-approved.
Patients are going overseas and paying AED 100,000 and sometimes more for services that should cost a lot less, not to mention the extra cost and disruption to their businesses associated with such travel.
Privacy is one concern for all patients, but especially for VIPs and celebrities. A second reason for going abroad is the false perception that treatments in Geneva, Beverly Hills or New York is better, just because it is so much more expensive (so-called prestige pricing), when in fact, it is similar or inferior. In addition, if these visiting patients are unhappy, there is not much they can do, and no one to complain to.
The third reason is that the Ministry of Health in UAE (MOH), which regulates all medical advertising to protect consumers, does not allow advertising for stem cells, as MOH has a legitimate concern that some practitioners with borderline ethics shall oversell it to patients – over-promising the “expected and guaranteed” results, or promising to cure cancer or autism, when in fact it does not.
Stem cell advertising is not allowed in many countries for the same reasons.
Hence, patients have no clue that it can be done in the UAE, where it is legal only in Dubai Health Care City and under strict regulatory supervision. Currently, the Dubai Health Authority is drafting regulations that would allow qualified institutions to provide stem cell therapy.
Stem cell therapy vs PRP
Confusion has arisen in the public’s mind as many practitioners are promoting PRP as “stem cell” therapy, especially in aesthetics, but even for sexual rejuvenation of men and women.
PRP (Platelet Rich Plasma drawn from a patient’s blood), is not a stem cell therapy, but does have growth factors that help with tissue repair, albeit modestly. Stem cell from fat is much more effective in tissue rejuvenation. PRP is popular because it is legal, easy to learn and relatively inexpensive. When PRP is combined with stem cell therapy, the cell therapy is rendered even more effective. Growth factors help instruct stem cells on what to do, hence best results are obtained when stem cells are combined with stem cell therapy.
What are the best sources of stem cells? Orthopedists have traditionally used bone marrow as a source of stem cell to inject joints or the spine, even though all medical evidence proves that fat has a lot more stem cells per milliliter than bone marrow. But many still use bone marrow, either because it is a procedure that can be billed to insurance as bone marrow aspiration, or because they do not know how to do a small liposuction to get the fat from the patient. Bone marrow has a different kind of stem cell than fat does, albeit at much lower numbers. While using one kind of treatment does help the body repair and regenerate damaged cartridges in the spine or joints, the combination of fat-derived stem cells, stem cells from bone marrow and PRP, provide all the tools the body needs to get the best possible results.
A good stem cell team should only use stem cells derived from your own body and should use strictly disposable supplies in a sterile environment with fresh laminar flow in a completely closed system to minimize any chance of contamination. The team documents the amount of stem cells injected using an advanced cell counter. Excessive charges, while legal, are in my opinion unethical when results cannot be guaranteed.
Some doctors use embryonic stem cells from abortions. This is relatively popular in China, Czech Republic and Russia where regulators are lax. This is still extremely experimental and does not have enough science behind it. It is also dangerous as the person can contract any genetic disease that was carried by the dead fetus. There is also a potential for the embryonic stem cells to develop into teratomas, a rare form of cancer.
What about stem cells from sheep? A few doctors in Germany are performing this procedure and promoting it as ‘live’ or ‘fresh’ stem cell therapy. The material is derived from sheep embryos. The person may develop tissue rejection requiring prolonged use of steroids and immune-suppressing agents to control this dangerous situation.
No published clinical evidence supporting therapeutic claims of the treatment known as ‘live cell therapy’ is available. It is advertised as having anti-aging effects and as a treatment for multiple conditions and diseases (erectile dysfunction, depression, and joint, neurologic, heart, kidney, lung, endocrine, and liver disease). Serious adverse events have been reported, including anaphylaxis, vasculitis, encephalitis, clostridial infections, peripheral nerve damage, and death.
This procedure is illegal in the USA and many other countries. This outbreak highlights the public health issues associated with stem cell tourism. Although authorities can prevent treatment at home, they cannot stop people going overseas for treatment.
When do we use stem cell therapy?
Orthopedics and Pain Management. Musculoskeletal pain is the number one reason for patients to visit a doctor followed by respiratory infections. Taking pain medications for life causes side effects such as dangerous bleeding from the stomach, liver and kidney damage or addiction. There are more than 10,000 publications confirming the safety, efficacy and benefits of stem cell therapy and PRP in joint and spine pain. Certainly, if you have the money, it is worthwhile trying before going under the knife. The only problem is that it is not covered by insurance. Results vary depending on the surgeon’s experience, equipment and treatment protocols used.
Men’s Health. Stem cell therapy and PRP can be effective in treating Erectile Dysfunction, especially for diabetics.
Cosmetic & Aesthetic Procedures. We use stem cell therapy for rejuvenation (hair, face and hands), for breast and buttock enlargement, and to repair and restore (treating stretch marks, and all scar types).
What advantages does Novomed have over other local and foreign providers?
Here are the many reasons why Novomed does it better than others within and outside the UAE:
- Small boutique centers ensure privacy and confidentiality – we can even close the center completely for certain VIP’s or operate on a Friday afternoon.
- We have a team of doctors who are familiar with minor liposuction – we only need 50cc, the size of an orange, to do the stem cell injection, under strict local anesthesia.
- Most importantly, at Novomed we maximize the results by:
- Offering a six-month follow-up with our dietician to decrease your refined sugar intake and junk food consumption. We can even do so on line with our Cyberhealth platform. All included at no extra cost.
- Checking your vitamin and mineral levels and tailoring your natural supplement replacement to your body’s needs. All included at no extra cost.
- Checking for low Dehydro-Epi- Andresteron (DHEA) in men and women above age 45 or low testosterone and low DHEA, which is common in men above 55.
- Having a team that is comfortable with safe hormone replacement and follow-up such as checking the prostate in men and the breasts and uterus in women. We also select patients for extra safety after checking their genetically determined estrogen metabolism to make sure they are not among the 10% of patients whose liver converts estrogens and estrones into cancerogenic estrogens.
- Reviewing the medications you are taking to make sure they are not contributing to your problem
- Checking sleep disorders in our sleep lab, frequently as an outpatient procedure. (Many men with sleep apnea, have high blood pressure as an additional factor beside diabetes or smoking that occludes their penile artery.)
- Checking for any psychological factors behind erectile dysfunction in men or painful intercourse in women (This is an optional service offered at a 25% discount for patients in the stem cell therapy program).
- In men with erectile dysfunction, should all other treatments fail, usually in patients with advanced penile artery occlusion and nerve damage (neuropathy) in diabetic patients, our same experienced team can offer penile implants.
We stress the following to our patients:
- We use a stem cell separator and incubator that enhances the results. We use the same equipment and protocols that we used in our Beverly Hills office. We use a cell counter to document the amount of stem cells transferred.
- Results are not guaranteed. The treatment is considered safe, but experimental, and should therefore be done under the supervision of an Investigational Review Board. We leverage our connection with our sister company (Novomed Reverse Aging Center in Beverly Hills) to provide the needed protocols and quality control. Improvement is expected in about half the patients. Other centers who guarantee results are less honest but definitely not better.
- The risks are rare. The biggest risk is that of spending the money and not getting the hoped-for results.
- There is extensive literature and medical evidence supporting the use of stem cells in orthopedics and in aesthetics. Other applications in neurology or anti-aging medicine do not have the same amount of evidence and will be provided in a very selective manner and as part of an Investigational Review Board (IRB) study.
- Patients who take advantage of the extra services offered by Novomed and mentioned above to maximize the results of their stem cell injections get much better results because of the comprehensive Interventionist Age Management and integrative – or holistic – doctors we have.