Governor Perry attacked for choosing new medical treatment

By Jane M. Orient, M.D.

Should Gov. Rick Perry’s choice of medical treatment be between him and his doctor?

Recently, the governor of Texas and presidential hopeful had a bad back treated by injecting some of his very own fat cells, after they had been cultured and treated in a laboratory. The innovative use of a patient’s own adult stem cells is showing great promise in many conditions, including damaged joints.

Even though he is a public figure, Gov. Perry is also a human being and a patient. Should we not wish him well, and thank him for sharing his experience with a treatment that might be of interest to thousands of Americans?

The Los Angeles Times (http://articles.latimes.com/print/2011/aug/19/news/la-heb-rick-perry-stem-cell-back-surgery-20110819) is instead suggesting that he is a hypocrite for opposing embryonic stem-cell research while getting treatment for himself. Apparently, the Times doesn’t see any difference between sacrificing a human life to extract cells for research or for treatment of somebody else, and taking some of a person’s own cells, with his fully informed consent, to use for his own benefit.

“Some think that stem cells…could someday be used to generate soft tissue and bone,” writes Eryn Brown for the Times. In fact, adult stem cells are already being used successfully for some 80 different ailments. Recently reported data show significant benefit in patients with osteoarthritis of the knee; it is likely that 10 percent or more of total knee replacements could be averted by such therapy (http://www.jpands.org/vol16no2/centeno.pdf). Veterinarians are now using autologous stem cells (cells from the same animal) to treat dogs.

But some physicians have expressed concern that “such treatments often have not been thoroughly vetted by researchers or approved by the FDA.”

How much research do we need before physicians can prescribe outside the confines of a study? As of this morning, there are already 15,096 articles listed in the U.S. National Library of Medicine on only one adult stem cell type (mesenchymal stem cells,-the same general type used in Perry), while there are only 12,477 papers published on the most commonly used antibiotic (amoxicillin, for which 52.3 million prescriptions were written in 2010).

While all medical procedures have risks, the use of the patient’s own cells is a one-on-one procedure that is logically part of the practice of medicine. It does not entail the public health risk of products manufactured for a large number of recipients. There is no FDA oversight for procedures like grafting a leg vein into the patient’s own coronary artery, and minimal oversight of transplanting tissues from cadavers. The FDA is always trying to expand its regulatory authority—causing enormous increases in costs and lengthy delays in making new treatments available to patients.

“Vetting” procedures by researchers also costs millions of dollars and stifles and delays innovation. And what do researchers do? Like doctors, they do the procedure on human beings—they differ from doctors in that they follow a protocol in order to collect data on a group of experimental subjects, instead of following the procedure they think is best for an individual patient.

Yes, the procedure used to treat Perry could lead to infection, blood clots, or cancer. Treatment with embryonic cells, if it becomes feasible, would also have these risks, plus more from immunologic effects. Currently available orthodox treatments—drugs and surgery—also have a long list of adverse effects. And if they were very effective, there would not be “desperate patients” seeking costly alternatives.

Powerful vested interests —big universities, big government, big pharma—want to control what patients are or are not allowed to have. A past president of the International Society for Stem Cell Research accused Perry of “setting the wrong example for ailing patients.”

On the contrary. Governor Perry is setting the right example for Americans: a patient exercising his own freedom to seek the care he thinks is best, and a physician doing what he believes is best for his patient.