Articles

Quack Clinics

Reuters recently reported on the raid of a stem-cell clinic in Hungary. This is welcome news, if the allegations are correct, but really is only scratching the surface of this problem – clinics offering dubious stem cell therapies to desperate patients. And in fact this is only one manifestation of a far greater problem – the quack clinic. They represent a serious problem for patients, doctors, and health care regulation.

Stem Cell Clinics

There is a very disturbing trend in the last few years – the proliferation of clinics offering stem cell therapy for a variety of serious, often incurable, diseases such as spinal cord injury, ALS, Parkinson’s disease, and other neurological disorders. These clinics claim to improve and even cure these diseases by injecting stem cells into the spinal cord or other parts of the body. Treatments typically cost 20-25,000 dollars, plus travel expenses, for a single treatment.

The problem is that these clinics do not have any published evidence that their treatments are valid. There is good reason to think that they are not – stem cell technology is simply not at the point yet where we can use them to cure such diseases. There are many technical hurdles to be overcome first – knowing how to control the stem cells, to get them to survive and become the types of cells necessary to have the desired therapeutic effect, and also figuring out how to keep them from growing into tumors. Basic issues of safety have not yet been sorted out.

So in essence what these clinics are claiming is that they are years, perhaps decades, ahead of the rest of the world. And yet they have no science to show for it. They should be able to produce dozens of studies demonstrating their technology, but they can’t.

Further, they should ethically be giving such treatments as part of clinical research, to establish their safety and efficacy, but they haven’t. What little information we have comes from outside observation. For example, Bruce Dobkin published a review of cases at one Chinese stem cell clinic. He concludes:

The phenotype and the fate of the transplanted cells, described as olfactory ensheathing cells, are unknown. Perioperative morbidity and lack of functional benefit were identified as the most serious clinical shortcomings. The procedures observed did not attempt to meet international standards for either a safety or efficacy trial. In the absence of a valid clinical trials protocol, physicians should not recommend this procedure to patients.

In other words – we don’t even know what the clinic doctors are injecting into patients and what happens to the cells, if any are even present. There are risks to the procedure without any evidence of benefit. And the clinic is not following standard ethical procedures for experimental treatments.

Although China seems to be a hot spot for such clinics, the recent raid occurred in Hungary. The reason for the raid was that the clinic in question did not have the permits necessary to use human tissue – the stem cells allegedly used by the clinic are reported to come from aborted fetuses. What is not clear is, if it were not for this issue, would the clinic still be free to offer a dubious treatment for serious diseases.

Robin Lovell-Badge of the National Institute of Medical Research in London is quoted as saying:

“I hope it scares others from offering untested treatments and will be a cautionary tale to members of the public.”

I share her sentiments but this statement strikes me as hopelessly naive. Such clinics have been in operation continuously over the last century, and they are increasing in number – not decreasing.

The Quack Clinic

Regardless of the treatment, the formula for operating a so-called quack clinic is now well-established. Typically such clinics are created by an individual, who may or may not be a physician. Often they are based upon one dubious treatment – this can be ozone therapy, an unconventional use of approved drugs, or an imagined new agent. Typically the therapy is based upon a fanciful and unproven philosophy of disease, such as the notion that all cancers are caused by fungal infections, or that all disease is caused by a liver fluke.

Clinics sometimes focus on one disease or condition to start, but over time the claims tend to expand to include more and more conditions (a good way to expand the customer base).

Here are the features of such clinics that should make any patient very cautious:

- The clinic often has an impressive name, such as “The Institute Of,” but lacks any formal affiliation with an established institution, like a university or hospital, and was founded and may even continue to be operated by one person. Essentially, a lone practitioner can easily surround themselves with the trapping of prestige and legitimacy by attaching fancy names to their operations.

- The clinic claims to treat or cure one or more diseases that is currently believed to be incurable. Their claims sound to good to be true.

- There is only one clinic in the world that can perform their special procedure or that uses their proprietary treatment. Sometimes, like with the stem-cell clinics, the treatment offered is a new and experimental treatment. The clinic takes advantage of the hype surrounding a new technology, but is premature in their claims.

- The clinic claims to cure a variety of diseases all with different causes and pathophysiology with a single treatment – the one cure for all diseases approach.

- The clinic is located in a country with little or no regulation.

- The clinic claims that it is the victim of repression. Typically they will say that either Big Pharma, the medical establishment, the insurance industry – or some other convenient villain is trying to suppress their revolutionary treatment.

- Testimonials are used to promote the treatments offered by the clinic, but they have not published appropriate research in legitimate peer-reviewed journals. Often this failing is defended with the excuse that they are “too busy curing patients to publish research.”

- When challenged by professional organizations, the clinic defends itself by appealing to politicians, using the testimonies of previous patients who believe they have been helped by the clinic and the accusation of a conspiracy of those trying to protect their monopoly. It is not difficult to find a sufficiently naive and scientifically illiterate politician to take up their cause and shield the clinic from efforts at regulation.

Of course, not every dubious clinic has every feature I outline above, but they tend to have most of them. Any of these features should be treated as a red flag and provoke extreme caution. Unfortunately, patients and  families of patients with serious or terminal diseases are often desperate. They want to believe the extraordinary claims, and are encouraged to believe that they have nothing to lose. However, I have seen first hand that they do. Such clinics have bankrupted families who could not deny their loved-one the chance of a cure. They have also robbed the terminally ill of whatever time they had left to spend with their families.

Occasionally I have had patients admit with anger that they wasted tens of thousands of dollars and wasted the last six months of their life on a false hope. But most of the time such a realization is too painful – there is too much insult being added to injury. Patients and families often convince themselves that the dubious treatment was worthwhile, despite all the evidence to the contrary. One patient of mine, after having stem cells injected into their behind to treat Parkinson’s disease, was convinced that their disease would have been worse without the treatment – despite the fact that their disease was end-stage and about as bad as it gets. Another patient’s father convinced himself that taking his son with muscular dystrophy to Mexico, at a cost of about $50,000, was worthwhile because now his son seems to be drooling a bit less (his neurological exam was unchanged).

There is also the recently reported case of the mother who was convinced that her blind child could see after getting stem cell therapy in China, despite the fact that objective opthalmological exams showed the child to still be blind.

These stories are extremely sad. These are also the same people who will give glowing testimonials that will help ensnare the next victim, and who will come to the aid of the clinic when the regulatory agencies finally catch up with them.

Conclusion

Regardless of where along the spectrum the operators of dubious clinics are from well-meaning and self-deluded to deliberate and callous frauds, the harm they do to the most desperately ill is incalculable. It is frustrating that regulatory bodies are generally ineffective in dealing with such clinics, unless they run afoul of a specific law like a ban on using fetal tissue.

In the US, it is actually getting more difficult. So-called “health care freedom” laws are being passed in more and more states – these laws erode the standard of care and create a safe zone where dubious clinics can thrive without fear of regulation.

Lovel-Badge, quoted in the article about this recent stem-cell clinic raid, says:

“Many of us have been deeply concerned about some of the clinics that are offering untested, and often illogical ‘stem cell’ treatments,” he says. “They take advantage of desperate individuals or their family members, charging them large sums of money for procedures that are unlikely to work, may in fact be dangerous, and may use cells of dubious origin.”

You can remove the words “stem cell” from her first sentence. There are clinics offering many types of treatments that are equally harmful and exploitative. I am glad to see some mainstream media attention to this problem, but they vastly underestimate the nature and scope of the problem.

Without the ability and political will to enforce a reasonable science-based standard of care, the public will continue to be victimized by quack clinics.

Posted in: Politics and Regulation, Science and Medicine

Leave a Comment (19) ↓

19 thoughts on “Quack Clinics

  1. Adrian says:

    Whoa, what happened to the full RSS feed? I’m just getting a crumby little excerpt.

  2. DevoutCatalyst says:

    “Whoa, what happened to the full RSS feed? I’m just getting a crumby little excerpt.”

    I get the full text. Maybe try resubscribing?

  3. Adrian says:

    DevoutCatalyst – can you double check? I unsubscribed and then tried both the Atom and RSS2 feeds, and both are showing up in Google Reader as excerpts.

  4. DevoutCatalyst says:

    I use the reader built into Opera. Just resubscribed again, and whether Atom or RSS2, the full text is displayed.

  5. Harriet Hall says:

    I am also concerned about all the “longevity” and “anti-aging” clinics that have sprung up in the US. There is no evidence that anything they offer actually prolongs life – it’s all based on speculation.

  6. Molly, NYC says:

    “The clinic claims to treat or cure one or more diseases that is currently believed to be incurable.”

    No duh. And make that incurable AND serious. Their marketing strategies tend to consist of making themselves the straws at which desperate patients (and their families) grasp. Scumbags.

  7. hatch_xanadu says:

    Beautifully, beautifully written post. VERY disturbing topic.

    I’ve heard of the scam cancer clinics and the “anti-aging” clinics Harriet Hall mentions, but news about stem cell clinics is new to me. The idea these quacks are running with, it’s . . . well, as it stands now, it’s no better than . . . than injecting a cheese sandwich into somebody’s spine, I guess.

    I’m not surprised such clinics are thriving, though. It really does seem that the general public is under the impression that stem cells are the cure for everything, and that the only reason they’re not curing everybody is that the politicians won’t allow them.

  8. Gabor Hrasko says:

    Checking the Hungarian papers I see that there are other groups ready to start similar clinics. It seems the message that came through is that those guys under arrrest had made some legal or logistics things wrong, but there are no problems with the underlying science in general.

    Skeptics are often blamed that they only criticise CAM and never the “traditional” medicine. In fact we wrote several articles about dubious stem cell “drugs” (StemXCell and others) earlier that are promoted by doctors as well. But we learn soon that these practices tend to move from science to the CAM field and we indeed criticizing CAM again. CAM is a kind of protective shield for these dubious practices.

    Gabor
    Hungarian Skeptic Society

  9. Versus says:

    If you have the time and are so inclined, you can turn a website or other forms of advertising of these false claims in to the Federal Trade Commission. It’s pretty easy to do from their website, http://www.ftc.gov/. If you look at their Industry Guidelines for dietary supplements, it’s quite clear that you can’t make such claims and that you must present a blananced view of the evidence pro and con. The Guidelines also frown on testimonials. Even though they are for the dietary supplement industry they can be applied to anything. http://www.ftc.gov/bcp/edu/pubs/business/adv/bus09.shtm
    The more complaints they get the more likely they are to investigate a particular practice or industry.

  10. gabsMD says:

    Regarding stem cells, have you heard about Plant Stem Cells? Its a new nutritional supplement here in the US. These plant stem cells (PSC Plant Stem Cells) used extracts from buds, young shoots and young roots. It is said that embryonic tissue found in PSC plant stem cells contains biologic energy and the genetic information for future plants. PSC plant stem cells also has auxins, which are plant hormones which were discovered by Charles Darwin in 1880. They stimulate cell growth and strengthen the immune system. They also contain Indoleacetic acud which helps regenerate tissues and lessens inflammation.
    PSC plant stem cells also contain gibberellins, which stimulate RNA and protein synthesis. The cytokinins found in PSC plant stem cells protect cells as they go into the process of cell division, thus they show promise in cancer therapy. Abscisic acid, also found in PSC plant stem cells create resistance to stress.

    Please check out their site and tell me what you think:

    http://www.plantstemcells.net/

  11. Calli Arcale says:

    Well, I’m sure they contain genetic information for future plants. That’s kind of the point of an embryonic plant. But how would that be helpful for a human being? It’s not like you really want plant tissue growing in your body. And these aren’t being injected, by the sounds of it, but rather eaten, which means the fact that there are stem cells is really irrelevant; they just get digested, and then it just becomes about the nutrients in them. And embryonic plants tend to have a lot of nutrients — the fuel and materials needed to start plant growth and sustain them until they start photosynthesis. Sorta like eggs, really.

    Mind you, I do greatly enjoy eating embryonic plants, and there is some great nutrition in them. I particularly enjoy walnuts, peanuts, almonds, brazil nuts, soy nuts, peas (including raw sugar snap peas), string beans, kidney beans, fava beans, soy beans, corn, wheat, oats, rice, wild rice, barley . . . . And many things made *from* embryonic plants, such as coffee and chocolate. Mmmm, chocolate….

    First observation from their website: they seem to use “embryonic” rather strangely. Though not very specific in their promotional material, they talk about buds and shoots harvested at an optimal time. These aren’t embryos.

    PSC Plant Stem Cell Nutrition™ is PSC Distribution’s new and unique brand of concentrated Plant Stem Cell extracts derived from organically grown buds and young shoots from trees and shrubs.

    A bud would be a flower bud or, in some species, a new plant budding off as a clone of the parent. It buds off in adult form. Flowers, of course, are characteristics of adult plants, not embryos. Shoots, meanwhile, may occur on adult — suckers coming up from the roots, the new season’s growth on an herbacious perennial, new branches starting — or shoots from newly germinated seeds (like alfalfa sprouts, which I find quite yummy on sandwiches). The latter sort of sprout is closer to “embryo” but really still isn’t. It’d be like calling a 12-year-old kid an embryo.

    As to whether or not there are stem cells in these things, I have no idea. I’m sure there are, but not the sort that could do anything helpful for humans besides being food.

    Of course, one could argue that of course there are stem cells, since these are taken from stems. :-P But if that’s what they’re privately arguing, then they are deceiving people.

    A plant embryo is neither a shoot nor a bud. It’s a tiny little thing inside of a seed. If you split a peanut seed in half, you can see it — it’ll be the little nub at one end that doesn’t seem to want to stick with either half of the peanut. It may even have a tiny leaf the same color as the peanut flesh (a cotyledon). This is the embryo. If left undisturbed, the embryo would grow, consuming the peanut’s endosperm (the fleshy bit that you eat), until it split the seed open on its own. A tiny root would come out, and a tiny stalk. The root would go down, and the stalk would go up, seeking the sunlight.

    The valuable part of an embryonic plant isn’t the embryo itself; it’s the endosperm around it. It’s full of nutrition, and our modern civilization *depends* on this as its primary food source.

    The second observation from their website: they talk about homeopathy, referring to the homeopathic concentration of the grape alcohol they sell (which is apparently somehow different than other alcohols, and also apparently present in their “embryonic plants”). So in all likelihodd, there are no stem cells at all in their products, and quite likely nothing but water.

    A question directly to you: you say that the “stem cells” offered by this company contain auxins which “stimulate cell growth” (presumably in plants) and “strengthen the immune system” (though since plants lack an immune system like ours, I wonder how this works). I find myself wondering exactly why you want to strengthen the immune system. Personally, I suffer from allergies and asthma, the products of a hyperactive immune system. And most deaths due to the Spanish Flu were due to an excessive immune system reaction. What’s so great about boosting the immune system? It seems to be set plenty high already, what with all of the allergies around.

    Talking of allergies, that’s another thing. They call their product “hypoallergenic” because it has no corn alcohol. But corn is a relatively uncommon allergy; since they don’t disclose what plant they’re actually using (if any), it’s impossible for a person with a food allergy to determine whether or not it is safe to take their product.

  12. wertys says:

    Check out this as an example of a complete quack clinic. It is run by a chiropractor who you will notice does not identify himself as such anywhere on the site. The owner of this site is currently pursuing back payments of nearly $40K from a disabled pensioner with Cerebral Palsy who was allowed to run up such a bill despite patently being in no way able to pay it. A really classy site run by a caring, nice guy with nothing to hide NOT

    http://www.hypermed.com.au

  13. wertys says:

    OMG, I just checked the website and it has a link to this very page ! My palm is now glued to my face and will not come off for at least 4 hours. My irony meter has expired and cannot be roused. When a quack clinic links to this website as part of warning their prospective johns about quack clinics there is no role left for satire in this world.

    Unbelievable.

  14. wertys says:

    Sorry that last post actually came after another one which didn’t make it up for some reason. The website I am referring to is

    http://www.hypermed.com.au

    It is perhaps the best example I can find in my state of exactly what this article is about.

  15. gabsMD says:

    Dear Calli, thank you for your comment.
    It seems that you are misinformed about what plant stem cells therapy really is.
    An embryonic plant is a plant which is still in the elementary stages of growth. It is not just a seed, because a seed in the plant world is an reproductive organ… this is why “embryonic” is not an all inclusive term.
    Secondly, digestion does not eliminate stem cells, based on the cellular level. If you have that assumption, then all components and nutrients in food would be destroyed during digestion; and if that is the case, food wouldn’t supply energy to our bodies.
    Plant stem cells are undifferentiated cells, which, when inside the human body, they can be used just like any other cell, except that these active cells can actually differentiate in the body… they do not become human tissue… but they do interact with toxins and chemicals in the human body, which can relieve our burdens. This further gives the body an opportunity to repair itself on a cellular level.
    I have spoken to one of the owners of PSC Plant Stem Cells Nutrition LLC and he will guarantee that if you let them develop a custom protocol for you, you can be free from allergies in 8 weeks. If we convince you, then you should tell the whole world what you know about us, after you have taken our classes.
    If you are interested, email: marquis@plantstemcells.net

  16. Joe says:

    Spam, spam, spam, spam …

Comments are closed.