Sunday March 26, 2017

The blunt truth about 'cutting edge' medical research

Stem cell research is often described in the media as being 'cutting edge.'

Stem cell research is often described in the media as being 'cutting edge.' (Getty Images/Cultura RF)

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A quick Google news search for 'stem cell therapy' will turn up no shortage of headlines like: "Stem cell therapy shows promise in treating spinal cord injuries," and "Stem cell therapy could help mend heart defects in children."

Phrases like "cutting edge research" will often be sprinkled liberally throughout the stories under those headlines. 

Health policy expert Timothy Caulfield says we need to curb the overenthusiasm when discussing stem cell research and other emerging fields of biotechnology.

That's because most of this research doesn't live up to the hype, he says, and all that hype can be a source of real social harm.

Tim Caulfield

Tim Caulfield, Canada Research Chair in Health Law and Policy at the University of Alberta, argues enthusiastically reporting about 'cutting edge' treatment may actually lead to social harm. (provided)

"If they're claiming a breakthrough, a genuine breakthrough, some kind of revolutionizing new technology that is going to change the way medicine happens, doubt it," says Caulfield, the Canada Research Chair in Health Law and Policy at the University of Alberta.

"[Stem cells are] a phenomenally exciting area of research, no doubt about it. But very few therapies have made it to the clinic."

Actual breakthroughs 'very rare'

Caulfield says the research into fields like stem cells and genetics is often presented as having the potential for "some big paradigm shifting breakthrough that's going to transform how healthcare is delivered."

But he says true medical breakthroughs are actually few and far between.

In his classes Caulfield asks his students to name 10 medical breakthroughs that have occurred in the last 100 years.

He says his students quickly go through the "greatest hits" — for example, anesthesia, vaccinations, antibiotics — and then the discussion gets more complicated.

"Science moves forward very, very slowly: three steps forward, two and a half steps back. You have these incremental movements."  - Timothy Caulfield

Caulfield says it is hard to make a direct link between this hype and actual harm taking place, but says in his research he has seen a "correlation between this hype and things like the marketing of unproven stem cell therapy, for example"

"There are clinics popping up all over the world, hundreds and hundreds of clinics, offering unproven therapies for everything from MS to autism to ALS to cancer to orthopedic problems, and there is really no evidence to support that therapy. And what those clinics are doing is they're leveraging the hype and excitement that is present in popular culture in order to legitimize their services."

Stem cells

Stem cells are unspecified cells that have the potential to develop into different types of adult cells. (Anne-Christine Poujoulat/AFP/Getty)

While many of these clinics may exploit people for their money — charging hundreds of thousands of dollars for multiple treatments — there is also the potential for real physical harm.

Caulfield cites a recent example, as reported in the New England Journal of Medicine, of three women who lost basically all of their eyesight after receiving an unproven therapy at a clinic in Florida.

Media not just to blame

Who is to blame for the hype around stem cells and other biomedical technologies?

Caulfield said the fault doesn't just lie on the media or on scientists — who may hype their own research in order to gather funding — but said there are several factors.

"It's a systemic phenomenon. There are incentives inherent in our research system right now: publish or perish, get research grants, create profile for your research institution, have a good news story." - Timothy Caulfield

Caulfield calls the phenomenon a "hype pipeline" where, starting from the published study, hype is then added to the story by the subsequent reports from the research institution, then by the media coverage, and so forth. 

Caulfield, a self-described "science geek", says areas of research like stem cells and genetics are exciting, but says people need to be very cautious.

"Follow the story, but wait for a body of evidence to emerge  — that's how people should view the stuff that's in the popular press," he said.

"And when you're talking about these clinics, be very cautious. Be very suspicious. If you have a serious illness, or you have someone in your family that has a serious illness, be very cautious about  clinics that are selling these therapies, because to be honest there aren't a lot of stem cell therapies that are ready for prime time."