First steps on a long road
One evening this March, at a military hospital in northeast China, Paraplegic Jason McCue moved his legs.
It happened when the 31-year-old Calgarian was watching a movie with his girlfriend and her cousin, the three of them lying on two beds they had pushed together in his little hospital room.
The movement was just a slight shift, from left to right.
McCue, who hadn’t even felt a sensation in his legs since he broke his back in a mountain biking accident nearly three years earlier, concentrated.
And then he moved them again.
His girlfriend, Kristie Hall, grabbed her video camera.
This could be the breakthrough they had been hoping for: the beginning of the end of his paralysis.
“I was freaking out,” says Hall. “It was awesome. It was overwhelming.”
The couple had made a long journey for this moment, raising thousands of dollars and travelling to Shenyang, China for a controversial stem cell treatment that they believe could help McCue walk again.
Such overseas therapies — based on the promise of emerging stem cell science — are becoming increasingly popular with North Americans. Patients say the $20,000 US treatments offer hope for spinal cord injuries and other conditions that, so far, western medicine has failed to provide.
“We see improvements in many, many patients,” says Dr. Sean Hu, co-founder of Beike Biotech, a China-based company that offers the procedure.
But North American experts are critical of the burgeoning number of stem cell therapies for sale in China, arguing they provide no benefit and even place patients at risk of infection.
While physicians in Canada say stem cells offer the promise of eventual treatments for conditions like spinal cord injury, they argue research into the cells has not yet advanced to that point.
“I’m very supportive of research in this area, but the way a lot of companies in China are doing it is completely unacceptable to me,” says Dr. Armin Curt, chair of spinal cord Rehabilitation research at ICORD, a University of B.C.-based research institute.
“They play with the patient without having sufficient and robust pre-clinical data. They’re playing and promising.”
McCue is well aware of the concerns voiced by critics.
He stopped listening to doctors in Canada some time ago. The soft-spoken former athlete has grown tired of hearing that there was nothing more they could do for him, that he will spend the rest of his life in a wheelchair.
He’s putting his faith in a group of microscopic cells that are said to be potent healers, no matter what the skeptics think.
“I believe in their system. I think there will be significant results,” he says.
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For McCue, the road to Beike Biotech’s hospital in China began on a mountain trail in British Columbia on June 27, 2004.
He was warming up for a downhill biking competition at Panorama mountain near Invermere, when he pulled up his front wheel, slid down a make-shift ramp and was propelled off his bike.
McCue was a fearless athlete who counted rock climbing, snowboarding and competitive mountain biking among his favourite sports. He had wiped out on his bike more times than he could remember.
But this time, he wouldn’t walk away.
The fall knocked McCue out cold. When he regained consciousness, his concerned friends were hovering over the young man with spiky black hair.
“I asked one of the guys, ‘are my legs touching the ground?’” he remembers.
“I couldn’t feel them. I knew I was in serious trouble.”
The hours and days after the accident were a blur. Paramedics carried him off the mountain on the back of a truck. He was transported by air ambulance to Foothills Hospital in Calgary where physicians rushed him into surgery.
His parents flew out from New Brunswick, his home province, to be by his side.
At some point, in a haze of drugs and pain, McCue learned that he had crushed his sixth Vertebrae — a spinal cord injury that would leave him confined to a wheelchair.
With only partial use of his hands, medical staff told McCue that he would likely have to use an electric wheelchair.
His life was forever changed.
For five months following the accident, he lived at Foothills hospital where he underwent intensive physiotherapy.
McCue had been living in Jasper, working as a land surveyor and doing his sports on the side, but his injury forced him to start over with a new career as a web designer. He moved to Calgary where he would have better access to medical care.
He had to re-learn daily routines — how to eat, how to get dressed — all over again.
“It’s very emotional, dealing with the loss of my freedom,” says McCue.
The young athlete did defy the odds, learning how to use a manual wheelchair in spite of the injury to his hands.
When his physiotherapy was over, however, doctors and nurses at the hospital didn’t give him a lot of hope for further recovery. There is no cure or treatment that can help paralyzed patients walk again, they explained.
“It was heartwrenching,” says Hall, his girlfriend. “They said ‘this is where you are and that’s all you are going to get.’”
Then, a year and a half ago, a friend gave McCue a Men’s Health magazine with an article about patients who were travelling to Chinese hospitals for stem cell treatments.
He started doing more research, reading blogs from patients who underwent the procedure at Beike Biotech’s facilities in China. Many patients reported benefits like better circulation in their lower body.
And some have had startling results, like moving their legs again.
McCue knew he had to go to China.
“I don’t have anything to lose,” he says.
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Beike bills itself as a Biotechnology company that offers “tomorrow’s treatments today.”
The Chinese firm is one of several around the world offering therapies based on stem cells — cells that scientists believe hold enormous potential to treat a long list of ailments, including spinal cord injury.
Prized for their ability to develop into many different kinds of cells in the body, scientists hope that one day they will coax the cells into rebuilding damaged structures, possibly improving movement in paralyzed patients.
Stem cell researchers, including the University of Calgary’s Dr. Sam Weiss, say scientists have been conducting such experiments on animals, but the research is still in its early stages.
“They are within a year or two of being comprehensively tested in people,” says Weiss, director of the university’s Hotchkiss Brain Institute.
In spite of warnings that stem cell science is not yet ready to provide treatments, patients are willing to travel long distances — and pay significant sums — to undergo the therapies.
Beike Biotech officials estimate they have treated 300 clients from 40 countries since they began seeing foreign patients two years ago.
At least 20 have come from Canada.
And the firm, which has treated about 1,000 patients since 2001, has ambitious expansion plans to meet the ballooning demand for its therapies.
Beike hopes to open locations in Thailand and Romania.
Dr. Sean Hu, a Beike co-founder, says there are no immediate plans to set up shop in North America, where he says it’s difficult to obtain the necessary approvals.
The therapies offered at Beike aren’t limited to spinal cord injuries.
Beike says it can help people with a variety of neurological problems: Parkinson’s, cerebral palsy and Multiple Sclerosis to name a few.
While the company cautions patients not to expect miracles, its website tells potential clients they can expect “some improvement in quality of life.”
In an interview, Hu says many spinal cord patients regain more control over their bladder functions and increase their sexual ability.
Occasionally, he claims, Beike patients have walked again.
He said one Chinese patient who had no sensation or movement in his legs can now walk one to two kilometres with the help of a crutch.
“We don’t have many (who can walk again), but we do have a few,” says Hu.
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On March 7, 2007, more than a year and a half after he first learned of the therapies, McCue lay curled on his side on a bed at a Beike hospital in Shenyang, China.
Physicians administered an anesthetic at the base of his spinal cord and then performed a Lumbar puncture, using a large needle to remove small amounts of his spinal fluid.
They injected McCue with three syringes full of saline and the stem cells that he had travelled so far to receive.
During the month that he stayed here, McCue underwent five treatments with these cells, which are taken from umbilical cord blood and amniotic membrane. There were also injections of what Beike calls “nerve growth factors,” in addition to intensive physiotherapy.
Company officials believe their treatments work in neurological patients because of the “growth factors” from stem cells. These activate neurons that have been inhibited by damage from disease or an accident, they say.
In total, McCue has raised $45,000 to cover the cost of these therapies as well as the month-long stay for himself, Hall and her cousin Jessica Schiewe.
In the days following his first injection, McCue’s circulation began improving — he wasn’t experiencing the chronic swelling that had plagued his feet.
He felt more sensations in his previously-numb legs, feeling the cold when he wheeled outside the hospital and the warmth inside.
Then, mid-way through his treatments, the unthinkable happened: McCue shifted his legs.
At first, he couldn’t believe he had voluntarily moved them on his own — until he tried it again.
“I thought about moving my foot and I could move my leg . . . It was great,” he says, with a grin.
McCue and Hall later showed the doctors and therapists at Beike how he could shift his legs when he concentrated. But staff at the hospital explained that this was probably a sign of his increasing strength from the hospital’s aggressive physiotherapy.
Beike’s stem cell treatments typically take longer to show results, doctors said.
But Canadian spinal cord injury experts like Curt say patients who receive these stem cell treatments aren’t likely to experience lasting benefits.
The UBC researcher and two other scientists published a study last year in the American Society of Neurorehabilitation journal where they examined seven patients who underwent a stem cell surgery at another Chinese hospital, this one in Beijing.
They conducted assessments of the patients before and after the treatment, which involved surgically implanting cells. They found no “clinically useful” improvements to the conditions of the patients.
Serious complications, including meningitis, occurred in five of the patients.
Beike’s stem cell treatments use different techniques than those in the study, but Curt believes neither approach will yield improvements. And he says the injections into the spinal column carry the risk of infection and bleeding.
“I do not understand how they can have the courage to do this in patients,” he says.
Beike’s Hu dismisses such criticism.
He says that safety is the first priority, noting that after treating some 1,000 patients in the past six years, none have experienced serious side effects.
As for skepticism that the firm’s stem cell treatments are effective, Hu says his team is conducting a double-blind study on patients that will prove the therapy’s benefits to western science.
“It’s always like that when a new technology comes along,” he says.
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On a warm June morning, McCue pushes his wheelchair up the ramp at his Calgary condo.
Before he went to China, he was too weak to make it up the ramp even once. Today — as the third-year mark of his accident approaches — he can navigate the incline as many as 10 times during a workout.
In the months since his return from China, he has not yet walked. But he can still move his legs and he is growing stronger, able to transfer himself in and out of his wheelchair with little help.
There is no question the physiotherapy sessions have helped his strength, although McCue believes the stem cells are also doing their job.
He is fully satisfied with his decision to travel to China and with the gains he’s made since the treatments. Beike physicians have told him it could take as long as nine months for the cells to complete their work.
“I’ve been progressing every day,” says McCue. “The downfall of the health system (in Canada) is they say ‘you’ve reached your plateau. Now go home.’”
Indeed, researchers like the University of Calgary’s Weiss say spinal cord patients are understandably impatient for new treatments. They are seeking out alternative therapies because there are so few options at home.
“I don’t think anybody can personally criticize or be negative about people who are trying to do the best they can for themselves,” says Weiss.
Others, like Curt, remain concerned about the trend of patients buying stem cell treatments. He says those who choose to undergo the procedure may be excluded from future North American treatments because the long term effects of the Chinese therapy are unknown.
For his part, McCue isn’t worrying about what western doctors think. He still believes Beike’s treatments could help him walk again and is already considering a second trip to China.
Maybe next time, he’ll return to Canada without his wheelchair.
“It’s going to happen,” McCue says.
“It’s just a question of how long it’s going to take.”
CanWest News Service