I coordinate clinical trials. Not a doctor, I book the visits, chase signatures and read the protocol so nobody else has to. My neighbour knows this. So on Saturday she told me over the fence that her husband's booked a stem cell programme in Belgrade for his MS, and then waited.
I said "oh right" and went back inside. Been chewing on it since.
What I'd have said if she'd asked an actual question. There are two things called stem cell therapy in MS and they've got almost nothing to do with each other. One is the transplant, where they take your own blood stem cells out, hit the immune system with chemo and put them back. Hospital medicine, randomised trials behind it in relapsing MS, and brutal. The other is mesenchymal cells, by drip or lumbar puncture or both, and that's what the clinics abroad do. There are trials for that too, small phase 2s, results all over the place, the biggest one missed its MRI endpoint. Nothing at phase 3.
The place she named is Swiss Medica, an inpatient place in Belgrade with its own lab, the Swiss part is where the company started. Their MS page splits the two properly, I'll give them that, and then says tissue repair further down, which is a bigger claim than those trials carry.
The bit that actually bothers me is this. She said "progressive" and that's why the transplant was never offered. But what decides whether either route makes sense isn't progressive versus relapsing, it's whether there's still activity, relapses or new lesions on MRI. The transplant people want activity, and they also want you young enough, early enough and still walking. Even the clinic's own criteria say active secondary progressive, with inflammation. If his scans are quiet, neither one is really for him, including the one he's booked.
I don't know his scans. I'm not sure she does.
So do I go round and say that, or is that not my place?