Leukaemia

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Is there a connection between Bacon and Leukaemia?

 

Bacon and leukaemia

Bacon and leukae

“Youngsters who eat bacon or ham twice a week increase their chances of getting leukaemia by 74%”, reported The Sun. It said that a study in children and teenagers in Taiwan found that those who ate processed meat more than once a week were more likely to have the condition. The newspaper said that other processed meat, such as hot dogs and sausages, also increased the risk, which could be caused by preservatives in the meat.

This case-control study found an association between leukaemia in two to 20-year-olds and eating cured or smoked meat and fish. However, this sort of study cannot prove that one thing causes another, and it has several limitations. This study should be regarded as preliminary evidence of an association. Larger further studies are needed to explore whether there is a causative link. There is an established link between eating cured meat and colorectal and stomach cancer. Other studies have found that a high consumption of fresh fruit and vegetables is associated with a decreased risk of several cancers.

Where did the story come from?

The research was carried out by Dr Chen-yu Liu and colleagues from the Harvard School of Public Health, Harvard Medical School, Kaohsiung Medical University in Taiwan and Yuh-Ing Junior College of Health Care and Management. The study was published in the peer-reviewed medical journal BMC Cancer.

What kind of scientific study was this?

This population-based case-control study compared 145 individuals with acute leukaemia to people matched for age and sex without leukaemia (controls).

Leukaemia is the most common childhood cancer. This study investigated how nutrition might contribute to its cause in a Han Chinese population in southern Taiwan. Studies have established a link between eating cured meat and colorectal and stomach cancer. Other studies have suggested that a high consumption of fresh fruit and vegetables is associated with a decreased risk of breast, colon, lung, pancreas, bladder, larynx, stomach, oesophageal and oral cancers.

The researchers found new leukaemia cases among residents of the Kaohsiung area, aged between two and 20 years and diagnosed between 1997 and 2005. The cases were identified by searching hospital records and records from the national health insurance system. By using both these sources, researchers believe they have identified all of the cases occurring in the area. Controls (people without leukaemia) were selected through a population registry of the study area. Up to three controls per case were matched for age and gender.

A face-to-face interview was conducted (with the patient or their parent, depending on age). The interview captured information on demographics, medical history, occupational history, smoking, alcohol consumption, diet, and exposure to various environmental hazards. The dietary questions were detailed, and they asked about frequency of consumption of various food groups, including fruit and vegetables, bean-curd foods, cured or smoked meat and fish, pickled vegetables and alcohol.

Using statistical methods, the researchers then compared responses between cases and controls to see whether consumption of any particular food group was more common in people with leukaemia. They also combined some food groups to assess the risk of these. They combined the two types of leukaemia for their analyses (acute lymphoblastic leukaemia and acute myeloid leukaemia), and performed separate analyses for two to five-year-olds and then for two to 20-year-olds.

What were the results of the study?

The researchers found some significant results in their analyses. For children aged two to five years, frequent consumption of bean curd food slightly reduced risk of leukaemia compared to rare or occasional consumption (though this was of borderline significance). Frequent vegetable intake reduced odds of leukaemia by 56%.

For two to 20-year-olds, frequent intake of cured or smoked meat and fish increased the risk of leukaemia by 1.74 times, while frequent consumption of bean curd food and vegetables reduced the odds.

What interpretations did the researchers draw from these results?

The researchers conclude that cured and smoked meat or fish in the diet “may be associated with leukaemia risk”. They also say that soy bean curd and vegetables may have a protective effect against leukaemia.

What does the NHS Knowledge Service make of this study?

This case-control study provides some evidence of a link between leukaemia and eating cured or smoked meat and fish.

This type of study, a case-control study, cannot prove causation. The problem with case-control studies is that unmeasured factors that are linked to both diet and leukaemia risk (i.e. confounding factors) can influence the result. The researchers report that they initially adjusted their analyses for age, sex, maternal age, birth weight, breastfeeding, parental education levels, parental and subjects’ smoking history, maternal vitamins and use of iron supplements. These factors were found to have no effect on the outcome. However, there are other factors which can have an effect that could not be measured, such as family history, genetics, medical history and specific environmental exposures.

Case-control studies are particularly susceptible to recall bias, i.e. parents/patients may not accurately remember their exposure (the food they ate) and other variables. The questionnaire asked about things that happened up to two years before individuals were born which, for some participants, would be 22 years ago. Food questions also asked about usual intake for the previous six months.

It is also important to explain further the 74% increased risk as reported in the newspapers. This is actually an increase in odds of leukaemia of 1.74 times (i.e. people who ate cured or smoked meat and fish were 1.74 times more likely to be from the group of leukaemia cases rather than controls). In absolute terms, 25% of people (aged two to 20 years) who rarely ate cured or smoked meat and fish had leukaemia, while 37% of people who ate it frequently had the condition. This is an increase of 12 cases in 100 people.

The increased risk from eating cured and smoked foods was only significant in people aged two to 20 years. When the researchers limited their calculations to two to five-year-olds, no link with leukaemia was found.

Although the researchers looked at bacon among all the other cured meats eaten in Taiwan (Chinese-style sausage, salted fish, preserved meat, ham, hot dog and dried salted duck), it is not clear how many people ate bacon or if the type of bacon eaten is similarly prepared to the bacon sold in the UK.

Overall, while this study provides preliminary evidence of a link between eating cured or smoked meat and fish and leukaemia, the link needs to be confirmed in larger studies.

Summary

“Youngsters who eat bacon or ham twice a week increase their chances of getting leukaemia by 74%”, reported The Sun. It said that a study in children and teenagers in Taiwan found that those who ate processed meat…

Links to Headlines

Bacon is ‘danger’ for kids. The Sun, February 2 2009

Leukaemia risk soars if your children in love bacon. Daily Express, February 2 2009

Bacon ‘gives kids cancer’. The Mirror, February 2 2009

Links to Science

Liu C-y, Hsu Y-H, Wu M-T, et al. Cured meat, vegetables, and bean-curd foods in relation to childhood acute leukemia risk: A population based case-control study. BMC Cancer 2009; 9: published: 13 January 2009

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Blood Care Awareness – What are leukaemia, lymphoma and myeloma? Get informed here!


Blood Cancer Awareness

Blood Cancer Awareness

Doctors to be offered online training to improve UK’s poor diagnosis rates for blood cancers

• A new training course has been developed by blood cancer support charity Leukaemia CARE, in collaboration with the Royal College of General Practitioners (RCGP), and launched to mark the start of Blood Cancer Awareness Month

• The course set to radically improve GP knowledge of blood cancer symptoms, potentially saving around 1,000 lives a year

• Blood cancer survival from GP referral stands at 83.6% – but falls to 53.1% if diagnosis is delayed until the emergency admissions route.

• However, blood cancer symptoms can be easily confused with the symptoms of other less serious illnesses like the flu, leading to 33% of blood cancers – more than 10,000 patients – only diagnosed via emergency admissions

• Blood cancers such as leukaemia, lymphoma and myeloma are statistically the nation’s fifth largest cancer threat with 34,000 people diagnosed each year, and are the third biggest cancer killer

A new online training course designed to raise awareness of the symptoms of blood cancer among GPs is set to radically improve the rate of early diagnosis, bringing the UK up to EU standards and potentially saving around 1,000 lives a year.

Blood cancer support charity Leukaemia CARE, in collaboration with the Royal College of General Practitioners (RCGP), has developed the course in a bid to deliver better outcomes for the 34,000 people diagnosed with blood cancers in the UK each year.


When combined, blood cancers like leukaemia, lymphoma and myeloma are statistically the nation’s fifth largest cancer threat and third biggest cancer killer. And yet because many of the symptoms of blood cancer experienced by patients, such as persistent fatigue, night sweats, joint pain, bruising and recurrent infections, may also be linked with a wide range of other less serious diseases, 33% of blood cancers – more than 10,000 patients – are only diagnosed via the emergency admissions route, including accident and emergency.

Research shows that early diagnosis has a major impact on survival rates. For instance, the one year survival rate for myeloma patients diagnosed following a GP referral stands at 83.6% – but falls to 53.1% if diagnosis is delayed until the emergency admissions route3.

While online courses for GPs are available for other major cancers, this is the first of its kind for all blood cancers. Free of charge, it combines information on how to recognise the symptoms with case studies and, like all RCGP training courses, carries Continuous Professional Development (CPD) points – which GPs must complete to demonstrate that they are meeting the standards set by the General Medical Council.

The news comes as the UK marks its third Blood Cancer Awareness Month (1-30 September).

We interview Tony Gavin the Director of Campaigning and Advocacy at Leukaemia CARE and Dr Ishani Patel who is a GP and the Royal College of General Practitioners (RCGP) Clinical Lead for Early Diagnosis of Cancer and Quality Improvement

Question – What is blood cancer?

Dr Ishani Patel

Dr Ishani Patel

Dr Ishani Patel – Blood cancer is an excessive growth of blood cells. For diseases such as lymphoma and leukaemia, this can be an excessive growth of white blood cells. The white blood cell is responsible for immunity and fighting off infection. However, when there is an overgrowth or an excessive amount of white cells, patients can often present with symptoms such as tiredness, excessive sweating, bone pains, bruising and bleeding. That’s a very brief overview of what a blood cancer is.

Question – How do leukaemia, lymphoma and myeloma differ from each other?

Tony Gavin – That is a huge question because within those disease areas there are also other disease types. There are 90 different leukaemias and 60 different lymphomas. There’s about 5 or 6 main types of myeloma, as well as other types, so we couldn’t really begin to describe the differences between them.

Collectively blood cancers are a huge problem in the UK and they are very poorly understood. At Leukaemia Care we think of them as a Cinderella disease, tucked away in the background with nobody fully aware of them, but blood cancers are the fourth largest notifiable cancer amongst men and women. Indeed if you look at the mortality rates and the people who die from blood cancer, more people die from blood cancer than die from breast cancer, more people die from blood cancer than die from prostate cancer. The sixth largest notifiable cancer in the UK is malignant melanoma (skin cancer). More people die from blood cancer than are actually diagnosed with skin cancer.
That’s how significant the problem is and that’s why we decided we needed to do something to help general practitioners recognise the signs and symptoms of the disease.

Question – What do the stages of different cancers mean?

Dr Ishani Patel – The different stages correspond with how much the disease has progressed.

For example in the context of blood cancers and the subset myeloma, if you present to the GP and are referred onto a specialist, your 1 year survival rate is 84% because you are diagnosed at an early stage, so stage 1.

However if you present as an emergency presentation, which is a third of all blood cancers, your 1 year survival rate drops to 55% so that’s a late stage diagnosis, which could be considered stage 3 or 4.

It’s difficult to drill into the detail of what each stage means because it’s obviously different depending on the type of blood cancer and as Tony’s just mentioned there are over 100 different types of blood cancers just within that terminology.

Question – What are the early signs and symptoms of blood cancers?

Dr Ishani Patel – Signs and symptoms to look out for include tiredness, excessive sweating, bone pain, bruising, bleeding, and recurrent infections. These can all present as individual signs or as a cluster of an early blood cancer. However if patients experience loss of appetite or weight loss, those are obviously signs of perhaps a cancer that has progressed.

Tony Gavin – With the lymphomas for instance you might have lumps in the neck or lumps in the armpit, or lumps in the groin. And the other thing to look out for is that quite a lot of the symptoms can be defined by something else. They could be just a common cold or flu or even menopause for the older patient. It’s when these signs and symptoms are persistent that you really need to take notice of them.

Question – Who treats these cancers and how?

Dr Ishani Patel – If we were to look at a classic patient journey, the GP who thinks there is a collection of symptoms that are causing concern would arrange for blood tests and perhaps a urine test or potentially even x-rays within primary care. They would arrange for what’s called a fast track cancer referral, which is a two-week-wait cancer referral where the patient can then be met by a haematologist. However, not all patients experience the same journey because of the varying ways that they present.

If a patient presents with, for example, a neck lump or a lump in their armpit or groin, they may go straight to a surgeon because they need to get a tissue sample or a biopsy to get a diagnosis.

However if a patient that presents with these symptoms then has a blood test and the blood test itself is abnormal, then they may be routed to a haematologist. Not everybody sees a haematologist straight away because it does very much depend on how they present in the first place.

Tony Gavin – The problem with bone pain is you would probably be referred to an orthopaedic surgeon before they realize it could be myeloma for instance. Within the blood cancer specialist community, within the haematology community, there are people that will specialise in leukaemias, lymphomas, and myelomas, and indeed within the leukaemias you may get people that specialise with chronic myeloid leukaemia, and those that specialize with acute myeloid leukaemia, so it varies. There are generalists and there are very, very specific specialists.

Question – How effective are the treatments?

Tony Gavin – That’s a really good question but a very difficult one to answer because you will find Tony Gavindifferent treatments for the whole range of different disease areas. I can quote one disease area where there is really, really good news. About 12 years ago survival rates for chronic myeloid leukaemia (CML) were poor. If you were diagnosed with CML in 2000 for instance then your survival prospects would be 3 – 5 years. In 2001 a new drug called Imatanib was developed – a tyrosine-kinase inhibitor. This class of drug has completely and utterly revolutionised the treatment of CML. Patients that respond to these drugs will not die from CML, they will not die from the leukaemia. This particular class of drugs is amazing, it’s one of the best good luck stories going around. It is a huge step change in the treatment of that particular disease.

Question – Please tell us about this new online tool, what it does and what its value will be.

Dr Ishani Patel – Leukaemia Care and the Royal College of General Practitioners have come together to develop a one hour learning course for not only GPs but all primary care health professionals. GPs are legally and professionally required to commit and evidence their own professional development i.e. the time they contribute to their own education. What Leukaemia Care has recognised is that the other cancers have a lot of attention both in the media and within GP education and we didn’t want blood cancers to be overlooked. So what this course does is provide case based scenarios almost like it is in real life. As a GP you’re sitting in your consultation room and a patient presents with a cluster of symptoms and it challenges the GP to think about what their next steps would be. For example if a patient presents with tiredness and with a lump in the neck what would they do next? And then once they have submitted their answers and evidenced their own reflection, it then takes them through to the gold standard and through the NICE guidelines on what they should do next, how to ensure rapid investigation and how to ensure that the patient’s route to diagnosis is as quick as possible.

Question – What one piece of advice would you give to someone who has just been diagnosed with a blood cancer?

Dr Ishani Patel – That’s a very tough question because there are different types of blood cancers. What I would say is that something that does get overlooked with all cancer treatments is nutrition. I would advise any patient going through or preparing to go through cancer treatments that could include steroids, chemotherapy, stem cell transplants and as Tony was saying tyrosine-kinase inhibitors that having a high protein diet and ensuring their nutrition is adequate will support them through their journey especially with managing the adverse effects of treatments. That would be my input from a GP perspective.

Tony Gavin – From my perspective, I would echo what Dr Patel has said but also say that they are not alone. They need to get in touch with a specialist organisation like Leukaemia Care, which can support them through their treatment. They can go online to leukaemiacare.org.uk and they can talk to our specialist nurse or talk to our care line experts. We have a care line that operates 24/7 so they can phone us at any time for help and advice and we can also put them in touch with patients who have been diagnosed with a similar disease so they can share their concerns and their worries. The other thing I have to say is there are breakthrough drugs coming through all the time in all the different disease areas and some of the new treatments coming through are superb. So first of all, don’t lose hope, get in touch with an organisation like Leukaemia Care and we’ll put you in touch with other groups too if you need to speak to somebody else.

We have a wealth of information online too and there’s lots that they can do to educate themselves on the disease.

Question – Where can people go for more information?

Dr Ishani Patel – Leukaemia Care provides robust information that is easy for patients to understand. From a GP perspective, I would encourage GPs to go to the Royal College of GPs website and do the online learning exercises to then be able to communicate that back to patients.

Tony Gavin – If patients do need more information once they have been in touch with Leukaemia Care, we can signpost them onto other areas.

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What is Leukaemia? Read our frequently asked questions blog and find out about the ‘Call on Us’ campaign


Manos Nikolousis

Manos Nikolousis

A leading UK blood cancer charity is ringing the changes for how we seek help in times of need, urging people to avoid putting their mental health at risk by ditching screen support in favour of the telephone.

Leukaemia CARE has launched its ‘Call on Us’ campaign, which encourages patients, relatives and friends to pick up the phone and chat through how they are feeling about the impact of blood cancer on their lives, rather than relying on the internet.

The campaign comes after the charity noticed the number of calls to its Care Line drop by more than half in four years, despite 40,000 people being diagnosed each year with a blood cancer or allied blood disorder, with the commonest ones being leukaemia, lymphoma and myeloma.

However, with respondents to a poll1 admitting that they were kept awake at night by worries including whether they were going to die (54%), how quickly the disease would progress (63%), whether the disease would affect their quality of life (44%) and how their family will cope with their diagnosis (44%), experts at Leukaemia CARE say that it is only through verbal contact that those touched by cancer can have their fears properly allayed.

They are also concerned that the general public are using the internet to self-diagnose with 85% saying they have looked up symptoms online. As a result of doing this, 38% say the wrong diagnosis made them panic and stressed them out, 32% wished they had never done it as what they read on the internet made them feel they had something serious when they didn’t and 29% would never Google their symptoms again, concluding it’s much better to just go to the GP.


To show our support for ‘Call on Us’ campaign PatientTalk.Org conducted an interview with Esther Wroughton (care director at Leukaemia Care) and Manos Nikolousis who is consultant haematologist at Birmingham Heartlands Hospital.

Question: What is Leukaemia?

MANOS NIKOLOUSIS – Leukaemia is a form of blood cancer which mainly affects the bone marrow of the patients. Within the term ‘Leukaemia’ there are different sub groups. The word comes from the Greek word where ‘leuk’ is ‘white’ and ‘aemia’ is the blood. It is a cancer of the white blood cells.

Question – How is this different from Lymphoma?

MANOS NIKOLOUSIS – Lymphoma is considered a blood cancer, but in most cases it actually starts from the Lymph glands. We have different Lymph glands in our body (in our neck, armpits, chest, abdomen and groin). Whilst Lymphoma tends to start in the Lymph glands, it can occasionally spread to the bone marrow or other organs as well.

Question – What are the signs and symptoms for both Leukaemia and Lymphoma?

MANOS NIKOLOUSIS – Leukaemia usually affects the production of blood cells in the bone marrow. Within bone marrow there are three different types of cells; the red cells which carry oxygen to different tissues, the white cells which fight infection, and platelets which prevent bleeding and form a blood clot when we have a wound. When a patient gets Leukaemia, all three different cell lines can get affected at the same time.

Therefore the symptoms can be tiredness (because of the reduction of red blood cells), infections (because of the under production of and low quality of white blood cells) and bleeding problems in the form of bruising around the body or nose/mouth bleeds.

With Lymphoma, this is slightly different. You might not have any symptoms, or you might notice symptoms including a swelling around the neck, night sweats or weight loss. If the Lymphoma has spread to the bone marrow, symptoms can be similar to leukaemia.

With both these conditions, patients can get tiredness and often describe their condition as feeling under the weather. Until the tests are done, it is hard to diagnose the symptoms, which is why from a clinical perspective it is extremely important to really listen to your patient and try to understand their symptoms when they come to your clinic.

Question – Is the NHS up to speed on cancer patient diagnosis?

MANOS NIKOLOUSIS – We are certainly getting better. This is shown by the amount of blood cancers that are diagnosed per year, which is a gradual increase year by year. We are getting better at diagnosing these blood cancers and also in giving patients the right treatment to get the best outcomes.

Question – Do you think there is room for improvement and if there is how can it be improved?

MANOS NIKOLOUSIS –

There is always room for improvement. Over the last twenty years, there has been a massive improvement in the risk specifications for haematology patients as well as their outcomes. Over the last ten years there are new molecular markers and new prognostic markets for Leukaemia and Lymphomas. We can also identify the patients who are not going to do very well and can identify the best treatments for them. Equally for those who are expected to do better, we can give them less intensive treatment and therefore try to minimise the risks from this. We are much better in offering the patient the best care.

Question – How effective are the treatments in the NHS compared to those in Spain?

MANOS NIKOLOUSIS – I’m not an expert on the Spanish healthcare system. However, over the last three years, the introduction of the cancer trust fund within the NHS means there are more efficient drugs and more treatments available here than in other European countries. The NHS is one of the healthcare organisations where clinical trials are important, which enables the novel drugs. It also allows us to see whether certain treatments work better than previous treatments.

Esther from Leukaemia Care

Question – What are your major criticisms of Cancer policy in the UK?

ESTHER WROUGHTON – Nationally, there are a lot of questions about cancer policy in the UK with the cancer reforms and cancer policy. I think that will become apparent throughout our news channels and we will find out a bit more about this throughout the year.

Question – Why do people use the internet for diagnosis?

ESTHER WROUGHTON – We all use the internet to search for things whether it be for shopping or to look up symptoms.

Leukaemia Care conducted a survey which highlighted that 85% of the population go online to look up their symptoms and that there is a trend to self-diagnose and to get support online. When searching for information about symptoms on the internet, there is a risk of putting two and two together and coming out with five or mistakenly thinking that your condition is less serious than it actually is and not getting prompt medical attention.

Therefore, we are launching the ‘Call On Us’ campaign to highlight the importance of talking to somebody, picking up the phone and making a call. The internet certainly has its place; it is great for getting factual generic information but it is not specific to the individual and it can’t give you that personal touch and ask how you’re feeling today. Symptoms may be different day to day. Plus the impact of a blood cancer can affect not just the patient but carers and family members as well.

Question – Do you think that one of the reasons people are self-diagnosing is to do with massive wait times at GP surgeries?

ESTHER WROUGHTON – Potentially, I think that’s a good point but I also think that when we are at home in the evenings we can easily use our iPad, our mobile phones and digital devices. It’s important to be aware that you are not getting specific tailored information.

Question – Do you think that people are not picking up the phone because they don’t want to relay personal details to someone they do not know at the other end of the line?

ESTHER WROUGHTON – Everybody is different. Some people prefer talking to someone on the phone whilst others prefer sending an email or accessing our live chat online service. The recent survey showed that 54% of blood cancer patients are kept awake at night worrying that they were going to die, whilst 63% worry about whether their diagnosis would progress more quickly and how that would affect their family members.

I think initially people can be worried about picking up the phone but once they do ring our Care Line they find they are speaking to an expert; someone who knows what they are going through, someone who has been there themselves or are a carer of somebody who actually has a blood cancer. The feedback about the Care Line is that people do find it an invaluable service; they can be put at ease and find it valuable to have one to one contact which really does relay their fears when they get that appropriate advice.

Question – What advice do you give to somebody with leukaemia?

ESTHER WROUGHTON – Pick up the phone and call our Care Line. It is like having a conversation with your friend and you will get that personal touch. They will ask how are you feeling today, is your diagnosis affecting your work, do you need financial assistance, do you need more appropriate medical advice or more information on your diagnosis?

After visiting the hospital or the G.P. patients can often have questions they’ve forgotten to ask or perhaps they didn’t take on board all the information given to them. They can have questions in the middle of the night, in the evening or when they wake up. The Care Line allows patients and carers to ask those questions and we are available 24 hours a day 7 days a week.

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Britain way behind the rest of Europe in utilising life-saving stem cell treatments – Find out about a new initiative called Precious Cells


Stem cell therapy

Stem cell therapy

It’s one of the most exciting fields of scientific research today, yet more than a third of the country say they don’t really know anything about it.

We have covered this area a number of times at PatientTalk.Org.

New treatments for Alzheimer’s, and Parkinson’s, or methods of repairing heart muscle, are vital in an aging society. Yet new research out today shows stem cell research, which has already made great progress in these fields and others, remains widely misunderstood and under-utilised.

Research  shows that 83% of parents with children under ten feel well enough informed about the science of regenerative medicine to make decisions about their or their children’s stem cells. So is it that a safe and common source of stem cells – umbilical blood cord – is massively under-utilised?  The first successful blood cord transplant was performed in 1988 and the method is now a treatment for many medical conditions.

Collecting umbilical cord blood and tissue is a fast way to build up a representative cord blood registry, but the combination of confusion amongst parents to be, and a lack of facilities and trained staff, mean that most of this potentially life-saving material will simply be destroyed.  The new research shows that only 28% of parents of young children have even been informed about the option of stem cell storage.


A new partnership between the charity Precious Cells Miracle and the NHS Trust Croydon will start to address this imbalance. PCM will provide NHS hospitals with the staff, technology and specialised equipment necessary to collect cord blood units from families willing to donate them. Patients can choose to donate their cord blood stem cells to build up the Government’s public stem cell bank, effectively donating to any person in need, or they can privately store them for their own family. Increasing awareness of the potential of stem cell research and clearing up confusion around the subject is expected to lead to much higher acceptance of regenerative medicine.

PatientTalk.Org interviewed Dr. Husein K. Salem, BSc PhD, Founder and CEO of Precious Cells International and Dr. Salmaan Dalvi, PhD, Head of Implementation and Governance at Precious Cells Miracle: Community Blood Cord Registry to find out more about stem cell therapy!

PATIENTTALK.ORG What actually is stem cell therapy?

DR. HUSEIN  SALEM Stem Cell therapy is the new form of medicine that were seeing coming through now it’s a medicine that’s actually been practised for over 60 years you’ve probably heard of bone marrow transplants.

PATIENTTALK.ORG Yes.

DR. HUSEIN  SALEM Yeah so it’s, bone marrow transplant is now called stem cell transplants and the idea of stem cell therapy is replacing cells in the body in specific organs depending on the type of disease that your treating with new cells that don’t have the problem that particular cells do have so if you  take the example of Leukaemia, you’ve got specific red blood cells that have cancer, so you’ll remove the cancerous cells replace them with stem cells and then the stem cells will then become healthy functional red blood cells that don’t have the cancer.

PATIENTTALK.ORG and what kind of conditions is it suitable for?

DR. HUSEIN  SALEM great question, I’m going to use the word theoretically, but theoretically stem cell therapy can be used to treat any disease, any disease that you think of because ultimately disease is a breakdown of cells in specific organs whether were talking about motor neuron disease,  Alzheimer’s, Parkinson’s, Leukaemia , diabetes  and if you think that within specific organs let’s take diabetes for example where within the pancreas the cells that produce insulin are no longer able to do that stem cell therapy becomes very exciting because you can replace the specific cells not the entire organ, but the specific cells within that organ that are no longer producing insulin with stem cells once those stem cells are within that organ they’ll then start to function as healthy cells and replace the ones that have been damaged and in the case of diabetes start producing insulin.

PATIENTTALK.ORG And why’s it considered an ethical mind field in some quarters?

DR. HUSEIN  SALEM Again a really great question one of the reason why Precious Cells are really supporting Stem Cell Awareness Day and it’s to push the fact that a lot of people are unaware that there’s are two types of stem cell research that goes on. There’s embryonic stem cell research and that’s actually the research that is clouded in moral ethical debates, because it takes stem cells from embryonic sources. Whereas there’s another whole form of stem cell therapy which is called adult stem cell therapy its taking stem cells from adults, from umbilical cord blood one of the areas that special cells group specialise in and that is completely endorsed and back by every major religion in the world by every major government in the world by every major scientific community, medical community and the Labe public.

PATIENTTALK.ORG And what are their cost implications?

DR. HUSEIN  SALEMI Another great question, obviously at the moment were talking about mostly clinical trials so there is still a lot of work to be done in terms of developing the actual treatments for a lot of these diseases, but what we do think, and what a lot of white papers are showing is that stem cell therapy will cost a fraction of what current treatments cost. Again this is one of the big reasons why major governments around the world are spending significant amounts of investment into developing this type of therapy because it’s going to be from an economic perspective a lot more cost effective for health care infrastructure.

PATIENTTALK.ORG What is provision like in the UK? Is it poor, is it good? Would you blame the structure of the NHS?

DR. HUSEIN  SALEM I’m going to pass you over to my colleague Dr Dalvi who’s head of implementation and governors, he’s got a great incite having worked within the NHS quad bled infrastructure for a number of years.

Doctor Salmaan Dalvi -The NHS structure is set up in such a way that the NHS has been funded for six hospitals in and around the London area to collect 50 thousand stem cell units from cord blood and supply the whole nation. That is not feasible when you’ve got mothers all over the country and when the NHS stores its cord blood it is then processed in Bristol, collected in and around London, processed in Bristol, stored in Bristol. You expect a hymnologist to be able to use it, when you have got nationwide, you’ve got 90 hundred hospitals, or maternity hospitals of good quality with a lot of diversity, of patients of a lot of different ethnicities to be able to give you good quality stem cells. For a country like the United Kingdom, when you’ve got roughly 70,000 birds why haven’t we collected the 50,000 that were targeted by the NHS itself, so that is a question in its self.

PATIENTTALK.ORG Would you advise travelling abroad for treatment?

DR. HUSEIN  SALEM No, it’s a case of various types of therapy developing the fastest and what we’ve found is countries where regulations are not as stringent as they are in places like the UK for example stem cell therapy has developed a lot faster for example in the far east, that said lack of regulation and control does mean that it also suffers from having a number of rogue treatment centres, and it’s very difficult for the public to really decipher between a credible centre and a rogue centres that may not actually be injecting stem cells from humans, could be injecting stem cells these have been reported cases of injecting animal stem cells into patients and charging £25,000-£50,000 pounds per procedure. So again it’s a case of the UK needing to invest more funding into stem cell therapies here to prevent reverse medical tourism, we’ve always been the centre of the world in terms of innovation, technology. With more investment here we wouldn’t need people to travel abroad for stem cell therapy.

Doctor Salmaan Dalvi -Can I add to that? What precious cells miracle is about is to collect Precious Cells as in cord blood stem cells from the UK for the use in the UK and abroad if we can give it to someone outside the UK that’s fine, but for now it is UK cord blood cells to be used in the United Kingdom for the United Kingdom therapies where we need it. There’s an urgent need for stem cells and we are not providing and we are not catered for that.

PATIENTTALK.ORG Could you tell us more about how these stem cell banks work?

DR. HUSEIN  SALEM Yes, sure. The technology behind bio banking is again a very well established it evolved from the IVF technology which is 60 years old in itself. It takes cord blood stem cells from the umbilical cord after the babies been born again this after the cord has been cut from the baby and the placenta’s been delivered so there’s absolutely 0 harm to the mum or the baby. It’s really important, there’s a lack of awareness in that people are worried it’s going to harm the mum or the baby that there is 0 risks to either. We have a team of trained specialists, called phlebotomists. There able to collect the cord blood from the cord, the blood itself will typically get anywhere between a 100-150 mills of blood, it then goes through a very technical scientific procedure that separates the red blood cells, the plasma and the stem cells that are in the cord blood. Then going through cryogenic technology which is freezing, it’s frozen in a very controlled manner, 1 degrees per minute it drops down. It’s finally put into liquid nitrogen, which is stored at minus 196 degrees. One of the questions a lot of people ask is how long can stem cells be stored for? The research around the world shows that stem cells can be stored indefinitely, so for over a hundred years for example. Then they’re kept in a database that Haematologists and transplant centres around the world can access, and if they have a patient who needs a specific tissue type match for the Leukaemia or thalassemia for example then they’re able to access that, that sample will be taken from the cryogenic banks that we hold, and shipped immediately to the physician who will then be able to perform the transplant. Part of marking stem cell awareness day is that were looking and were establishing more and more centres around the country precious cells group is leading this through precious cells miracle alarm, and were looking for more and more trust to really get on board and to contact us they can find out more information about how both the public, so patients themselves can get involved and also healthcare professionals who need to understand more education so they can educate their parents. They can go onto our website http://www.preciouscellsmiracle.com .