Installment 85 - Ask the Doctor/Dr. Jorge Gavino/ProgenCell/January 2016

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Jeannine

Pioneer Founding member
About Dr Gavino

Dr Gavino started learning about bone marrow derived stem cells in 1999. Initially, while doing some orthopedic work with a colleague, Dr Romero, using bone marrow as stimulant to regenerate knee cartilage; they both realized all the potential of the components of the bone marrow. Later on, published literature helped the doctors understand why orthopedic patients with knee problems were responding so well to bone marrow derived stem cell therapy. By 2006, Drs. Gavino and Romero had treated many orthopedic patients. They noticed that stem cell treatment was also helping patients who had immunologic conditions and improving patients' lungs, heart and other organs.

In 2008, they decided to open ProgenCell, a clinic specifically for stem cell therapy, using mostly autologous adult stem cells from bone marrow for degenerative conditions. Safe and effective medical procedures are their priority. They now treat a range of conditions including immunological diseases, some neurological diseases if not too advanced, opthalmic diseases, metabolic diseases as well as orthopedic conditions.

Paseo de los Héroes #9111 Suite 202
Zona Río, Tijuana, Baja California
MEX.: 01(664) 200-2321 Ext. 107
01(800) 044- 6235 Ext. 107
USA: 1 (888) 443- 6235 Ext. 107
FAX from USA: (206) 350- 2353

www.progencell.com
http://jorgegavinomd.com/


Q & A

Q: I found your website information most interesting. It stated under Stem Cell Therapy Limitations, "If stem cell production in the bone marrow is low, then the amount of cells harvested is limited causing a poor transfusion with a low number of cells." My question is why, since you are not bound by FDA regulations, would you not be able to expand the cells to make the treatment more effective? If someone goes all the way to Tijuana, pays for therapy, only to have a poor harvest, it would be extremely disappointing.
A. Although we are not regulated by the FDA, the regulatory aspect is present in all countries. We can definitely make cell expansion to give each person the greatest possible benefit. However, it is only considered for cases where there is limited number of stem cells. But, always taking into consideration the potential benefits and avoiding the possible risks for each individual, we tend to use bone marrow; it contains several growth factors and is well known to be the main source of stem cells production, and these migrate to other tissues in the body. We never consider a poor cell procurement as a possible option, each patient meets previous requirements.

Q: My condition is ulcerative colitis. The best procedure I've seen so far is a combination of both IV and a direct injection into the infected area. For UC/Crohn's there are 2 studies that have isolated cells that will find their way to the intestine, but I probably can't wait long enough to benefit from that. I'd like your professional opinion on treating ulcerative colitis with stem cells.
A. Based on our experience, we believe that because ulcerative colitis and Crohn’s disease have systemic affection backgrounds, intravenous application of stem cells offers the best results. Considering that will depend on the damage extent of the localized lesions, which can be varied in number, size or degree of severity.
The local and direct application, even when it is possible, is impractical, with implications such as greater risk and the need for greater technical resources; direct injection is not adding benefits to the patient beyond the same potential intravenous stem cells. We do not recommend direct application because the related benefits, do not justify the risks.

Q: As I'm reading about the risks and benefits of treatment, I'm also noticing that some firms perform work within the USA and some outside the USA. What is involved in going to Tijuana and why would it be preferable to treatment in the U.S. if I elect to take that route?
A. Traveling to Tijuana (or to any part of the world) for medical purposes, involves a lot of factors, and you should consider the following:
Decision: Any medical treatment decision should be based on availability, safety and efficacy of the treatment, with minor acceptable risks.
Availability: There are some procedures that you will be able to get legally in Tijuana that you cannot get in the US, such as cell expansion, for example, “more than minimally manipulated cells”. We are an established medical team, which started research many years ago; we are up to date on related studies/therapies going on in other parts of the world. We constantly update our techniques and procedures to improve the safety and efficacy in benefit of the patient. No need to travel around the globe.
Timing: We all expect a very promising future for stem cell therapy, but it may take the FDA a long time to approve all applications. Some patients need to act now, and Tijuana may be their best option. Getting an appointment can take less than a week, and talking directly to the doctor may happen the same morning.
Cost of treatment is a big factor since insurance companies do not cover stem cell procedures yet. Consider into your equation your out of pocket expenses: Full cost of procedure, medication, traveling expenses, etc
Most important to select the proper clinic and doctor who will perform the procedure. Ask enough questions, so you feel assured that you are selecting the right doctor. Ask for the name of the doctors, address, regulatory licenses, etc., Low cost is not always the best choice. Be careful If they ask you for money in advance, (and even before evaluating your case); it could be a sign of them being more interested in your money than in your health.
Quality of services. To our clinic you are not a file number. Every patient becomes a priority and will be treated in a very personal level. Besides our quality assurance program, you will find modern equipment, all sterile disposable material, and state of the art facilities (see inside clinic).
Travel. On the travel side, it is not much different than to travel to another city. Since Tijuana has grown a lot, it has become very easy to get hotel reservations, finding restaurant options and local transportation. Since this will be medical travel, we suggest you get a companion for the trip, it makes things much easier. Don’t forget to bring your passport.

Q: Is systemic delivery of stem cells best or a localized shot to the area of injury? How about prp treatment?
A. The stem cell infusion method is performed according to the condition subject to improvement. Localized applications can be done in many cases, most of the time when a local application is necessary. Combining them (both systemic and local application) offers greater chance of success and benefits to the patient. We do not recommend localized applications by themselves. The use of PRP can only provide a fraction of the benefits offered by stem cell therapy because they contain only one derived growth factor from platelet destruction. Stem cell therapies include multiple stimulatory factors and multiple growth factors.

Q: If someone is healthy and wants to stay that way, do you recommend periodic stem cell treatments? If so, how often would a person need to get a treatment? Are cells banked or would it require a new harvest each time?
A. I do recommend it. It is not easy to achieve and maintain good health, and you cannot stop the aging process, but you have the possibility of delaying it, or to modulate it by maintaining a healthy lifestyle. Because stem cells play a key role being responsible for cell regeneration, on damaged tissues the use of stem cell therapy is recommended.
Frequency of stem cell treatments is determined on a case-by-case basis, considering several factors. A more frequent application will be required in those patients with a high predisposition for certain diseases (such as diabetes, or neurodegenerative diseases) or with poor health habits, lack of daily exercise, and age. For this group of patients, stem cell treatments could be recommended up to three times a year; on the contrary regarding healthy patients, a single stem cell treatment annually could be more appropriate.
Regarding the source of the cells, our preference as a first option is to harvest fresh stem cells for each treatment, but there are specific limitations to each patient where banking is preferred. On those cases a cell harvest is performed on the first visit and taken to our lab to be cultured, expanded and cryopreserved for several future infusions.

Q: I see asthma on your list of conditions treated, but I don't see COPD. Do you treat COPD? If so, how successful have you been and what is the approximate cost? Do patients require more than one treatment normally?
A. We have different stem cell programs with significant benefits for our patients with lung diseases, including COPD. Many have reported “life changing benefits”. The final result depends on the health condition of that specific patient at the time of procedure. Since stem cells need a certain amount of tissue viable for regeneration, some patients have achieved a greater improvement in comparison to other patients with similar diagnosis. We have seen greater improvements when procedures are repeated 2 or 3 times along a 12 month period, it is necessary to asses each patient individually to determine the number of treatments that could be required to meet expectations. Cost of treatments varies in a range of $4,900.00 to $9,500.00 USD, subject to complementary techniques determined at the initial evaluation.

Q: Can stem cell treatment help with hearing loss? If the answer is yes, is there an age limit as to when a person could be considered a good candidate for such treatment?
A. If the cause of the hearing loss is degenerative, metabolic or immune in nature, then stem cell therapies pose a significant potential for improvement. If the hearing loss was caused by a physical accident, then there is organ damage; the possibility of improvement is minimal or nonexistent.
For any stem cell program, we generally recommend patients to be under the age of 75 years old. Some exceptions may apply so each patient goes thru an individual evaluation with the intention to determine the potential improvement on that specific case.

Q: Do you use other types of therapies along side stem cell treatment such as growth factors or laser?
A. Treatment programs that include stem cell therapy have a number of options available that allow the patient to obtain a significant improvement. In some cases, the use of growth factors are recommended as an integral part of the therapy, while in other cases they are offered as an option. Although we do not prefer the use of laser, other techniques such as ozone therapy, hormonal therapy, vitamin infusions and detox supplements are considered complementary to optimize stem cell therapy.

Q: After treatment should a patient take any kind of precautions i.e. rest more, don't exercise strenuously, don't take steroids or NSAIDS, etc. What about steroids before treatment?
A. Our goal is always to improve the patient’s condition as much as possible, so we provide them with particular recommendations for appropriate care about their specific disease. For some cases it is required to temporarily limit exercise, in other cases, an exercise routine helps efficacy of stem cell therapy. Most cases return to their normal daily activity as soon as day after of treatment.
It is important to stress the commitment of the patient with himself regarding lifestyle, including dietary habits, and avoiding harmful or toxic products that decrease the effect of cell therapy. We do not recommend the use of steroids, neither before nor after treatment.

Q: How do you see stem cell treatments improving in the next 10 years? Will gene therapy also play a role? Is that something you may be offering as well?
A. It is not possible to determine how fast or slow the stem cell field will progress, but I am sure that stem cell therapy in 10 years will be a very important part of medicine. We base the use of stem cells on autologous therapies, allowing patients to have a safe and effective option with minimal risk. Since we developed this protocol, we have evolved therefore made significant progress obtaining better results on patient’s health with the use of stem cells. Currently we offer it because it has the best chance of improvement for a large number of diseases that do not have any efficient treatment. And in some medical conditions the existing treatment has many side effects that in the long run will end up being more harmful for other organs of the patient than the original disease itself. Gene therapy will also evolve and is probable that in the future will be used with stem cell therapy as a joint protocol. Today we do not offer gene therapy, but you can be sure that our commitment is to keep our research and knowledge updated, always trying to find more efficient solutions for improving patient’s health, either with gene therapy or any other emerging therapy. Today and in the future we will treat with whatever therapies are available that result in the best interest of the patient.
 
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