Medicine of the Future

Stem Cells: Breathing Life to Ailing Hearts
By Earl D.C. Bracamonte

Initially studied as cure for cancer cases, stem cells are now seen as a beacon of hope for severe heart conditions.
People experiencing heart ailments, which before could only be treated, in most cases, with heart transplant, can now look unto the future with a new sense of hope. Together with the latest discoveries in regenerative medicine, the life expectancy in dreaded heart conditions are held in abeyance.
Those who've undergone the procedure experience a rebirth of sorts; that, like the mythical phoenix, virtually rise from the ashes from whence they came.
“I was diagnosed with cardiomyopathy while completing my internship at the Makati Medical Center. My heart muscle cells aged faster than my actual age. As such, some aspects of my heart lost its pumping function. What was funny was that I cleared all tests, except for the cardiac bypass test that I decided not to take as it was too risky. My blood pressure remained at 170/110 despite medications. In fact, my ejection fraction was at an all-time low of 21% as against a normal person who functions with 50% or higher. Aside from my high blood pressure, I experienced vomiting blood during clinical duty, got easily tired with shortness of breath, had blood clots in my extremities – micro emboli formation – that were very painful, until one day I just passed out. I was, at first, reluctant to undergo the procedure. It is costly and the bone marrow extractions are excruciatingly painful,” confessed Dr. Allan Evangelista, an accomplished practitioner of the Doctors for the Barrio program. He finished a Master's degree course under the Ateneo de Manila-DoH-Pfizer tripartite 'Leaders for Health Program' (LHP) that sent health practitioners to far-flung barrios around the country.
Dr. Evangelista is the first Asian patient of The Medical City undergoing stem cell treatment and study for chronic heart disease. Out of a million stem cells only one specialized stem cell can be extracted. The extraction will then be shipped to the United States where they'll be cultured and then injected intravenously to the patient upon its return.
“In medical books, the only treatment for chronic heart diseases is a heart transplant. However, Dr. Alfredo Bengzon, my superior at the LHP and former Health Secretary, didn't want me to undergo the operation because I was young when first diagnosed.”
Today, the 36-year-old doctor is enjoying an extended lease on life, thanks to the very promising field of Regenerative Medicine. Dr. Evangelista is currently the chief health program officer (Division 1) of the Bureau of International Health Operations at the Dept. of Health. His office addresses all concerns on anything that has to do with international health including cooperation of projects with foreign funding, screen doctors who want to train abroad, facilitate medical missions from overseas (including medicine, manpower and equipment), as well as oversee programs on medical tourism.
Regenerative Medicine is an innovative program that involves the engineering of living cells, tissues and organs to preserve and enhance organ function and improve the quality of life. Proponents of the treatment say it can be used to prevent disease and maintain wellness, as well as restore organ function lost or impaired due to disease, injury, or aging.
It is a procedure that allows the patient to, quite literally, be his own healer.
The key lies in stem cells or “master cells,” which have the ability to grow into any one of the body’s 200 cell types or sensitized to attack diseased cells, including malignant tumors. They can replicate themselves many times over and theoretically, do so without limit, so long as the person is alive.
Therein lays the power of the treatment. “We’re working with the patient’s own living cells. That’s what makes this different from other treatments using conventional, often toxic, drugs and devices,” explains Dr. Samuel Bernal, consultant adviser on Regenerative Medicine for The Medical City.
Dr. Evangelista was initially advised by his superior in the LHP Doctors for the Barrio program, Dr. Alfredo Bengzon, who also sits as CEO of The Medical City, to undergo the stem cell treatment. He initially declined, knowing that the likely costs would be steep for his income bracket, not to mention the maintenance phase of the treatment. He was then referred to The Medical City, a pioneer in this new medical field, who waived most of the procedural costs.
The unique properties of stem cells have spurred worldwide interest in research on possible treatment for other diseases such as cancer, kidney failure, Parkinson’s and Alzheimer’s, spinal cord injury, stroke, burns, diabetes, osteoarthritis, and rheumatoid arthritis. With stem cell treatment, healthy unspecific or undifferentiated cells are extracted from the patient and, under complex laboratory conditions, induced to transform into cells with highly specialized functions. These are then reintroduced into the body as organ repair agents or, as in Dr. Evangelista’s case, heart-repairing cells. “Instead of relying on toxic chemicals to combat disease or donated organs to restore lost function, we’re using the patients’ cells to combat their conditions by regenerating their own organs,” explains Dr. Bernal.
“But the purpose of Regenerative Medicine is not only to treat patients who are already ill but also prevent the onslaught of diseases as well,” he added. Thus, wellness and aesthetic applications of Regenerative Medicine are also available.
While research into Regenerative Medicine forges on, Dr. Bernal stresses that the patient’s well-being is the doctor’s foremost concern. “This is not an academic exercise. This is about making patients’ lives better.”
Indeed, with the ever-growing range of treatments available, a constant dialog between patient and doctor allows each to consider the unique circumstances of the case, and agree on a plan of care most appropriate to these circumstances. With Regenerative Medicine, the approach is even more personalized, as it responds to the patient’s uniqueness at the level of his own cells.
Having completed three treatment sessions so far, Dr. Evangelista proudly reports that his ejection fraction is up to 38% from a low of 21% and his blood pressure is now down to 90/70 after a year. What the charts don’t show is a bright confidence in the future. “There's always a 'downer' in any situation and in my case it's the susceptibility to arthritis. Stem cells newly introduced to the body will create high levels of uric acid. And although I felt chilling sensations and skin rashes after my first intravenous session, I just keep feeling better and better. The dizzying spells and micro embolus formations are gone,” he declares.
The Medical City (TMC) is a JCI-accredited private tertiary hospital with the mission of putting the patient at center stage and delivering service of great worth. It offers diagnostic and treatment services that address a broad range of diseases using state-of-the-art technology such as computed tomography, magnetic resonance imaging and cardiac catherization and intervention services.
TMC has distilled over forty years of experience in hospital operation and administration towards the establishment of its new world-class health care complex that serves some 40,000 in-patients and 380,000 out-patients annually. At the heart of TMC's service philosophy are new paradigms of hospital care addressing the entire continuum of health needs, and the patient as an equal, informed and empowered partner in the pursuit and preservation of health.
It has a regular medical staff of 350 physicians, all of whom are experienced, recognized and established experts in their various fields of specialization. They are complemented by 610 visiting consultants. This core of professionals is supported and assisted by a 1,400-strong human resource team, composed of administrative, finance and support services.
“We are well-positioned, experiencing sustained growth, and equipped with 4 decades of solid history. The thrusts of our four-pronged main program is on the alleviation of cases on the cardiovascular including organ transplant; oncology including Alzeihmer's disease; neuro-sciences and regenerative medicine; all for the improvement of a patient's life span,” enthused Dr. Evangelista's specialist, Dr. Eugene Ramos who, aside from heading the hospital's Cardiovascular Center, is also the director for the Medical Management & Services Development office.
The Joint Commission International (JCI) is widely recognized as the most prestigious accrediting body for international health care organizations. In its evaluation by JCI, TMC received almost perfect scores (9.8/10) in standards related to access to care, continuity of care, quality improvement and patient safety. Truly a gold standard: an exceptional achievement by any measure.
The Medical City proves that it is the country's “Capital of Health,” the center of all that is new and true about every person's total wellbeing. Owned and operated by Professional Services Inc., a quasi-public corporation from an alliance of 900 shareholders with a singular vision, TMC, as a health institution, effortlessly puts into action its credo “Patient on Center Stage, Service of Greater Worth.”
And with stem cells as the 'medicine of the future,' serious conditions, like chronic heart diseases, can now, literally, be a thing of the past; addressed now with more positive results.
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