When is a cure not a cure?

Medical Edge

By DR. JONATHAN KERR

Every so often, medical researchers develop a miracle cure for a deadly and disabling disease. In 1922, Canadian scientists Banting and Best discovered that insulin can treat

hyperglycemia (high sugar levels in the blood), which overnight changed

Type 1 Diabetes from a virtual death sentence into a treatable

condition.

as a quick and easy way to lose weight, and thousands of people starting taking it in over 70 countries.

However, doctors started noticing that patients taking this drug were having heart attacks and strokes. Further research showed that patients with

cardiovascular disease or diabetes who were given Meridia had a 16 per

cent increased risk of serious cardiovascular events, compared with

those given a placebo.

Sure, patients lost some weight, but they were having heart attacks and strokes instead. As a result, Meridia was taken off the Canadian market in April of 2010.

So, when is a cure not a cure?

Patients with multiple sclerosis (MS) are optimistic that a new "liberation surgery" proposed by an Italian physician Dr. Paolo Zamboni will rival

the discovery of insulin.

Multiple sclerosis affects approximately 75,000

Canadians, and is commonly thought to be an autoimmune disease in which the body attacks its own nervous system, leading to symptoms such as muscle

weakness, sensory loss, and fatigue.

In contrast, Dr. Zamboni has hypothesized that MS is actually caused by poor drainage of blood from the brain, a condition known as chronic cerebrospinal venous

insufficiency (CCSVI). He believes that a surgical procedure that opens

up the veins in the neck will allow for more drainage, and thus reduce

the symptoms and severity of MS.

Currently, this procedure is not funded in Canada. Supporters of the technique are lobbying the government to fund the procedure, and some have even traveled overseas

to have the surgery completed, costing as much as $20,000.

The Belleville Intelligencer recently highlighted the story of two local MS patients, one who travelled to Poland for the procedure, and another who is raising funds to have the

surgery in Costa Rica.

But there are many questions still left unanswered.

First, there has been no proof that the liberation surgery actually works. Second, there have been some reports of serious complications from the

procedure.

One patient who underwent the procedure at the renowned Stanford University facility in California actually died from a severe brain hemorrhage (bleeding inside the brain). Another patient at the

same facility needed emergency open-heart surgery to remove a stent that

had become dislodged from her neck veins. On Oct. 19, an Ontario man,

Mahir Mostic, died one day after undergoing the procedure in Costa Rica.

Like Meridia, are the risks of this new treatment too high? Are we going to find out 10 years from now that the liberation procedure increases the

risk of other dangerous medical events?

Physicians and scientists are asking everyone to take a deep breath and allow for more time to conduct the proper research to show that this procedure does in fact

work to treat multiple sclerosis, and does not produce unintended side

effects. To date, there have been no research studies conducted using a

control group, which would provide the best possible medical evidence.

Even Dr. Zamboni himself has advised caution. In October he warned that patients should avoid the surgery until further clinical trials have

been conducted.

There are seven studies underway in Canada already, and many others around the world, hoping to determine if the procedure truly works, and just as important, if it is safe.

Canada's doctors and politicians have asked the public to show patience while the true benefits and harms of the procedure can be understood, and so

do I.

My heart goes out to the thousands of patients and their families affected by multiple sclerosis. I truly hope this is a miracle cure, but until we know that the liberation procedure is more like

insulin, and less like Meridia, let's wait until the research has been

completed.