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American doctors are clamouring for Canadian multiple sclerosis patients who are travelling abroad for a controversial treatment they can't get at home, a U.S. neurologist says.

"Every IR (interventional radiologist) in every town is competing with each other, 'Who can see more Canadians?' " Dr. David Hubbard, head of the Hubbard Foundation in San Diego, said in an interview with Postmedia News Tuesday.

Canadians are travelling to Bulgaria, Poland, Mexico and other countries for the procedure known as "liberation therapy," which involves opening blocked veins in the neck.

"I'm actually more worried about some of these American doctors who are doing it," Hubbard said.

"In the States, every IR is doing it. If anything, we have the opposite problem. I actually think it's happening too quickly in the United States."

Developed by Italian physician Paolo Zamboni, the procedure is based on a theory that MS is not an autoimmune condition but a vascular disease that can be treated with surgery.

Canada has among the highest MS rates in the world. There is no known cure.

An expert panel convened by the federal government to review Zamboni's theory, and his treatment, recently concluded that there is insufficient evidence to justify clinical trials and that MS research already underway should be concluded first.

Major projects studying liberation therapy and the theory behind it are being conducted in British Columbia, Alberta and Saskatchewan. Newfoundland and Labrador is funding a study of patients who go abroad for liberation therapy. Local neurologists will examine patients before and after treatment, and they'll be matched with other MS patients, who have not undergone liberation treatment, in order to evaluate its effectiveness.

Hubbard and two other experts in CCSVI, or chronic cerebro-spinal venous insufficiency, met with members of Parliament and senators Tuesday to discuss the latest science on MS "and to advocate on behalf of Canadian patients," said Liberal MP Kirsty Duncan.

Zamboni theorizes that abnormal blood flow from the brain contributes to MS; his technique involves opening veins with a balloon or stent.

Duncan said 12,500 "liberation" procedures have been performed worldwide in more than 50 countries, and that "80 to 97 per cent of MS patients show one or more venous abnormalities."

"If you talk to the interventional radiologists — the people who actually do the liberation procedure — about one-third of MS patients seem to respond very well," she said.

"This is significantly better than the outcomes for the drugs that exist today."

Duncan said Canadian MS patients who go abroad for treatment need proper followup care and that a registry needs to be put in place to track those who have been treated.

Hubbard's son was diagnosed with MS in May of 2009. He discovered then that "really nothing much had changed since I was a resident 30 years ago.

"The theory then was that MS was caused by a virus, or possibly an autoimmune theory. Basically 40 years later, billions of dollars of research later, every article in the journals started with, 'The cause of MS is unknown.' Current articles are still beginning that way."

He says the theory that the immune system is attacking myelin, the lining of the nerve cells, "has not been validated."

He said doctors discovered severe obstructions to his son's jugular veins in his neck. "They were dilated with a simple catheter that's put in the femoral vein in the thigh. Almost immediately his symptoms improved," said Hubbard, whose foundation tests and treats CCSVI in MS patients. So far, 209 patients have been treated.

"Half of our patients in southern California are coming from Canada," Hubbard said. "That's just not right, especially when it's being prevented by a very small number of angry neurologists in Canada."

Mark Haacke, a medical physicist and MRI expert at Hamilton's McMaster University who directs the MRI imaging research centre at Wayne State University, said that he has "probably personally reviewed over 1,000 cases (of MS patients) so far, and there are venous abnormalities everywhere."

Dr. Sandy MacDonald, a cardiovascular thoracic surgeon from Barrie, Ont., who was trained in liberation therapy by Zamboni, said that of 298 patients treated at a clinic in Cabos San Lucas, Mexico, "96 per cent were Canadians.

"I personally don't believe in medical tourism," he said. "I think it behooves us to actually look after Canadians and treat them in Canada."

"My plea is that the Canadian researchers actually do the trials. We need the support of the federal government for funding and we need to do a randomized, controlled multi-centre trial to actually prove that this therapy works, or doesn't work," he said.

"If it doesn't work, then it needs to be abandoned. If it does work, then it needs to be endorsed and paid for" by the provinces and territories, he said.

Last year, an Ontario man died after undergoing the treatment in Costa Rica. Mahir Mostic had surgery in June. Blood clots formed around the stent that was inserted in his neck; his friends said he couldn't find a doctor willing to treat him in Canada.

The Niagara Falls man returned to Costa Rica in October, where he died soon after he was given medication to dissolve the clots, which may have triggered internal bleeding.

"I think it's unethical and unconscionable that when people come back and they're looking for help, they have medical appointments cancelled, they have tests cancelled," Duncan said. "They go to the emergency and they're sent home."

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http://www.vancouversun.com/health/specialists+competition+Canadian+patients/4246308/story.html