Singaporeans heading to Malaysia for stem cell therapy on knees
When scans last year showed significant damage to his knee cartilage, Mr Johnny Lam started looking for solutions.
For years, the 58-year-old had endured pain and swelling in both knees but this condition had become unbearable, making it excruciating to walk and affecting his active lifestyle.
Cartilage acts as a shock-absorbing cushion between bones at the joints. When the cartilage is damaged, bones can rub against each other, resulting in pain and inflammation.
Recalling his consultation with a doctor at Sengkang General Hospital, Mr Lam said he was told that his only option was a total replacement of both knees.
However, with replacements typically lasting 15 to 20 years, and given his relatively young age, the doctor advised him to do it later to avoid having to get a possible second replacement.
“I couldn’t accept that and didn’t want to just wait for the surgery because it was already very painful to the point where it hurt even to walk or stand,” he told CNA.
“I was worried that if it was so bad at that point, how much worse would it get when I’m in my sixties or seventies?”
Desperate for a solution, Mr Lam started researching alternatives and came across a Malaysian company based in Selangor that was marketing stem cell therapy.
According to its website, the company – International Cancer Therapy & Stem Cells Technology (ICT & SCT) – works closely with locally certified laboratories and doctors to offer services such as stem cell treatment to both local and overseas customers.
“I did have some reservations at first because I didn’t know how trustworthy they were and also the quality of what they would inject into me, but after enquiring more and doing more research, I felt more reassured and was willing to take a bet,” said Mr Lam.
In July last year, he flew to Kuala Lumpur to undergo stem cell therapy for both knees at a private clinic.
The treatment involved harvesting stem cells from donated umbilical cord tissues, followed by the culturing of these cells in a certified laboratory, according to the company's Mr Lim. Stem cells are a type of cell with the potential to develop into various types of cells that may be able to help repair some parts of the body.
The cultured cells were then injected back into the damaged knee cartilage, where they developed into new cartilage tissue, Mr Lim added.
The patient, Mr Lam, reported a challenging period but ultimate success.
“My knees started swelling a few hours after the injection and it was very painful … the pain lasted for about three to four days,” he recalled.
“After that, the swelling went down and my left knee felt fine but the pain remained in my right knee, so I went back for a second round of injections in November for my right knee, and this time, the swelling lasted for one week but after that, I had no more pain in my knee," Mr Lam said.
“Both knees are totally fine now, I can dance, run and even jump with no pain,” he said, adding that he paid RM30,000 (US$6,700) in total for the treatments.
NOT APPROVED AS MAINSTREAM TREATMENT IN SINGAPORE
Mr Lam is not the only Singaporean crossing the border to undergo stem cell therapy in hopes of repairing knee cartilage.
With the treatment currently not approved as a mainstream clinical service for cartilage repair in Singapore, some patients have been going to private clinics in Malaysia to bet on stem cell therapy.
These patients are reluctant to take up existing treatments such as total knee replacement or microfracture surgery, where tiny holes are drilled in the surface of a joint to signal to the body to create new tissue in the joint.
Kuala Lumpur Sports Medicine Centre (KLSMC), which has performed more than 1,000 stem cell procedures to regenerate knee cartilage since it opened in 2007, said it sees one Singapore patient each year on average.
“Singaporeans have a lot of good medical services back in Singapore so it’s only when they have specific reasons such as they don't have a choice, then they come to us,” said KLSMC consultant orthopaedic surgeon Dr Saw Khay Yong.
Similarly, ICT & SCT’s Dr Lim said he has received more enquiries about stem cell therapy from Singaporeans in the past year.
Of the four patients CNA spoke to who had undergone stem cell therapy in Malaysia, all said they had experienced significant improvements in their knees after the treatment.
Mr Tong Peng Cheong, 73, who underwent stem cell therapy for his right knee in 2014 and for his left knee in 2020 at KLSMC said the pain in both knees subsided after he completed the treatment.
Unlike Mr Lam, who used stem cells from a donated source, Mr Tong's stem cell therapy involved harvesting stem cells from his own body, which were cultured in a lab, before being injected into his knees.
“I didn’t know if it would work or not but I wanted to give it a try because I didn’t have many options and did not want to do a total knee replacement,” he said.
“I wanted to tell the doctor that even if it failed, I wouldn’t blame him.”
Another Singaporean patient, who wanted to be known only as Mr Lee, said he is able to walk normally again and without pain after undergoing stem cell therapy on his left knee in 2014 at KLSMC.
Now aged 61, he had gone for the therapy after his orthopaedic surgeon in Singapore suggested it.
“My doctor said it wasn’t approved in Singapore but told me that there was a doctor in Malaysia that has done research in that area and could perform the treatment on me,” he said, adding that his knee gradually improved and he experiences pain only occasionally.
According to the four patients CNA spoke to as well as KLSMC’s Dr Saw, stem cell therapy in Malaysia can cost anywhere from RM30,000 to RM120,000 depending on the complexity of the case, whether a patient needs to undergo corrective surgery before taking the injections, as well as how many booster injections they require.
This is to allow more data to be obtained for further review of the use of mesenchymal stem cells, said the Ministry of Health (MOH) in response to queries from CNA on Dec 23.
The ministry said it had reviewed the use of stem cells for cartilage repair but found a “lack of consistent evidence” in published literature to support the therapy as a mainstream clinical service.
In 2022, the National University Hospital (NUH) conducted a study of 440 knees from 392 patients and found an 80 per cent success rate in the use of stem cells in two years and a 72 per cent continued success rate over 10 years, where patients did not need an additional procedure.
The treatment involved harvesting a patient's stem cells from the lower back region, followed by the culturing of these cells in the laboratory. The cultured cells were then injected back into the damaged knee cartilage, where they develop into new cartilage tissue.
Speaking to CNA, Professor James Hui, who led the study, said he has been allowed by MOH to continue performing cultured stem cell treatment for repair of cartilage for research purposes in NUH.
Prof Hui said the treatment is currently limited to patients aged 55 and below but he would make exceptions for very fit patients aged 56 and over.
He added that the cost of stem cell treatment to repair knee cartilage at NUH is between S$12,000 and S$15,000 (US$8,800 to US$11,000).
'Willing to take a bet': Singaporeans heading to Malaysia for stem cell therapy on knees - CNA
