When does Golf Digest.com publish a story about stem cells?

When golf legend Jack Nicklaus publicly announces that his decades-long back pain has been reduced following experimental stem-cell therapy.

“I’m not a doctor,” Nicklaus said about his 18 major championship titles and 120 tournament victories. “But I think that stem cells are going to change the direction of orthopedics, totally.”

Nicklaus was 76 in 2016 when he had the treatment. He had suffered severe back pain most of his life, sought out various treatments that did not help, and had competed in tournaments while in pain many times.

Dr. Joseph Cabaret gives himself an “exosome” treatment at his office in Camarillo. Exosomes are a new area of research in regenerative medicine. “Exosomes are the future and their discovery can be likened in importance to penicillin and antibiotics in the 1930s,” he said.

Another man who is as relieved as Nicklaus, and for the same reasons, is a patient of Dr. Joseph Cabaret in Camarillo. (The patient is anonymous for reasons of medical privacy.) When he was in his 40s, the man received stem-cell therapy for a painful knee condition, and he told the VCReporter, “I am now pain-free.” He calls his treatment “extremely easy and painless. From the beginning to the middle to the end, it was a positive experience. What I like about Dr. Cabaret was that he looked at things in an alternative way.”

Likewise, a patient of Dr. Stephan Sweet, who practices in Ventura, found Sweet to be a shoulder expert who was “thinking outside the box.”

She was able to return to work right after Sweet treated her shoulder with stem-cell therapy, because the pain she had experienced for a long time was gone. “Surgery was not an option for me,” she told the VCReporter. “I would have been out of work for two months, and in physical therapy for even longer, unable to exercise, and unable to do normal routine activities.” Like Nicklaus, she had previously tried many other things, including acupuncture, steroid shots and more. “Other treatments had failed to ease my pain,” she said.

She was 36 when diagnosed with tendinitis and a rotator cuff tear. She could not exercise or even lift groceries. After her stem-cell therapy, she felt “immediate improvement, and I did not have to take any time off work.” Her recovery took “much less time than recovery from surgery would have.”

Stem-cell therapy has been available for years from several local physicians. Sweet has offered it since 2017. Cabaret has offered it since 2013.

As an orthopedist, sports medicine is one of Sweet’s specialties. He treats patients of all ages for joint injuries, bursitis and arthritis. But people do have fears about something so controversial.

Dr. Stephan Sweet specializes in sports medicine and orthopedics at his Ventura practice, and offers stem-cell therapies. Sweet cautions that “Patients should be wary of traveling seminars with non-orthopedic doctors who may be unqualified to adequately treat musculoskeletal disorders. There are a number of local seminars that are advertised by companies that are often targeting senior citizens. They charge much more than they should, and without adequate diagnoses.”

“I explain it to patients,” Sweet told the VCReporter. For example, stem cells can help to renew shoulder tendons, making them “a good option for people who are not surgical candidates. I don’t push it on anyone.”

Stem-cell therapies are called “regenerative” because they use patients’ own cells, rather than manufactured, pharmaceutical products. “Regenerative” means cells can regrow themselves — when hair or toenails are trimmed, for example, a person’s own body regenerates new nails and hair. When wounded, skin cells regenerate into scars, which form new skin. Stem cells are obtained from patients’ own bodies; minimally invasive techniques extract them from bone marrow, fat or blood.

Sweet points to a medical study of shoulder surgery, where the patients also received stem cells. “The combination of surgery plus stem-cell treatment had better results than surgery alone,” Sweet said. The study assessed injecting stem cells at the same time as surgery. Six months later, 100 percent of the surgery-plus-stem-cell patients had healed, while 67 percent of the surgery-alone patients healed. In a follow-up 10 years later, 87 percent of the surgery-plus-stem-cell patients had healthy shoulders, while only 44 percent of the surgery-alone patients did.

Stem-cell treatments involve complicated expertise and are dangerous if not performed by experienced physicians. Nonetheless, like old-fashioned snake-oil salesmen, some unethical clinics are preying on vulnerable patients, offering unsafe procedures that sometimes harm people. To avoid problems, it’s important that patients do some background research on clinics that advertise treatment. California State Assembly Speaker Pro-Tem Kevin Mullin is pushing legislation (AB 617) to create a Stem Cell Clinic Regulation Advisory Group. “It is clear that more must be done to ensure the proper regulation of for-profit stem-cell clinics,” Mullin said in a press release.

“Patients should be wary of traveling seminars with non-orthopedic doctors who may be unqualified to adequately treat musculoskeletal disorders,” Sweet said. “Complications can occur with any procedure, but the risks are low. It is important for patients to see a board-certified medical doctor who has surgical training relevant to the procedure being performed.”

Sweet has served as team physician at the college level in tennis, football, water polo and track. He is board-certified by the American Board of Orthopedic Surgery. “There are a number of local seminars that are advertised by companies that are often targeting senior citizens. They charge much more than they should, and without adequate diagnoses,” he warned.

Other experts offer similar cautions. Cabaret specializes in regenerative medicine, pain management and addiction medicine. Safety is his primary concern, and one he does not see travelling stem-cell salespeople sharing.

“Whenever something goes wrong with a regenerative medicine procedure, it is not the therapy itself that is to blame,” he told the VCReporter. “It is the result of operator error, unsound judgment or poor technique. There are so many companies now that come into town and offer seminars, and then schedule a day or two of procedures, and then leave.”

“If something goes wrong, then what?” Cabaret continues. “I think people often fail to consider the aftermath and management of a complication when a procedure is done by someone who is not an established local provider. If, God forbid, something does go wrong, that’s when you want your doctor right by your side, as intimately concerned and involved as he was before and during the treatment, if not more so.”

Luxe Medical Spa Manager Monica Focil, left, and Medical Director Dr. Haimesh Shah offer stem-cell therapies at their Thousand Oaks, Camarillo, Oxnard and Ventura locations. “These therapies can also be used for nerve regeneration for certain types of nerve injuries, and cartilage regeneration for arthritis,” Shah said.

There are a number of long-established local doctors who have the expertise to advise patients about safety. Luxe Medical Spa (with offices in Camarillo, Oxnard, Thousand Oaks and Ventura) has offered stem-cell therapies for two years, and Luxe’s director, Dr. Haimesh Shah, was the medical director of the Hyperbaric Medicine and Wound Healing Center at St. John’s Hospitals in Camarillo and Oxnard from 2013 to 2018. Shah is a diplomate of the American Board of Venous and Lymphatic Medicine and the American Board of Laser Surgery.

“We primarily treat face and neck skin with stem-cell therapy,” Luxe Manager Monica Focil told the VCReporter. “We also treat scars, including burn scars, that might be any place on the body.

“Patients are usually very concerned about stem-cell treatment initially,” Focil explained. “But after their first treatment, they do notice improvements in the appearance of their skin.” She said that seeing the results of initial treatments allays patients’ fears, as they experience for themselves that it is safe.

Shah creates a personalized plan for each patient based on their medical condition; there is no risk of a one-size-fits-all approach. He told the VCReporter that stem-cell therapy is used for hair loss treatment, facial skin rejuvenation and Volume Replacement Therapy to treat blood circulation problems. “These therapies are also used for nerve regeneration for certain types of nerve injuries, and cartilage regeneration for arthritis,” Shah said.

When Cabaret first began making stem-cell therapies available in 2013, “these therapies were still considered ‘new’ and ‘revolutionary,’ ” he said. “While they had existed outside the United States for some time, there were very few doctors offering them on U.S. soil. At the time, you would hear about elite or professional athletes traveling to Europe or Latin America, and spending tens of thousands of dollars per treatment, which was really beyond the reach of most people living in this area.

“When I started, I visited Dr. Joseph Purita in Florida, one of the pioneers and thought-leaders of stem-cell treatments in the U.S.A. He was often in the news for saving a professional athlete’s career through the deployment of stem cell therapies.”

That visit led Cabaret to offer stem cell therapies in his own practice. He has found that any joint, tendon, or ligament problem may be amenable to stem-cell therapy. He sees patients seeking stem-cell therapies who “range in age from early 20s to 70s and 80s.”

“I have also treated fibromyalgia with stem cells with complete resolution of symptoms, which remains true four years after treatment,” Cabaret said. “I presented these findings at a lecture at the Cell Surgical Network Annual Meeting in 2015.”

One stumbling block for many people is that medical insurance companies do not cover stem cell treatment, because the U.S. Food and Drug Administration still classifies it as “experimental.” Proponents are working to gain FDA approval, but the process of advancing new medicine from “experimental” status to “approved” can take years or even decades. “We do our best to make the out-of-pocket costs for these procedures feasible to the patient,” Sweet said. Some stem-cell patients have raised treatment financing through GoFundMe campaigns.

Cabaret also offers “exosome” treatments, which he describes as the “cutting edge” of regenerative medicine, because they are the part of stem cells that drive healing. “We can think of it like a beehive,” he said. “What we want is the honey, but we have to go through the bees to get to the honey. Exosomes are like honey, and stem cells are like the bees. What we’re really after is the exosomes, and in the future we won’t need to go through stem cells anymore to get to the exosomes. Exosomes are the future, and their discovery can be likened in importance to penicillin and antibiotics in the 1930s,” he said.

For local stem-cell therapy patients who are “now pain-free” — and for Jack Nicklaus — the future is now. For them, stem-cell therapy has already brought new meaning to the phrase “game-changer.”