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How Much Cannabis Do Cancer Patients Take?

Dragana Komnenov PhD
cancer treatment using cannabis

How much do you need in order to stop the nausea and pain?

Between thirty and ninety percent of chemotherapy recipients experience nausea and vomiting associated with cancer treatment. It can occur at any point before (anticipatory), or immediately after (acute, within a day of treatment). Or even after the first twenty four hour (delayed).

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Repeated episodes of vomiting could become detrimental in individuals who are already substantially compromised, such as cancer patients. This is because the risks of dehydration and electrolyte imbalance are too great. The therapeutic need for antiemetics and pain relief associated with cancer and available chemotherapy agents is still unmet.

Cannabis Stops Nausea and Vomiting

According to the recent meta-analysis — published by JAMA (2015) — there are twenty eight studies evaluating the therapeutic potential of cannabinoids in treating nausea and vomiting associated with chemotherapy. Cannabinoids used ranged from THC and THC-like compounds, nabilone and dronabilone. Then there was a mix of THC and CBD in 1:1 ratio. The doses for THC ranged from 5-60mg per day. Meanwhile, there was a THC:CBD administration in spray form containing 27mg and 25mg of each compound, respectively.

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Results suggested that the number of patients showing complete alleviation of nausea and vomiting was greater in groups consuming cannabinoids. The patients were four times more likely to experience this positive effect if they were consuming cannabinoids.

Cannabis Relieves Cancer-Related Pain

Chronic pain alleviation with cannabinoids is under review in more than 2,000 cancer patients to date. Most of the patients experienced improvements in pain measures when using cannabinoids, either as smoked THC (1-5 cigarettes/day) or as a THC:CBD spray (27mg and 25mg/millilitre, respectively). The average number of patients experiencing reduction in pain (of at least thirty percent) was greater in the cannabinoids group compared to placebo.

One study — published in Neurology (2007) — reported that smoked THC exerted the greatest benefit. With patients reporting a three-fold plus improvement in pain.

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Cannabis Helps with Sleep

Furthermore, there is evidence that cancer, cancer treatments, and their side effects have links with insomnia and poor quality of sleep. Although the therapeutic potential of cannabis and cannabinoids-based therapies have not been directly evaluated in cancer patients, reports describing beneficial effects exist for other patient populations.

Research suggests that the synthetic (THC-like) cannabinoid nabilone can help with insomnia and greater sleep restfulness in fibromyalgia patients. Furthermore, eleven additional trials found a positive association between consuming cannabinoids either as THC or CBD alone, or in combination and improvement in sleep quality, and the results were similar for all cannabinoids. So, you can imagine how much more effective the plant will be.

Cannabis Kills Cancer Cells

Recent investigations have shown that activation of cannabinoid-based signaling can also kill cancer cells, and thus prevent further spreading. Besides these antiapoptotic and antiproliferative actions, research shows that cannabinoids can stop the spread of cancer cells. This occurs by the compounds attacking other aspects of cancer progression.

The first step that a collection of cancer cells has to do to survive is establish blood supply with the host, a process called neovascularization. One of several studies — published in the FASEB Journal (2003) — suggests that activation of CB1 and CB2 receptors by THC prevents the host’s blood vessels from establishing connection with cancer cells. The second plan of attack of cancer is to enable cancer cells to move. This is a process called cellular migration, which is arguably the most important step for cancer spreading. To spread into other tissues, the primary cancer cells have to enter either the lymphatic or blood vessels.

Several studies investigating glioma and cervical cancers have identified reduced migratory potential of cancer cells in vitro with CB1 receptor activation. Furthermore, the invasiveness of cancer is dependent on its ability to degrade the surrounding tissue such that the cancer cells can grow and move, a process requiring a set of important matrix degrading enzymes called matrix metalloproteinases.

Cannabis Decreases Invasiveness of Cancer

CBD and THC can decrease invasiveness of breast, lung and cervical cancer, according to studies. If the primary tumor succeeds through neovascularization, migration and invasion leads to metastasis. This is the transfer of malignant cells from one area to distant organs. And is one of the most frequent reasons for death of cancer patients. Evidence also shows that CBD-rich extracts can shut down the signaling cascades that enable breast cancer cells to metastasize. While THC can inhibit crucial pathways to metastasis of lung cancer.

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Dosing: How Much do you Need to Kill Cancer Cells?

The main difference in studies examining cannabinoid-based treatments of cancer-associated side effects and cancer itself lies in the dose. For example, most studies exploring the effects of THC and CBD on cancer cell death, and prevention of migration, invasion and metastases employ concentrations in the micromolar range. How does that translate to the concentrations in the blood after consuming cannabis?

According to the pharmacokinetic parameters of THC, ingestion of 10mg of THC results in concentration of THC of thirty two nanomolar in whole blood. That is roughly a hundred to a thousand-fold less than what is in use for in vitro studies that result in cancer cell death. This doesn’t necessarily mean that this relationship is linear. It also doesn’t mean a person would need to consume a thousand-fold more to achieve cancer-killing concentrations.

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The safety and efficacy profile of consuming cannabis in amounts that would yield micromolar concentrations in blood has not been investigated. Perhaps the future lies in devising a strategy for site-specific delivery of THC and CBD. At  higher concentrations and only to the tumor microenvironment. Regardless the future looks promising for cannabis as a treatment for cancer.

Dragana Komnenov
  • Avatar
    pat minturn

    Appreciate all the information I can get!!!!!!!!!!

    February 6, 2019 at 7:39 pm Reply
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    Keen Rostova

    The integration of cannabis for pain reliever is indeed a bold move but I’m sure it helps the patience. Let’s be open about it but let’s push for moderate consumption.

    June 25, 2020 at 11:14 am Reply

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