Many patients struggle with the decision between cannabis or chemotherapy.
But is it rational to refuse chemotherapy in favor of cannabis medicine? And most importantly – is it actually a choice between cannabis or chemotherapy, or is there another way?
Until relatively recently, few believed that cannabis had any medicinal qualities at all. Especially among medical professionals, there was a high degree of skepticism surrounding natural treatments for chronic conditions. But, there has also been a growing skepticism among patients. Many treatments have adverse side effects. Some patients question the safety and efficacy of pharmaceutical therapeutic options.
This difference in opinion between patients and professionals is especially dramatic when it comes to cannabis and cancer.
Cannabis or Chemotherapy? What Works?
Cannabis advocates, like Rick Simpson, have long and (passionately) argued that cannabis cures cancer. Simpson, a cancer survivor, offers a method for making high THC oil (now called Rick Simpson Oil or RSO in his honor). Some believe his widely shared experiences with RSO are a glimpse into how cannabis can help patients with cancer. But, and this is an important point, individual cases should not be seen as an indication of a universal cure.
Scientific research examines these cases within a broader spectrum of care, evidence, and testing. In other words, peer-reviewed research is set up to find out if these cases are the exception or the rule.
That means, in 2020, there are no cannabis-based drugs for the treatment of cancer, no Food and Drug Administration (FDA) approvals, and clinical trials are a rarity. From the perspective of the scientific and medical communities, there is no conclusive evidence that cannabis cures cancer.
Proof of Concept: Preliminary Research
Numerous preliminary studies have demonstrated that cannabinoids like THC and CBD kill cancer cells by promoting cell suicide in mutant cells. Cannabinoids trigger apoptosis through various mechanisms, including CB1 and CB2 signaling and ICAM-1 proteins.
Early work, in Petri dishes and animal models of cancer, shows us that cannabinoids can slow down cancer growth, metastasis, and can even promote cancer-cell suicide. The authors behind “The heterogeneity and complexity of Cannabis extracts as antitumor agents” published in 2019 highlighted several recent studies about cannabis for the treatment of cancer. 1)The heterogeneity and complexity of Cannabis extracts as antitumor agents. (2019). Oncotarget, 10(41). doi: 10.18632/oncotarget.26983.
As per the author’s research review, fresh studies have demonstrated THC:CBD combinations reduce melanoma cell viability. Combinations of cannabinoids also induced multiple myeloma apoptosis, and these combinations were most beneficial for targeting breast cancer cell lines.
The researchers behind this paper then went on to assess the effectiveness of different extracts of different cancer cell lines. They explained, “In this research, we attempt to characterize the antitumor effects of 12 whole Cannabis extracts on 12 different cancer cell lines sourced from different tumor origins.”
These results indicate that cannabis “extracts impaired the survival and proliferation of cancer cell lines as well as induced apoptosis.” Interestingly, the authors determined that whole-cannabis extracts are more powerful for targeting cannabis cell lines than single cannabis compounds.
Beyond Chemotherapy, Cannabis for Pain and Side Effects
Sometimes, it’s not a question about cannabis or chemotherapy. It’s about cannabis and chemotherapy. Cannabis is an established conjunctive therapy around the world for the treatment of cancer-related pain, particularly for harsh side effects from chemotherapy, or potentially to boost the powers of chemotherapy itself.
In 2017, in “A selective review of medical cannabis in cancer pain management,” the authors explored the results of five clinical studies. Although the authors noted many studies lacked “statistical power,” they also concluded, “There is “evidence suggesting that medical cannabis reduces chronic or neuropathic pain in advanced cancer patients.” Furthermore, both low and high doses of THC, as well as THC:CBD combinations seemed to deliver positive results for pain reduction. 2)Blake, A., Wan, B. A., Malek, L., Deangelis, C., Diaz, P., Lao, N., … O’Hearn, SO’Hearn). A selective review of medical cannabis in cancer pain management. Annals of Palliative Medicine, 6(S2). doi: 10.21037/apm.2017.08.05.
Cannabis And (Not Or) Chemotherapy?
As far back as 1982, researchers found strong support for THC-rich cannabis as an anti-nausea drug. In this early study, comparing THC and prochlorperazine, both were equally effective for the reduction of nausea and vomiting. Further, as per the study’s conclusions, “There were more drug-related effects associated with THC, but these did not reduce the patients’ preference for the drug, and were associated with nausea reduction.” 3)Thomas, J., Andrysiak, T., Fairbanks, L., Goodnight, J., Sarna, G., & Jamison, K. (1982). Cannabis and cancer chemotherapy. A comparison of oral delta-9-thc and prochlorperazine. Cancer, 50(4), 636–645. doi: 10.1002/1097-0142(19820815)50:4<636::aid-cncr2820500404>3.0.co;2-4
Finally, there is also evidence suggesting cannabis combined with chemotherapy can improve the effectiveness. Israeli researchers recently published the results of a study looking at CBD in combination with doxorubicin ( a chemotherapy drug) for the treatment of cancer. As per their assessment, “the doxorubicin-mediated cell death is significantly more potent — requiring an order of magnitude lower dose — when co-applied with CBD.” 4)Neumann-Raizel, H., Shilo, A., Lev, S., Mogilevsky, M., Katz, B., Shneor, D., … Binshtok, A. M. (2019). 2-APB and CBD-Mediated Targeting of Charged Cytotoxic Compounds Into Tumor Cells Suggests the Involvement of TRPV2 Channels. Frontiers in Pharmacology, 10. doi: 10.3389/fphar.2019.01198
What Patients Should Know About Cannabis for Cancer
Patients and physicians have long assumed that smoking or vaping cannabis for pain, nausea, and appetite during cancer treatments is counter-intuitive. Doesn’t this increase the cancer risk? Thankfully, studies have proven that smoking cannabis correspondingly produces only a minor amount of carcinogenic effects – especialyl compared to cigarettes. 5)Palmer, J. (2007). Cannabis smoke beats tobacco for toxic chemicals. New Scientist, 196(2635-2636), 9. doi: 10.1016/s0262-4079(07)63173-x That being said – inhaling any smoke brings carcinogens into the lungs.
Further, patients who face radiation and chemotherapy look to cannabis to alleviate the debilitating and painful side effects of these treatments. Chemotherapy can cause nausea, discomfort, pain, and vomiting. It can also decrease appetite and increase anxiety and depression. Moreover, early research suggests that, fortunately, cannabis may alleviate these side effects.
Today it’s not uncommon to hear about cancer patients who have taken up cannabis to alleviate these effects. As a result, slowly, more doctors who are ‘with the times’ are offering prescriptions to ease the discomfort of their cancer patients.
So in conclusion, don’t ask yourself cannabis or chemotherapy. Ask your doctor to consider adding cannabis to chemotherapy treatments. Patients should at least talk to their doctors about adding cannabis as a conjunctive therapy to other cancer treatments. Experiment with potencies, cannabinoid profiles, and formats to find one which is comfortable and effective.
References [ + ]
|1.||↑||The heterogeneity and complexity of Cannabis extracts as antitumor agents. (2019). Oncotarget, 10(41). doi: 10.18632/oncotarget.26983.|
|2.||↑||Blake, A., Wan, B. A., Malek, L., Deangelis, C., Diaz, P., Lao, N., … O’Hearn, SO’Hearn). A selective review of medical cannabis in cancer pain management. Annals of Palliative Medicine, 6(S2). doi: 10.21037/apm.2017.08.05.|
|3.||↑||Thomas, J., Andrysiak, T., Fairbanks, L., Goodnight, J., Sarna, G., & Jamison, K. (1982). Cannabis and cancer chemotherapy. A comparison of oral delta-9-thc and prochlorperazine. Cancer, 50(4), 636–645. doi: 10.1002/1097-0142(19820815)50:4<636::aid-cncr2820500404>3.0.co;2-4|
|4.||↑||Neumann-Raizel, H., Shilo, A., Lev, S., Mogilevsky, M., Katz, B., Shneor, D., … Binshtok, A. M. (2019). 2-APB and CBD-Mediated Targeting of Charged Cytotoxic Compounds Into Tumor Cells Suggests the Involvement of TRPV2 Channels. Frontiers in Pharmacology, 10. doi: 10.3389/fphar.2019.01198|
|5.||↑||Palmer, J. (2007). Cannabis smoke beats tobacco for toxic chemicals. New Scientist, 196(2635-2636), 9. doi: 10.1016/s0262-4079(07)63173-x|