Medical Minute

COMMONLY ASKED QUESTIONS ABOUT CANNABIS & CANCER

In this column, our readers have the opportunity to ask our staff nurse anything they want to know about using cannabis plant medicine. She will provide quick and concise answers to big questions. In this issue, our focus is cancer and how cannabis interacts with the disease process.

Medical marijuana is now available in 33 states and recreational marijuana is available in 11 states. This surge in legalization is leaving many newly-diagnosed patients with questions. In 2018, it was predicted that 1.7 million1 new diagnoses of cancer would be given. Receiving this news can be scary. The more the patient and family can be informed about their diagnosis, the better. Read below for some commonly asked questions about cancer and cannabis.

HOW DOES MARIJUANA HELP CANCER?

Marijuana helps cancer by assisting with direct symptom relief. U.S. research has shown that the use of cannabis to relieve symptoms caused by chemotherapy is greatly effective. This is due to the antiemetic, or nausea-relieving capabilities of cannabis. THC has been licensed for palliative care as a pharmaceutical and is currently on the market for cancer patients in two drugs, Dronabinol2 and Nabilone. Both have been shown to be effective for nausea and vomiting. Cannabis can also elevate mood, assisting with anxiety and depression often felt by the patient. Pain relief is another positive effect felt from the use of cannabis plant medicine. According to a study done in 20163 by Dr. Abrams for Current Oncology, research showed that not only can cannabis assist with neuropathic pain caused by chemotherapy, it can also prevent it. Proof that these symptoms can be managed with cannabis or cannabinoid therapy is huge for the medical community and patients alike.

WHICH CANNABIS STRAINS ARE BEST FOR CANCER?

This can be a difficult question to answer due to the fact not all strains or cultivars are available in each state that has legalized plant medicine. Cultivars can be specific to an area or breeder. Stories have begun to surface from individuals that have used cannabis for their cancer treatments. These individuals are sharing success stories of what was effective for them on an individual basis. The results will not be the same for each individual due to the unique variances in the endocannabinoid system. Some prefer high THC strains, whereas others are using CBD only for relief. Other patients are choosing to use a hybrid cultivar of CBD and THC to assist with their symptoms. The term hybrid comes from the mixing of various genetic traits to make a blended strain of cannabis.

The high-THC cultivar known as Northern Lights 4 is at the top of the list for many patients thanks to its ability to provide relief from nausea and vomiting caused by chemotherapy treatments. CBD naturally assists with pain and inflammation. The CBD-rich

cultivar Charlotte’s Web was once only available to medical marijuana patients in Colorado and now is readily available online for anyone that can find their way to the website. A hybrid cultivar known as ACDC contains both CBD and small amounts of THC. This type of hybrid allows the patient to have little to no psychotropic effects and all the healing effects of CBD.

[Choosing the right strain for cancer can be tricky. As research continues for the best answers if you or someone you know wants to use cannabis for their cancer, I highly recommend that you keep a journal. To do this you would simply write down the name of the cultivar, the method you consumed it (smoke/vapor, capsules, edibles, topical, tincture, etc,) how much you consumed, and the effect it provided you. This way you have ongoing documentation of what works for you and what doesn’t.]

CAN CANNABIS CURE MY CANCER?

While there are several studies showing the possibility2 of cannabinoids like THC and CBN obliterating cancer cells, whether or not cannabis can truly cure cancer is still to be determined. This is not a black and white question, there is a lot of grey area. Results are favorable but they vary for each individual. No two individuals should expect the same results. However, studies are promising in animal models. An article5 published in the Journal of the National Cancer Institute in 1975, mice were given THC for 20 consecutive days and their tumor size shrank. Another study6, published in the International Journal of Oncology in 2017, said that the combining of cannabinoids, such as THC and CBN may amplify the cancer treatment benefits.

Cannabinoids may have antitumor effects shown by various mechanisms such as the induction of cell death, the inhibition of tumor metastasis7, and the inhibition of cell growth. The more research that can prove these qualities, the more theories can be developed and dosing formulations can begin to surface.

WHAT KILLS CANCER - THC OR CBD?

Which came first, the chicken or the egg? The answer depends on the person being asked. Some patients have found relief in CBD only treatment. Others require THC as a catalyst to CBD. Research has shown that both have been effective in killing cancer cells. The main problem with cancer is how fast the cells multiply. This is called cell proliferation. One reason we could hear so much about cannabis helping cancer patients is that cannabis is known to inhibit cell growth, or better known as being an anti-proliferative. 8

The method of consumption is also a factor to consider when treating cancer with cannabis. Smoking or vaping will not produce the same effect that consuming cannabis via tincture or capsule will. It is important to distinguish that difference.

1. https://www.cancer.gov/about-cancer/understanding/statistics National Cancer Institute

2. https://www.ncbi.nlm.nih.gov/pubmed/16501583?dopt=Abstract “Cannabinoids and Cancer: pros and cons of anti-tumor strategy” British Journal of Pharmacology. Maurizio Bifulco, Chiara Laezza, Simona Pisanti, Patrizia Gazzerro. January 29, 2009.

3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791148/ “Integrating cannabis into clinical cancer care” Current Oncology. Dr. Abrams. March 2016.

4. https://www.marijuanabreak.com/best-marijuana-strains-cancer “5 Best Marijuana Strains for Cancer Symptom Relief” Marijuana Break. July 3, 2019.

5. https://academic.oup.com/jnci/article-abstract/55/3/597/912322?redirectedFrom=fulltext

“Antineoplastic Activity of Cannabinoids” Journal of the National Cancer Institute. A. E. Munson, L. S. Harris, M. A. Friedman, W. L. Dewey, R. A. Carchman. September 1975.

6. https://www.spandidos-publications.com/10.3892/ijo.2017.4022 “Anticancer effects of phytocannabinoids used with chemotherapy in leukaemia cells can be improved by altering the sequence of their administration.” Katherine A. Scott, Angus G. Dalgleish, Wai M. Liu. May 29, 2017.

7. https://www.fasebj.org/doi/abs/10.1096/fj.11-198184?rfr_dat=cr_pub%3D- pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&journal- Code=fasebj

“Cannabidiol inhibits lung cancer cell invasion and metastasis via intercellular adhesion molecule-1” The FASEB Journal. Robert Ramer, Katharina Bublitz, Nadine Freimuth, Jutta Merkord, Helga Rohde, Maria Haustein, Philipp Borchert, Ellen Schmuhl, Michael Linnebacher, and Burkhard Hinz. December 23, 2011.

8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4171598/ “Cannabinoids as therapeutic agents in cancer: current status and future implications.” Chakravarti, Bandana et al. July 17, 2014.