FIGHTING BREAST CANCER WITH KNOWLEDGE

At least one in eight women will develop breast cancer in her lifetime. More than 300,000 women and 3,000 men are estimated to be diagnosed with new cases of breast cancer in 2019 alone. Second to lung cancer, breast cancer is the second main cause of cancer death. 85% of breast cancer occurs in women with no family history of breast cancer. These instances of cancer occur as a result of genetic mutations that happen as part of the aging process or as a reaction to experiences throughout our lives.

Due to advances in treatment science, early screenings, and increased awareness of symptoms and signs, the mortality risk associated with breast cancer has decreased. Incidence rates have been on the decline since 1989, but there are still roughly 3.1 million breast cancer survivors living in the United States. With the recent trend in cannabis legalization, many patients and survivors have turned to cannabis for relief from symptoms of their cancer and/or conventional treatments, and science has begun to back up the efficacy claimed in anecdotal evidence.

WHAT IS BREAST CANCER? Breast cancer is a cancerous growth that begins in the breast tissues of both women and men, though it is significantly more common among women. As with all cancers, breast cancer begins with an abnormal mutation of cells. 1 Cells may be replicating that should not be or sticking around when they should decompose. This abnormal cell growth results in a tumor, which, when malignant, can be the beginning of cancerous growth. For breast cancer, this process begins in the breasts and, in advanced stages, can move to glands and lymph nodes (metastatic cancer), which can then spread throughout the body’s cell network. Even if your family has no history of cancers, these genetic mutations can happen to your cells as a result of getting older or simply through daily life encounters with pollution, chemicals, and everything else we come in contact with.

TYPES OF BREAST CANCER There are three main types of breast cancer: invasive, noninvasive and metastatic. 2 Additionally, there are five (0 - 4) stages of cancer, with a higher number correlating with increased severity due to the disease spreading further. 3

INVASIVE BREAST CANCER | There are multiple forms of invasive breast cancer, but the most common is invasive ductal carcinoma (IDC), making up about 80% of all breast cancer instances. According to breastcancer.org, “Invasive means that the cancer has “invaded” or spread to the surrounding breast tissues. Ductal means that the cancer began in the milk ducts, which are the “pipes” that carry milk from the milk-producing lobules to the nipple. Carcinoma refers to any cancer that begins in the skin or other tissues that cover internal organs — such as breast tissue.” 4

NON-INVASIVE (IN SITU) BREAST CANCER | Unlike their invasive counterparts, non-invasive breast cancer has not invaded tissues surrounding the breast. 5 These cancers stay “in the same place,” or “in situ,” and are sometimes referred to as carcinoma in situ. These types of breast cancer do not grow into or invade tissues within or surrounding the breast area. Some cancers can possess both invasive and non-invasive cells that have mutated and such instances are treated as cases of invasive cancer.

METASTATIC BREAST CANCER | Also referred to as Stage IV Breast Cancer, Metastatic Breast Cancer is a type of breast cancer that has spread to other parts of the body, most commonly the liver, brain, bones, or lungs. 6 As a cancerous tumor grows, cancerous cells may break off from the original infected breast tissue, traveling through the lymphatic system or entering the bloodstream.

CONVENTIONAL TREATMENT FOR BREAST CANCER Treatment for breast cancer will vary largely based on the stage and type of breast cancer. 7 Standard treatment options include local treatments, systemic treatments, and clinical trials. Local treatments specifically treat the tumor without affecting the rest of the body. These treatments include surgery and/or radiation to remove the cancerous growth. Systemic treatments are used to treat cancer cells throughout the entire body, and can be administered by mouth or in the bloodstream. These are among the more common treatments that you may have heard of, including chemotherapy, hormone therapy, and immunotherapy. Additionally, experimental treatments such as drugs that are still being researched and practices that are in the early stages of study may also be available to breast cancer patients. Patients should discuss treatment options with their oncologist(s) before making a decision. Some oncologists and surgeons may be open to complementary treatment options such as cannabis when used in conjunction with conventional cancer treatments.

CANNABIS & BREAST CANCER

Cancer organizations are beginning to recognize the efficacy and prevalence of medical cannabis applications as they relate to cannabis treatments. BreastCancer.Org lists common anecdotal evidence of cannabis helping with pain, nausea, appetite stimulation, insomnia, and anxiety surrounding treatment and diagnoses, and goes so far as to offer advice and cautions as to beginning a cannabis regimen for breast cancer treatment.8 According to Virginia F. Borges, M.D., MMSc., professor of medicine and director of the Breast Cancer Research Program at the University of Colorado Cancer Center, cannabis is helpful in mitigating side effects of prescription drugs that are used to control side effects.

“By adding in medical marijuana, it often allows me to cut back on the number of drugs I prescribe [to patients],” explains Borges. “With a high-quality source for medical marijuana and knowing how it affects an individual, using medical marijuana can put more control back in the hands of my patient. If someone is feeling good, she may only need to take one or two drops per day. If she’s not feeling good, she may need three or four drops per day. Many of the prescription drugs don’t have this flexibility. Any time you can give control back to a person when they’re living with cancer, it’s a good thing.”

In spite of doctors and healthcare professionals beginning to accept cannabis as a part of treatment, studies are still in their early

stages when it comes to supporting these anecdotal claims with clinical data. 9 The main problem is the legality of cannabis on the federal level and the focus on the harms of cannabis in previous studies that received funding. There has been a lack of focus on the benefits of cannabis until recently, and studies that have been performed or are currently being performed suggest cannabis can play a role in treatment but have not found enough “robust scientific evidence to prove that these can safely and effectively treat cancer.” 10 Most of these studies have been carried out on cancer cells or animals with cancer, which makes it difficult to generalize these limited laboratory results to humans beyond anecdotal testimony. 11

While studies may still be in their early stages, testimony from patients and the results of animal studies suggest that cannabis, specifically active cannabinoids such as THC and CBD, could help play a role in both the mitigation of negative side effects of treatment and prescriptions as well as preventing cancer cells from spreading any further. 11/12 In the meantime, modern cancer treatments continue to advance to allow for early detection and appropriate treatment as determined by your surgeon and oncologist. If you’re considering using cannabis in addition to your conventional treatment, you may want to introduce the idea with one or more of your doctors and see what their opinion is and if they have any recommendations for your medicinal use.

1. https://www.breastcancer.org/symptoms/understand_bc/statistics ”U.S. Breast Cancer Statistics.” BreastCancer.Org. Feb 13, 2019. 2. https://www.breastcancer.org/symptoms/types “Types of Breast Cancer.” BreastCancer.org. Oct. 16, 2018. 3. https://www.cancer.ca/en/cancer-information/cancer-101/what-is-cancer/stage-and-grade/staging/?region=on “Staging Cancer.” Canadian Cancer Society. 4. https://www.breastcancer.org/symptoms/types/idc “Invasive Ductal Carcinoma (IDC).” BreastCancer.org. March 9, 2019. 5. https://www.breastcancer.org/symptoms/diagnosis/invasive “Non-Invasive or Invasive Breast Cancer.” BreastCancer.org. Sept. 19, 2018. 6. https://www.breastcancer.org/symptoms/types/recur_metast “Metastatic Breast Cancer.” BreastCancer.org. June 10, 2019. 7. https://www.cancer.org/cancer/breast-cancer/treatment.html “Treating Breast Cancer.” American Cancer Society Website. 8. https://www.breastcancer.org/treatment/comp_med/types/medical-marijuana “Medical Marijuana.” American Cancer Society Website. BreastCancer.org. Oct. 10, 2018. 9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852356/ Śledziński, Paweł et al. “The current state and future perspectives of cannabinoids in cancer biology.” Cancer medicine vol. 7,3 (): 765-775. Feb. 23, 2018. 10. https://scienceblog.cancerresearchuk.org/2012/07/25/cannabis-cannabinoids-and-cancer-the-evidence-so-far/ Arney, Kat. “Cannabis, cannabinoids and cancer – the evidence so far.” Cancer Research UK. July 25, 2012 (updated May 2018). 11. https://www.cancer.gov/about-cancer/treatment/cam/hp/cannabis-p “Cannabis and Cannabinoids (PDQ®)–Health Professional Version.” NIH National Cancer Institute. June 18, 2019. 12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2360617/ Guzmán, M et al. “A pilot clinical study of Delta9-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme.” British journal of cancer vol. 95,2 (2006): 197-203. July 11, 2006.