First of all I would like to say that this is in no way bashing on potential medical benefits of cannabis. This article will focus towards today’s knowledge on cannabis as a cure for cancer, researches that are done and data that has been collected and will try to debunk general misconception about medical use of cannabis in cancer patients. I will not neglect the benefits of cannabis when it comes to depletion of symptoms and side-effects in cancer patients and chemotherapy. This is something that is strictly subjective as some benefit and some don’t. I will not take “personal experiences”, hypothesis and superstitions into consideration, just facts like clinical trials and double blind studies with acknowledgment from scientific community.
When talking about benefits or side-effects of cannabis I will be always referring to cancer patients and lab mice.
One of the most common misconceptions that need to be debunked straight away is “Cannabis kills cancer cells in petri dish”. This is true, but it is also true that bleach does it as well, even faster. Things do not work that way, simple mechanisms that can be explained easily, when it is projected on a bigger scale organism like human being. There are much more elements that need to be taken into consideration, like type of tumor, toxicity on the host, side-effects and overall efficiency of the product; this is just the minority of the factors.
Next one is ”I have heard…My friend has…My family member had…”. There are so many reasons where one might get cured from cancer (just general lifestyle and type of cancer play enormous roles in healing), even placebo does it. There is no connection between correlation and causation. It might be true that cannabis helped, but we need to know why and how, if that is even true. Data is the only thing that matters here. Everything else is just a game of broken telephone. Take a look at this video and you will understand much better why someone’s personal statements are not the facts.
Some of the potential benefits of cannabis is in symptomatic therapy or treatment such as reducing nausea and vomiting, for stimulation of appetite, as a painkiller and for sleep improvement.(1) Small amount of surveys has been done on this subject, where most of them that were done suggest prescription of cannabis by physicians in US , but predominantly for symptom management.(2)
Animal testing has showed that cannabinoids could give sort of a protection against development of certain types of tumors.(3) Another study suggests that THC may inhibit the growth of tumors cells in vivo and in vitro.(4) Mechanisms of action of cannabinoids as anti-tumor agent are summarized in two reviews, where tumor cells are killed without effecting their counterparts.(5,6) Cell death usually occurs through stimulation of endoplasmic reticulum, part of cell where proteins move through, by destroying proteins and eventually leading to cell death.(7) There are few studies where cannabinoids are responsible for anti-tumor effect in breast cancer. Some of them are focused on CBD when it comes to programed cell death in breast cancer where CBD inhibits the growth of cancer cells while having non-tumorigenic effect on normal breast cells.(8,9,10) CBD may also lower cancer metastasis and decreasing invasiveness.(11) Treating mice with THC has inhibited tumor growth by 60% by reducing the growth of blood vessels, but on the other hand there has been shown enchanted tumor growth in mice whom tumor had normal immune response, treatment with THC. (12,13) Meta-analysis of 34 in vivo and in vitro studies showed that 33 studies confirm cannabinoids kill glioma cells (tumor that starts in brain or spine) in mice.(14)
It is clear that there are many properties of cannabis: anti-emetic, anti-tumor, analgesic, anti-inflammatory, appetite stimulating effect on mice that cancer patients might benefit from. These are all the reasons why so many hypotheses exist. Unfortunately, we are not same as mice, similar but not the same. This is the first step when it comes to understanding potential benefits of cannabinoids. Lot of research has been done on lab mice, it is time to do them on humans, especially as there are little to no chances of overdose when consuming cannabis, and there are plenty people that would volunteer in researches. Again, unfortunately there are many lobbies and laws that prevent this, as well as criminalization and outlawing the cannabis plant.
Research on humans is not that overwhelming as on mice, especially for non-smoking group. Most of the people that ingest cannabis are smokers. Monograph presented by Health Canada on marijuana concluded that there is large amount of molecular and cellular evidence that support carcinogenic effect of inhaled marijuana, but there is no actual epidemiological evidence to support two of them are in any correlation.(15) Majority of studies are conflicting and in contradiction with each other so connection between marijuana usage and cancer is still inconclusive, especially among smoking population. Only few studies have been conducted and recorded, where cannabis was administered proper way and not by inhaling.
PubMed is not showing any on-going clinical trials on treating cancer with cannabis but there is around 20,000 studies or reviews under the search term cannabis and cannabinoid while majority of them being 6 years old. Roughly 1000 papers on connection between cannabinoids and cancer have been published. Most of them establishing that cannabis could help with cancer treatment side-effects.
Small pilot study of intra-tumoral injections of THC in patients with type of central nervous system tumor was conducted and showed no significant clinical benefit.(16,17) Israeli study proposed that CBD could be used as addition to the current treatment of GVHD (acute graft versus host disease) in patients undergone stem cell transplantation.(18) Two studies were focused on pediatric use of cannabis as anticancer treatment but both agreed that further research is needed to elucidate general knowledge and effect of cannabinoids on gliomas.(19,20)
Some of the studies that are undergoing are:
- The Combination of Cannabidiol and Δ9-Tetrahydrocannabinol Enhances the Anticancer Effects of Radiation in an Orthotopic Murine Glioma Model. Mol.Cancer.Ther. 2014. http://mct.aacrjournals.org/content/13/12/2955
- Cannabis, cannabinoids and cancer – the evidence so far. Cancer Research UK, 2014. http://scienceblog.cancerresearchuk.org/2012/07/25/cannabis-cannabinoids-and-cancerthe-evidence-so-far/
- Cannabidiol as potential anticancer drug. Br J Clin Pharmacol. 2013. http://www.ncbi.nlm.nih.gov/pubmed/22506672%20
- Non-hallucinogenic cannabinoids are effective anti-cancer drugs. Anticancer Research, 2013. http://www.sgul.ac.uk/news/news/study-shows-non-hallucinogenic-cannabinoidsare-effective-anti-cancer-drugs
- Cannabis Extract Treatment for Terminal Acute Lymphoblastic Leukemia with a Philadelphia Chromosome Mutation. Case Rep Oncol. 2013. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901602/
These are just some of the newer ones, many more are still in process of gathering data.
To conclude this whole research, from the small amount of clinical trials that were done on humans there is not enough evidence to support the thesis that cannabis cures cancer in humans the same way it does in mice. There may not be enough evidences and references in this article to support symptomatic therapy, but anyone that is willing to do research can find huge amounts of studies on this subject. Symptomatic therapy is for now only axiom that can be deduced, something that is beneficial for cancer patients. It will not cure them from cancer, but it may improve their lives significantly.
”Medicinal Cannabis” is helping cancer patients, not curing them.
- Abrams DI: Integrating cannabis into clinical cancer care. Curr Oncol 23 (2): S8-S14, 2016.
- Doblin RE, Kleiman MA: Marijuana as antiemetic medicine: a survey of oncologists' experiences and attitudes. J Clin Oncol 9 (7): 1314-9, 1991.
- National Toxicology Program: NTP toxicology and carcinogenesis studies of 1-trans-delta(9)-tetrahydrocannabinol (CAS No. 1972-08-3) in F344 rats and B6C3F1 mice (gavage studies). Natl Toxicol Program Tech Rep Ser 446 (): 1-317, 1996.
- Bifulco M, Laezza C, Pisanti S, et al.: Cannabinoids and cancer: pros and cons of an antitumour strategy. Br J Pharmacol 148 (2): 123-35, 2006.
- Velasco G, Sánchez C, Guzmán M: Towards the use of cannabinoids as antitumour agents. Nat Rev Cancer 12 (6): 436-44, 2012.
- Cridge BJ, Rosengren RJ: Critical appraisal of the potential use of cannabinoids in cancer management. Cancer Manag Res 5: 301-13, 2013.
- Vara D, Salazar M, Olea-Herrero N, et al.: Anti-tumoral action of cannabinoids on hepatocellular carcinoma: role of AMPK-dependent activation of autophagy. Cell Death Differ 18 (7): 1099-111, 2011.
- Shrivastava A, Kuzontkoski PM, Groopman JE, et al.: Cannabidiol induces programmed cell death in breast cancer cells by coordinating the cross-talk between apoptosis and autophagy. Mol Cancer Ther 10 (7): 1161-72, 2011.
- Caffarel MM, Andradas C, Mira E, et al.: Cannabinoids reduce ErbB2-driven breast cancer progression through Akt inhibition. Mol Cancer 9: 196, 2010.
- McAllister SD, Murase R, Christian RT, et al.: Pathways mediating the effects of cannabidiol on the reduction of breast cancer cell proliferation, invasion, and metastasis. Breast Cancer Res Treat 129 (1): 37-47, 2011.
- Romano B, Borrelli F, Pagano E, et al.: Inhibition of colon carcinogenesis by a standardized Cannabis sativa extract with high content of cannabidiol. Phytomedicine 21 (5): 631-9, 2014.
- Zhu LX, Sharma S, Stolina M, et al.: Delta-9-tetrahydrocannabinol inhibits antitumor immunity by a CB2 receptor-mediated, cytokine-dependent pathway. J Immunol 165 (1): 373-80, 2000
- McKallip RJ, Nagarkatti M, Nagarkatti PS: Delta-9-tetrahydrocannabinol enhances breast cancer growth and metastasis by suppression of the antitumor immune response. J Immunol 174 (6): 3281-9, 2005.
- Rocha FC, Dos Santos Júnior JG, Stefano SC, et al.: Systematic review of the literature on clinical and experimental trials on the antitumor effects of cannabinoids in gliomas. J Neurooncol 116 (1): 11-24, 2014.
- Health Canada: Marihuana (Marijuana, Cannabis): Dried Plant for Administration by Ingestion or Other Means. Ottawa, Canada: Health Canada, 2010.
- Guzmán M, Duarte MJ, Blázquez C, et al.: A pilot clinical study of Delta9-tetrahydrocannabinol in patients with recurrent glioblastoma multiforme. Br J Cancer 95 (2): 197-203, 2006. [PUBMED Abstract]
- Velasco G, Sánchez C, Guzmán M: Towards the use of cannabinoids as antitumour agents. Nat Rev Cancer 12 (6): 436-44, 2012.
- Yeshurun M, Shpilberg O, Herscovici C, et al.: Cannabidiol for the Prevention of Graft-versus-Host-Disease after Allogeneic Hematopoietic Cell Transplantation: Results of a Phase II Study. Biol Blood Marrow Transplant 21 (10): 1770-5, 2015.
- Singh Y, Bali C: Cannabis extract treatment for terminal acute lymphoblastic leukemia with a Philadelphia chromosome mutation. Case Rep Oncol 6 (3): 585-92, 2013.
- Foroughi M, Hendson G, Sargent MA, et al.: Spontaneous regression of septum pellucidum/forniceal pilocytic astrocytomas--possible role of Cannabis inhalation. Childs Nerv Syst 27 (4): 671-9, 2011.
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