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Wednesday 17 April 2019

Cannabis for Cancer Patients

 

 
All of us will die one day. Most of us are aware of the fact. However, when a person is told that he or she may only have a short period of time left before death, it changes the way the person looks at life. Some of the most common effects of this pronouncement are fear and depression. For a cancer patient, suffering with terminal illness in the advanced stages of the disease, especially one of its more aggressive forms, this is usually the mindset. In addition to the mental trauma of diagnosis, comes the physical assault of the treatment, when the person starts undergoing conventional cancer treatment, such as chemotherapy, radiation and surgery. The already shattered mind of the individual is now faced with a near breakdown of the physical body. As the powerful cancer drug cocktails try to combat the malignant cells in the body, they leave the patient drained out, nauseous, without an appetite, unable to sleep, anxious, weak, and in intense pain. Bodies that cannot regain strength after these powerful treatments, coupled with the general weak state of mind, result in a majority of cancer patients wilting and dying within a short period of the diagnosis.

Almost as important as the usage of cannabis to directly combat cancer cells is the usage of cannabis to alleviate the side effects of powerful cancer drugs in patients . Many cancer patients have reported a much better appetite, reduced nausea, better sleep, reduced anxiety, reduced pain and reduced fatigue through the use of cannabis, in addition to the chemotherapy, surgery and powerful cancer drugs. In many places, patients have chosen to self medicate with cannabis because professional physicians refuse to officially prescribe it, as it is a banned substance worldwide. Unofficially, though, a growing number of physicians are having conversations with their patients about cannabis as part of the treatment. This situation is seeing a change in conventional medical approaches, with patients influencing the nature of medications through their adoption of cannabis, thus convincing physicians that cannabis works, rather than this fact coming out of research and medical bodies. Not that research is lacking. There are studies which say the usage of cannabis increases the effectiveness of conventional chemotherapy treatment, as the body is able to process the medications better, possibly be reducing the toxic effects of the cancer drugs and healing the damage that they are causing to the body and mind.

Many states in the US that have legalized cannabis for medical use cover numerous forms of cancer and their treatment as qualifying conditions for medical cannabis prescription and use. Cancer patients are among the largest groups of persons using medical cannabis in these areas. Yet, this is a minuscule fraction of the number of persons suffering from the numerous varieties of cancer worldwide. As we degrade our food, water, air and environment, treat ourselves with synthetic medical and recreational drugs, cancer is growing exponentially worldwide. Poorer populations do not even have access to the conventional cancer treatment, which is prohibitively expensive and only affordable to those who are covered by medical insurance or have the money to pay the hefty bills that private hospitals impose. You hear often that screening of a much wider human population should be one of the proactive steps to take, so that cancer is detected early. This is a passive action, not a proactive preventive one, aimed at trying to tackle the root causes. Along with cleaning up our food chain and environment of carcinogenic contaminants, the worldwide legalization of cannabis for recreational and medical use along with home growing will enable individuals in the most poorest and remotest areas to at least grow or access cannabis. It would go a long way, in not only handling cancer's treatment side effects, it may even prevent cancer itself from afflicting a person.

The plant is nothing new and it is not unknown to us, requiring extensive clinical trials and regulation to test its safety on humans and animals. It has been around for 28 million years. Humans have been using the plant for tens of thousands of years at the very least. Humans and other animals have evolved receptors in their bodies to work together with cannabis in wonderful and still mysterious ways. Prevention is any day better than cure even though it may cost very little and hence reduce the vast opportunities for the medical and pharmaceutical industries to make money. But then much greater than any medical industry is the health and well being of even one single individual. Here we are talking of hundreds of millions, not to mention other animals that now are helpless victims to the growing spread of cancer. The irony of it all is that cannabis was once the drug of the poorest persons in the world. Legalizing cannabis for recreational purposes so as to reduce the pain and suffering of cancer patients is one of the most humane things to do.  

Related articles

The following list of articles taken from various media speak about the above subject. Words in italics are the thoughts of yours truly at the time of reading the article.
 
 
'Results
Of 45 gynecologic cancer patients prescribed MM, 89% were receiving chemotherapy; 56% were undergoing primary treatment. MM was used for a median of 5.2 months (range 0.6–25.4). Over 70% of patients reported improvement in nausea/vomiting, compared to 36% of patients using MM for pain relief (p = 0.02). Of 41 patients with follow-up information, 71% found MM improved at least one symptom.

Conclusions
Among a small sample of gynecologic cancer patients prescribed MM for symptom management, self-reported follow-up indicated symptom relief for the majority of patients and minimal therapy-related side effects. This data can prove useful for counseling gynecologic cancer patients on the efficacy and side effects of MM.'

https://www.sciencedirect.com/science/article/pii/S2352578921001247?via%3Dihub

 
'Researchers reported that the adjunctive use of cannabis extracts was associated with reductions in patients’ nausea and vomiting, and also with improvements in subjects’ overall quality of life. Although the majority of patients did report side-effects, these effects were largely limited to non-serious events such as sedation and dizziness.

They concluded: “The oral THC:CBD cannabis extract was active and tolerable in preventing CINV [chemotherapy-induced nausea and vomiting], when combined with guideline-consistent antiemetic prophylaxis for a study population with refractory CINV. … Further research is necessary to determine the significance and durability of improvements observed in specific AQOL-8D [quality of life] dimensions.”'

https://norml.org/news/2021/07/15/clinical-trial-cannabis-extracts-effective-for-refractory-chemotherapy-induced-nausea


'Researchers reported: “Medical cannabis use led to improvements in achieving personalized pain goals and lower overall opioid requirements. No serious adverse events with cannabis were reported, and most patients who used cannabis reported that benefits outweighed negative effects.”

Authors concluded: “Our results support prior studies suggesting cannabis may improve pain and minimize opioid utilization in both cancer and non-cancer settings. … Incorporating cannabis into routine cancer care may improve pain control and minimize opioid requirements.”'

https://norml.org/news/2021/06/17/clinical-trial-cancer-patients-reduce-their-intake-of-opioids-following-medical-cannabis-treatment


'Introduction: Nausea and vomiting are the most distressing symptoms reported by oncology patients undergoing anticancer treatment. With the currently available treatments, vomiting and especially nausea remain problematic, highlighting the need for alternative treatments.

Discussion: Here we review in vitro and in vivo evidence for the effectiveness of the nonpsychoactive cannabinoid cannabidiol (CBD) in managing nausea and vomiting. In addition, we also review the evidence for CBD's acidic precursor, cannabidiolic acid (CBDA), and a methylated version of CBDA (CBDA-ME) in these phenomena. Finally, we explore the potential role of CBD in the treatment of cannabinoid hyperemesis syndrome.

Conclusions: CBD has demonstrated efficacy in reducing nausea and vomiting, with CBDA and CBDA-ME being more potent. The data suggest a need for these compounds to be evaluated in clinical trials for their ability to reduce nausea and/or vomiting.'

https://www.liebertpub.com/doi/10.1089/can.2021.0041


So we contaminate our environment, food and water with dangerous man-made chemicals in the pursuit of quick money. These chemicals cause cancers in our bodies. To treat these cancers we make dangerous synthetic drugs, in the pursuit of quick money, that not only fail to treat the cancers, but also result in a collapse of most other body systems. This leads to a weakening and collapse of humans on increasingly larger scales as time goes by. But we do nothing to stop the contamination and weakening of our bodies that evolved over hundreds of millions of years and the contamination of our environment, food and water. Instead we continue searching for more powerful man made chemicals, to make more money faster, in the name of medicine for our environment, bodies and minds believing that we are masters of nature or, if not that, smarter than nature, whom we can fool like our gullible fellow men...but nature is not looking to make more money faster..she only deals in life and death...


'Results: Of the 21 participants enrolled (CBD, n = 16; THC, n = 5), 18 (86%) completed the primary outcome measure at day 14 and 8 completed at day 28. The median maximum tolerated doses were CBD, 300 mg/day (range 100–600 mg); THC, 10 mg/day (range 5–30 mg). Nine of 21 patients (43%) met the definition of response (=6 point reduction in TSDS). Drowsiness was the most common AE.

Conclusions: Trials of medicinal cannabis in advanced cancer patients undergoing palliative care are feasible. The doses of THC and CBD used in this study were generally well tolerated and the outcome measure of total symptom distress is promising as a measure of overall symptom benefit.'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232640/


'Cannabis has been used to relieve the symptoms of disease for thousands of years. However, social and political biases have limited effective interrogation of the potential benefits of cannabis and polarised public opinion. Further, the medicinal and clinical utility of cannabis is limited by the psychotropic side effects of ?9-tetrahydrocannabinol (?9-THC). Evidence is emerging for the therapeutic benefits of cannabis in the treatment of neurological and neurodegenerative diseases, with potential efficacy as an analgesic and antiemetic for the management of cancer-related pain and treatment-related nausea and vomiting, respectively. An increasing number of preclinical studies have established that ?9-THC can inhibit the growth and proliferation of cancerous cells through the modulation of cannabinoid receptors (CB1R and CB2R), but clinical confirmation remains lacking. In parallel, the anti-cancer properties of non-THC cannabinoids, such as cannabidiol (CBD), are linked to the modulation of non-CB1R/CB2R G-protein-coupled receptors, neurotransmitter receptors, and ligand-regulated transcription factors, which together modulate oncogenic signalling and redox homeostasis. Additional evidence has also demonstrated the anti-inflammatory properties of cannabinoids, and this may prove relevant in the context of peritumoural oedema and the tumour immune microenvironment. This review aims to document the emerging mechanisms of anti-cancer actions of non-THC cannabinoids.'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226605/


'Conclusions: Latest available prevalence estimates indicate that a significant proportion of patients in the United States with cancer use cannabis and/or cannabinoids (18.3-40.0%). There is substantial evidence for the effectiveness of cannabis and cannabinoids in treating cancer-related pain; specifically, oromucosal THC/CBD spray. There is conclusive evidence for the effectiveness of cannabis and cannabinoids in relieving chemotherapy-induced nausea and vomiting; specifically, oral THC.'
https://ascopubs.org/doi/abs/10.1200/JCO.2020.38.15_suppl.12091


'Results: Ninety-six cancer patients (mean age 60.0y (±13.9); 41 (42.7%) males) had at least one follow-up (FUP) and were included in the study. The main cancer types were breast (19.8%), lung (9.4%) and colorectal (9.4%). Adverse events (top three: drowsiness, low energy and nausea) were reported in 28% of patients, with 9% having to stop MC [medical cannabis]. Mean Brief Pain Inventory scores significantly improved between baseline, FUP-2 and FUP-3 for worst pain (5.4± SEM 0.3 vs 4.3±0.3 and 3.7±0.4) and average pain severity (4.2±0.2 vs 3.2±0.3 and 3.2±0.4). Anorexia improved (3.4±0.3 vs 2.2±0.4 and 1.7±0.4), as measured via the revised Edmonton Symptom Assessment System (ESAS-r). ESAS-r wellbeing improved significantly between baseline and FUP-1 (4.4±0.2 vs 3.7±0.2). Between baseline and each FUP, approximately a third of patients dropped their use of concurrent medications (including analgesics, antidepressants and anxiolytics), as measured by the Medication Quantification Scale. Conclusions: The CPP data support the safety and effectiveness of MC as a complementary option for improving pain control, appetite and quality of life in SCC.'
https://ascopubs.org/doi/abs/10.1200/JCO.2020.38.15_suppl.12106


Is it a case of oncology specialists lacking knowledge about cannabis or having excellent knowledge about which blockbuster cancer drugs top the pharma sales charts?


 'According to the survey, 24.5 percent of respondents attending an oncology office in Michigan said that they used medical cannabis. Of those, 81 percent said that it mitigated their pain, 77 percent said that it improved their appetite, and 73 percent said that it reduced their anxiety. Fifty-five percent said that cannabis “improved their ability to tolerate [cancer] treatment.”

However, separate survey data published in the journal Clinical Oncology reported that many oncology health care specialists remain unwilling to explicitly recommend cannabis therapy to their patients. Investigators reported that 84 percent of respondents “believed that they lacked sufficient knowledge about cannabis to make recommendations.” More than six in ten expressed concerns over their inability to recommend a specific cannabis dosing regimen to their patients.'
https://norml.org/news/2020/06/18/cancer-patients-frequently-turning-to-cannabis-but-many-oncology-specialists-still-reluctant-to-recommend-it


'The researchers from the Minnesota Department of Health (MDH) and the Oncology Research Center at HealthPartners/Park Nicollet found that patients with cancer who enrolled in Minnesota’s medical cannabis program reported significant improvement in symptoms, including reduced anxiety, lack of appetite, depression, disturbed sleep, fatigue, nausea, pain and vomiting, within four months of starting the medication.

“It is encouraging to see this evidence that Minnesota’s medical cannabis program is helping cancer patients,” said Minnesota Health Commissioner Jan Malcolm. “In addition to helping people with qualifying conditions, the program was designed to help advance scientific understanding of the treatment potential of cannabis. These latest findings demonstrate that the program is making valuable contributions toward that goal as well.”'
https://content.govdelivery.com/accounts/MNMDH/bulletins/23cc6d0


'In a report publishing in the Journal of Palliative Medicine on March 26, researchers say that cancer patients were more likely to favor forms of medical marijuana with higher amounts of THC, which relieves cancer symptoms and the side effects of cancer treatment, including chronic pain, weight loss, and nausea.

By contrast, marijuana formulations higher in cannabidiol (CBD), which has been shown to reduce seizures and inflammation in other studies, were more popular among non-cancer patients, including those with epilepsy and multiple sclerosis, say the study authors.

Cancer patients were also more likely to prefer taking oil droplets containing medical marijuana under the tongue than "vaping".'
https://www.eurekalert.org/pub_releases/2019-03/nlh-sst032219.php


'RESULTS:
A significant reduction in scores was found across all symptoms when comparing baseline scores with the average score submitted within the first 4 months of program participation (all Ps < .001). The proportion of patients achieving 30% or greater symptom reduction within the first 4 months of program participation varied from 27% (fatigue) to 50% (vomiting), with a smaller proportion both achieving and maintaining those improvements. Adverse effects were reported in a small proportion of patients (10.5%).

CONCLUSION:
Patients with cancer enrolled in Minnesota’s medical cannabis program showed significant reduction across all eight symptoms assessed within 4 months of program participation. Medical cannabis was well tolerated, and some patients attained clinically meaningful and lasting levels of improvement.'
http://ascopubs.org/doi/10.1200/JOP.18.00562


'Summary: The endocannabinoid system is a potential therapeutic target. Cannabinoids may be considered as potential adjuvant in cancer-related pain management. Cannabidiol appears to be the drug of choice. Analgesic trial designs should evolve to get closer to real-life practice and to avoid biases.'
https://journals.lww.com/co-oncology/Abstract/publishahead/Cannabinoids__a_new_approach_for_pain_control_.2.aspx


Sounds like a great option for summer and global warming related sweats too...

'Results: Treatment of five patients with advanced cancer with synthetic orally administered dronabinol resulted in the successful management of persistent symptomatic paraneoplastic night sweats.

Conclusion: Dronabinol and/or medicinal cannabis are promising therapies for palliation of night sweats in cancer patients.'
https://www.liebertpub.com/doi/abs/10.1089/jpm.2018.0551


'The cannabis plant contains a number of compounds with research-backed benefits for cancer patients. The science-based case that it is a safe and effective medicine will be made below, with plenty of links to double-blind studies, authoritative sources, and leading experts. The takeaway being that the plant and preparations derived from it can provide relief of cancer-related symptoms like pain, nausea, and inflammation. Some research has even shown that some cannabis compounds may slow cancer growth and shrink tumors.

Cannabis can also elevate your mood at critical moments, and even help you psychologically come to grips with the difficult times ahead. This is no small thing. Many of the medicines you will be prescribed, and procedures you will undergo—helpful as they may be—will leave you feeling depleted (to say the least).

Cannabis is restorative—to body and soul.'
https://www.leafly.com/news/health/how-to-use-medical-marijuana-for-cancer


'Conversely, large observational studies suggest patients with cancer using cannabis report significant improvement of many common symptoms. Cannabis use appears well tolerated, with few serious adverse effects reported.'
https://link.springer.com/article/10.1007/s11912-019-0757-7


'Sufficient evidence supports the use of Cannabis for palliative indications in oncology; however, patients should be carefully selected, guided and followed. Promising research suggests the potent antineoplastic activity, but more data must be accrued before conclusions can be drawn.'
https://www.tandfonline.com/doi/abs/10.1080/13543784.2019.1561859?journalCode=ieid20&


'Marijuana and its derivatives are increasingly being used by cancer patient to mitigate cancer and treatment-related side effects, and the use is increasing as recreational use of marijuana is being legalized in more states.'
http://ascopubs.org/doi/abs/10.1200/JCO.2018.36.34_suppl.228


'In a 1990 survey of more than 1000 oncologists on the use of cannabis for chemotherapy-induced nausea/vomiting, “almost one half (48%) would prescribe marijuana to some of their patients if it were legal.” In a recent survey, more than 90% of pediatric oncologists expressed willingness to help children access medical cannabis. A sample of general healthcare practitioners showed that 83% of respondents support the use of medical cannabis for cancer patients with poorly controlled symptoms, and another recent survey of medical oncologists shows high levels of discussion occurring with patients and support for cannabis use by oncologists''
https://www.liebertpub.com/doi/10.1089/can.2018.0029


'Chris Chapman tried dozens of medications to counter "side effects on top of side effects" of his chemotherapy cancer treatment. The side effects were mitigated with medical marijuana, which allowed him to discontinue all of those medications. This poignant short from filmmaker Angie Bird welcomes you to "Chappy's" kitchen to show you how this couple goes through chemo, together.'
https://video.nationalgeographic.com/video/short-film-showcase/how-weed-butter-helped-this-couple-through-chemo


'This survey-based study of cancer patients at a large comprehensive cancer center within a state with medically and recreationally legalized cannabis found that nearly a quarter of patients reported active use. More than half of active users reported that legalization significantly increased their likelihood of using, and cannabis use was spread across demographic subsets, including age, sex, and cancer diagnosis subsets. Respondents reported using a diverse mix of cannabis products, which were evenly divided between inhaled and edible modalities. Cannabis was used commonly for the relief of physical symptoms, but use for neuropsychiatric symptoms was nearly as frequent. Even among never users, the respondents indicated substantial interest in learning more about the role of cannabis in cancer care. Despite nearly all respondents wanting more information/education directly from their hematology/oncology providers, most reported that they were more likely to get information from sources outside the health care system.'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5698756/


'There is evidence, although limited, to support the use of cannabis pharmacotherapy in the treatment of different forms of pain in patients. If a patient with chronic pain and their healthcare provider work together through first- and second-line treatment modalities without success, a trial of cannabis or a cannabinoid may be a reasonable next step. '
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922297/


'In the study, which included more than 900 cancer patients in Seattle, nearly one-quarter reported using medical marijuana in the past year. In addition, almost all the participants said they wanted to learn more about medical marijuana, according to the study, published today (Sept. 25) in the journal Cancer.'
https://www.livescience.com/60500-cancer-patients-medical-marijuana.html


'This study will use a novel oral THC/CBD capsule formulation (‘TN-TC11M’, Tilray) derived from Cannabis sativa L. extract. It contains delta-9-THC and CBD in a 1:1 ratio, with each oral capsule containing 2.5mg THC and 2.5mg CBD. This is intended to provide equivalent systemic exposures to THC and CBD as those obtained from nabiximols (a single dose of nabiximols which comprises 2.7mg THC and 2.5mg CBD). In contrast to nabiximols, TN-CT11M was formulated for a consistent and reproducible pharmacokinetic profile, allowing patients to self-titrate as needed without a concern for a delayed onset. Investigational product will be dosed similarly to the Duran study, and administration will commence 24 hours prior to chemotherapy to confirm tolerability.'
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6144412/


'Recreational use of C sativa potentially alleviates anxiety, depression, pain, and nausea and improves general well-being in patients with newly diagnosed HNC (Head and Neck Cancer). Additional study of whether these effects are maintained throughout treatment and among long-term survivors is warranted and could provide interesting insight.'
https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2688527


From the archives 38 years ago..

Cancer Patients: Joints or THC?
http://science.sciencemag.org/content/209/4460/999
 
 
'In 1937, weed was placed under the Harrison Narcotics Act. Narcotics authorities claim it is a habit-forming drug, that its use is injurious to mind and body, and that it causes the people who use it to commit crimes. Here are the facts: Weed is positively not habit forming. You can smoke weed for years and you will experience no discomfort if your supply is cut off. I have seen tea heads in jail and none of them showed withdrawal symptoms. I have smoked weed myself off and on for fifteen years, and never missed it when I ran out. There is less habit to weed than there is to tobacco. Weed does not harm the general health. In fact. most users claim it gives you an appetite and acts as a tonic to the system. I do not know of any other agent that gives as definite a boot to the appetite. I can smoke a stick of tea and enjoy a glass of California sherry and a hash house meal.' - Junky, William S Burroughs, 1977, originally published in 1953


'Grade IV glioblastoma multiforme is a deadly disease, with a median survival of around 14 to 16 months. Maximal resection followed by adjuvant radiochemotherapy has been the mainstay of treatment since many years, although survival is only extended by a few months. In recent years, an increasing number of data from in vitro and in vivo research with cannabinoids, particularly with the non-intoxicating cannabidiol (CBD), point to their potential role as tumour-inhibiting agents. Herein, a total of nine consecutive patients with brain tumours are described as case series; all patients received CBD in a daily dose of 400 mg concomitantly to the standard therapeutic procedure of maximal resection followed by radiochemotherapy. By the time of the submission of this article, all but one patient are still alive with a mean survival time of 22.3 months (range=7-47 months). This is longer than what would have been expected. '
http://ar.iiarjournals.org/content/39/10/5797.short


'I once kicked a junk habit with weed. The second day off junk I sat down and ate a full meal. Ordinarily, I can't eat for eight days after kicking a habit.' - Junky, William S Burroughs, 1977, originally published in 1953 
 
 
'Measured by the standards established by Warburg, most pesticides meet the criterion of the perfect carcinogen too well for comfort. As we have seen in the preceding chapter, many of the chlorinated hydrocarbons, the phenols, and some herbicides interfere with oxidation and energy production within the cell. By this means they may be creating sleeping cancer cells, in which an irreversible malignancy will slumber undetected until finally - its cause long forgotten and even unsuspected - it flares into the open as recognizable cancer.' - Silent Spring, Rachel Carson, 1962


'Today we find our world filled with cancer-producing agents. An attack on cancer that is concentrated wholly or even largely on therapeutic measures (even assuming a 'cure' could be found) in Dr. Heuper's opinion will fail because it leaves untouched the great reservoirs of carcinogenic agents which would continue to claim new victims faster than the as yet 'elusive' cure could allay the disease.

Why have we been so slow to adopt this common-sense approach to the cancer problem? Probably 'the goal of curing victims of cancer is more exciting, more tangible, more glamourous and rewarding than prevention,' says Dr. Heuper. Yet to prevent cancer from ever being formed is 'definitely more humane' and can be 'much more effective than cancer cures'. Dr. Heuper has little patience with the wishful thinking that promises 'a magic pill that we shall take every morning before breakfast' as protection against cancer. Part of the public trust in such an eventual outcome results from the misconception that cancer is a single, though mysterious disease, with a single cause and, hopefully, a single cure. This of course is far from the known truth. Just as environmental cancers are induced by a wide variety of chemical and physical agents, so the malignant condition itself is manifested in many different and biologically distinct ways.' - Silent Spring, Rachel Carson, 1962 


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