I’m blessed to say that the shadow of cancer has so far stayed away from my door and that of my immediate family. But my friend Ana wasn’t so lucky. Her mother got pancreatic cancer, and after several rounds of chemo she was hanging on by a thread to make it to her 80th birthday. She wanted to die though. Dosed up on morphine, she was confused, wracked with pain, had no appetite and couldn’t sleep.
Living in Belgium, the family’s young, open minded doctor found a legal loophole through which she could prescribe medicinal cannabis oil to her ailing patient. And after a few drops on the tongue of the whole cannabis plant oil containing both THC and CBD, the opioid fog began to lift. In fact soon after she stopped taking the morphine and remained completely lucid up until the moment she died. Her pain had eased, she could laugh and joke with her family, and lived out her remaining weeks with peaceful dignity. This wouldn’t have happened if she hadn’t had the possibility of taking medical cannabis.
I’ve previously written about whether cannabis can cure cancer. Numerous people say thanks to their medical marijuana regime they are now cancer free today. However, not everyone feels they can make that leap of faith. Many instead choose a more orthodox oncology route complete with surgery, chemo or radiotherapy. But one does not necessarily rule out the other, and increasingly patients are turning to medical cannabis as an adjunct to the cancer treatment they are receiving.
So let’s look at the ways medical marijuana can complement conventional cancer treatment.
Stop nausea and vomiting
A common experience of patients going through chemotherapy are intense feelings of nausea, retching and vomiting. Jeff Moroso, endured 12 rounds of chemo for his colon cancer. In an interview with Newsweek he described just how difficult the treatment was to bear, despite the cocktail of other meds he was prescribed to counteract the side effects. “I felt real sick, incapable of doing anything except for lying there and trying to hang on,” he recounted. And so he turned to cannabis. The improvement was dramatic and by the seventh round of chemo, he’d come off the other prescription pills.
Oncologist Donald I. Abrams, M.D at San Francisco General Hospital is in no doubt about the cannabis plant’s ability to quell nausea and vomiting. In his paper ‘Integrating cannabis into clinical cancer care’ he declares, “I have often said that I need a clinical trial to demonstrate that cannabis is an effective antiemetic about as much as I need a placebo-controlled trial to demonstrate that penicillin is an antibiotic!”
And in the recent review of the effects of cannabis by the Health and Medicine Division of the National Academies of Sciences, Engineering and Medicine, adults with chemotherapy-induced nausea and vomiting were one of the only health conditions for which “there is conclusive evidence” that certain oral cannabinoids show good results at preventing and treating those ailments.
The THC based medication, Nabilone (Cesamet) and a synthetic version of the cannabinoid Marinol (Drobinal) are both prescribed in certain countries, including the US, for chemo induced nausea and vomiting when other medications have failed. While in countries or US states where medical cannabis has been legalised, chemo induced nausea is a common qualifying condition.
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2. Encourage appetite
For anyone who’s smoked a joint in their time, it’s not unusual to find yourself with the munchies – that uncontrollable urge to eat junk food. That’s because THC, the cannabinoid found in abundance in most recreational strains of cannabis, convinces the brain that we are in fact starving (when usually we’re not). So, it wouldn’t be a huge leap to think that the cannabinoid might have the same effect on people whose appetite has been affected by chemotherapy or indeed the final stages of cancer itself.
In a study published in the Annals of Oncology in which patients were given THC, 64% of patients with advanced stage cancer reported improved appetite and 73% found a greater appreciation for food. The subjects also reported increased quality of sleep. However, evidence remains elusive to prove that THC can counteract the severe weight loss known as cachexia experienced by up to 90% of cancer patients.
3 Reduce cancer related pain
According to the Mayo Clinic, 1 in 3 patients undergoing cancer treatment experience pain, with the number rising if the disease reaches an advanced stage. This can be due to the cancer destroying tissue near the tumour, or putting pressure on surrounding nerves, bones or organs. Pain can also be as a result of the cancer treatment itself, with chemotherapy sometimes causing nerve damage.
Patients are typically prescribed painkillers, which for more intense pain can include opioid based medication such as morphine.
But for Oncologist Donald I. Abrams MD, morphine and its ilk can sometimes take away from a cancer patient’s quality of life rather than adding to it. In his paper published in ‘Current Oncology’ he echoes the experience of my friend’s mother.
“Patients who have been put on high doses of opiates at the end of life by their well-meaning oncologist or palliative care team frequently feel totally unable to communicate with their loved ones in their precious remaining time because of altered cognition. Many have successfully weaned themselves down or off their opiate dose by adding cannabis to their regimen.”
He states how despite THC’s analgesic qualities, “patients often report significant pain reduction from strains that are predominantly CBD-rich.”
However, when it comes to hard results from clinical studies, for the moment the jury remains out. While research into the use of cannabis preparations for general cancer pain show some promising results, the achilles heel appears to be ameliorating chemotherapy induced neuropathy. To date there has only been one clinical trial testing the THC/CBD medication Sativex on patients with chemotherapy induced neuropathy, with subjects finding no overall difference between between Sativex and the placebo.
4. Lessen feelings of anxiety
Feelings of fear, hopelessness and anxiety are commonly experienced by people in the grips of cancer, with a 2012 study entitled ‘Anxiety and Depression after Cancer Diagnosis’ finding that 41.6% of patients encountering feelings of anxiety and 29.4% those of depression.
Medicating anxiety or depression, be it with plant based medicines such as cannabis or pharmaceutical options, should if possible be accompanied by some kind of psychological therapy, which is often available through cancer support groups.
But, as a measure to lessen feelings of anxiety, studies show the cannabinoid CBD to be particularly effective. That’s because it partially activates the 5HT1-A serotonin receptor which is heavily involved with mood and anxiety disorders. Not only that, CBD’s inhibition of the enzyme responsible for breaking down the body’s natural mood enhancing chemical Anandamide, is also thought to help reduce anxiety.
5. Prolong life expectancy for patients with brain tumours
British biopharmaceutical company GW Pharma recently published a report in which they announced the successful combination of their cannabis based medication Sativex (Nabiximols) with temozolomide, a form of chemo given to patients with glioblastoma multiforme (GBM), an aggressive type of brain tumour. The patients taking Sativex alongside temozolomide had an 83% one year survival rate, compared to 53% for patients who were just undergoing chemotherapy alone.
While these results apply to only one type of cancer and one particular form of chemotherapy, the study’s lead investigator Professor Susan Short, PhD, Professor of Clinical Oncology and Neuro-Oncology at Leeds Institute of Cancer and Pathology at St James’s University Hospital, finds them encouraging. She says, “these promising results are of particular interest as the pharmacology of the THC:CBD product appears to be distinct from existing oncology medications and may offer a unique and possibly synergistic option for future glioma treatment.”
A cancer diagnosis is a very personal journey. None of us have the right to stand in judgement about the choices any individual makes about tackling the disease. Is cannabis the cancer cure holy grail? Some people say so. For others it’s a practical way to make their treatment more bearable. And who knows, with the plant’s antioxidant properties and numerous potential cancer cell killing effects, it might just increase the chances of beating the disease as well.