Breast cancer is the leading cause of death in women under 50 in the UK. The shocking truth is that almost 5,000 people will be diagnosed with breast cancer this Breast Cancer Awareness Month. Recent statics reveal that one in seven women in the UK will develop breast cancer in their lifetime, and while uncommon, men are also at risk. Despite breast cancer survival improving, with figures doubling in the past 40 years in the UK, there are still around 11,500 women and 80 men dying from breast cancer in the UK every year.
The conversation around medical cannabis for the prevention and treatment of disease, both in community and media, has increased massively in recent years as people boast its healing powers. But is the evidence strong enough to advise cancer patients to clear out their medicine cabinets?
It is important to be aware of the compounds that make up the cannabis plant; the two most dominant being cannabidiol (CBD) and tetrahydrocannabinol (THC). THC is the active cannabinoid that causes a “high” when it is smoked or ingested. Since the legalisation of medicinal cannabis in the UK since November 2018, specialist doctors have been able to prescribe medicinal cannabis. Despite this, many NHS doctors are still reluctant to prescribe it to patients due to the limited research to support claims. There have been small studies on cancer cells and CBD which are promising, however, they are not conclusive.
English-born Australian actress Olivia Newton-John, who is battling cancer for the third time, has recently spoken about her treatment, praising medicinal cannabis for helping her feel ‘fantastic’. She says “It’s helped me incredibly, with pain, with sleep, with anxiety. Particularly when I had to wean myself off morphine and I used cannabis which is not going to kill you like opiates can.” Newton-John claims “It was instant. I felt a big change in my mobility and pain relief. It got me off morphine, which is a huge deal”. Newton-John’s experience supports the thinking that while there is not yet enough research to claim that medicinal cannabis is a treatment for cancer, evidence has shown that it can be used to complement cancer treatment and help ease the side effects of these treatments.
One common side effect of cancer treatment is nausea and loss of appetite, making it hard for patients to maintain a healthy weight. While there is no evidence that CBD alone can have any positive effects, ingesting cannabis that delivers THC and other cannabinoids into the bloodstream may help to stimulate appetite. Common side effects of cancer that often cause pain include inflammation, pressure on vital organs and nerve injury. In some cases, the pain can be so severe that it becomes resistant to opioids; powerful pain relievers often given to cancer patients. It has been found that while CBD indirectly acts on the CB2 receptors, helping to lessen inflammation, THC acts on the CB1 receptors, which may help reduce pain caused by nerve damage.
In the medical study ‘Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer’* it is revealed that The National Cancer Institute currently recognises medicinal cancer as an effective treatment for relieving symptoms associated with cancer. The article shares that it has been found that when CBD and THC are combined and followed by radiation therapy, there is an increase of autophagy and apoptosis in cancer cells; the cells naturally remove unnecessary or dysfunctional components. It also found that CBD has the ability to inhibit the reproduction of cells in different types of cancer models and that cannabidiolic acid can inhibit the migration of breast cancer cells.
Chemotherapy often causes nausea and vomiting which can be relieved with compounds found in cannabis. However, the antinausea effects have tended to come from THC as opposed to CBD, so it is important for users to prepare for the psychoactive effects that may follow, although many people do find relief while low dosages of THC. Moreover, alongside sickness, another common side effect of chemotherapy is insomnia due to steroids given during treatment. Some cases found that the use of cannabis helped with this inability to sleep, leaving patients feeling well-rested and provides a mental break; possibly helping with feelings of depression and anxiety caused by exhaustion.
Prof. Dr. Tamara Lah Turnšek, one of the speakers at Europe Canna Expo 2019, has carried out extensive research within the field of cancer and medicinal cannabis. In an interview with Health Euoropa, Dr Turnšek discusses pre-clinical studies of cannabis and cannabinoids in Slovenia. As the director of The National Institute of Biology, she explains that there are ongoing pre-clinical studies that are being supported by MGC Pharmaceuticals. The focus of these studies is on the efficiency of cannabinoids for eliminating tumour growth and the safety of the drugs for patients. She says “We are essentially testing cannabinoids in oncology with the hope that oncologists will use them in future, and that patients in need will receive a specified combination of cannabinoids that will be effective for them. That is the ultimate goal.”
Dr Turnšek reveals the three unknowns when it comes to concluding the effectiveness of using medicinal cannabis to treat patients:
The way the drug is processed by the body may differ from patient to patient. This is also known as cannabinoid pharmacology.
Due to unknown chemical transformations, there is a risk of damage being caused to normal tissues i.e. neurons being damages by THC in developing brains
Lack of knowledge about how cannabinoid extracts (CBD or THC alone) would interact combined with other drugs used in conventional therapy i.e. using cannabis alongside chemotherapy.
In the current medical climate, it can be argued that the stigma surrounding the use of medicinal cannabis is the biggest hindrance to the progression of clinical evidence. Dr Turnšek says “It is also important to understand that the older generation of doctors often do not have and do not want to gain knowledge regarding medical cannabis.”
“I understand that doctors themselves are torn between the stigma and negative connotations on the one hand and their duty to help patients in need on the other.”
The use of the medicinal cannabis is subjective on the doctor as many are still reluctant to prescribe it to treat any kind of disease and feel more comfortable using more conventional drugs, understandably, they are cautious of the possible risks and with no directives on how to use the drug, possible dangers are high.
As is it possible to buy CBD for personal use, it is important to be aware of the risks of self-medication. As supported by Dr Turnšek who says “it is my strongly held opinion that patients should gain access to medical cannabis only via medical doctors”. “At present, patients can purchase products and treatments which may not even contain the correct levels of cannabinoid or even any cannabinoid at all, which may endanger their health.”
While research into medical cannabis and cancer is still in its early stages and therefore it cannot scientifically be supported as a treatment for the disease, anecdotal evidence does suggest that it may be used by those needing relief from symptoms alongside cancer treatment. It is important that people talk to their doctor before using CBD or any other compound to treat any kind of disease.
*Federica Pellati ,Vittoria Borgonetti,Virginia Brighenti,Marco Biagi, Stefania Benvenuti and Lorenzo Corsi